The opioid epidemic has become a major concern across the nation and rightly so. It shows no signs of letting up and is resulting in thousands of deaths each year. Many people have become addicted and prone to serious risks to drugs that they may have started taking innocently for pain due to injury, disease or surgery.
Experts are now recommending that physicians in clinics and hospitals work to find other options for pain control rather than constantly turning to medications including high-risk opioids for every diagnosis.
Here are just a few options available to a variety of patients that can often decrease pain and help them experience a better quality of life without the need for more addictive drugs.
Minimally Invasive Interventional Options
Specifically targeted injections, nerve blocks, and ablation procedures in trained and experienced hands are effective and safe in many patients. More recently, wireless peripheral nerve stimulation (PNS) that is still available only in some pain centers nationwide including Pain and Spine Center of Charlottesville have revolutionized the approach to chronic pain management. These may reduce the need for too frequent follow-ups and for medications that may result in serious side effects, either alone or in combination.
Anti-epileptics, such as Neurontin and Lyrica, can be effective at treating some types of pain. While you may think of anti-epileptics as merely being anti-seizure drugs, they are actually much more than that. Many of them work on nerve pain and are effective in controlling diabetic neuropathy and other neuropathies and neuralgias. Research studies have also shown that these drugs can be used with good results for fibromyalgia and chronic nerve pain that is unrelated to cancer.
Similarly, some antidepressants affect pain transmission down the spinal cord. Tricyclic antidepressants are the most studied in this regard. The ones most frequently prescribed for pain are amitriptyline and Cymbalta. Antidepressants are best used for pain that is related to nerve damage, arthritis, headaches and migraines, fibromyalgia and low back pain. Keep in mind that antidepressants do not work immediately on pain but may instead need several weeks to build up in the body before providing significant relief.
Acetaminophen and NSAIDs
Acetaminophen in recommended doses of less than 3000 mg a day is an effective and relatively safe option. NSAIDs are non-steroidal anti-inflammatory drugs that are typically purchased over-the-counter although some stronger prescription options are available. The most familiar generic options are ibuprofen and naproxen sodium. These drugs work best for decreasing inflammation around muscles or joints that could be causing pain and are effective short-term options for back pain and arthritis particularly.
Muscle relaxants, such as the popular Flexeril, can also help with some types of pain. These drugs do just what their name suggests by decreasing tension in muscles, such as happens after an injury or because of underlying arthritis or inflammation. However, they may produce drowsiness and should be taken with caution.
There are many non-medicinal therapies that also show promise in treating pain. Physical therapy, massage and behavioral approaches including cognitive behavioral therapy (CBT) and biofeedback work well for many people who have chronic pain.
These interventional and non-opioid medication options may be more effective than opioids for modulating chronic pain, yet reduce the risks of addiction and overdose that may result in serious consequences including death.