It’s a challenging time for managing pain. Opioids are effective and have their place, but if you take them you face a risk of addiction. Yet if you’re experiencing pain, you need relief. What are your options?

To start, it depends on what type of pain you have. With acute pain, you can typically point to a cause — you slipped on ice and broke your wrist, you’ve developed appendicitis, or you’re recovering from joint replacement surgery, for example. It’s a warning sign telling your brain something might be wrong, and it generally eases up as you heal.

Chronic pain is complicated, and many people get relief from combining multiple treatment methods.

Chronic pain is different. It lasts for at least several weeks, and it may come and go without any obvious reason.

You could have chronic pain in the form of headaches, back pain, arthritis pain, or other types of pain. And sometimes, acute pain develops into chronic pain. For example, pain after surgery might not subside as expected. 

Prescribing opioids

According to the International Association for the Study of Pain, opioids can be effective and appropriate for treating acute pain, and for relieving pain in people who are at the end of their lives. 

“The reason that doctors often prescribe opioid pain medications is that, despite their dangers, they work when other pain relievers don’t,” says Sal Raichbach, PsyD, director of clinical services at Ambrosia Treatment Center in West Palm Beach, Florida. “For patients experiencing severe levels of pain, opioid medications are fast-acting and powerful enough to provide relief.”

Opioids are highly addictive, though, so they should only be used for a few days for acute pain, and if you’re at high risk for addiction you should talk to your doctor about other options for pain management. 

You have other options for acute pain. Raichbach says medications like acetaminophen, aspirin, ibuprofen or naproxen can be useful for treating mild to severe acute pain.

Opioids generally aren’t recommended for chronic pain, though. “Opioids are not a good choice for any chronic or long-term condition, as efficacy wears off over time, side effects can be an issue, and of course addiction is possible,” says Amy Orr, US Pain Foundation ambassador and author of Taming Chronic Pain.

What else can I try for pain relief?

Chronic pain is complicated. The feeling of pain starts in the brain, Raichbach points out. So some treatments outside of medication can work. And many people get relief from combining methods. For example, you might find that cognitive behavioral therapy, physical therapy and over-the-counter pain medications bring relief. 

These treatments could help you get chronic pain under control.

  1. NSAIDs. We tend to dismiss these medications, but that might be a mistake. “Non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen are often as effective as opioids,” says David D. Clarke, MD, president of the Psychophysiologic Disorders Association.
  2. Minimally invasive procedures. Nerve blocks, epidural injections, and spinal cord stimulation can help reduce pain, says Paul J. Lynch, MD, chief executive officer of Pain Doctor, Inc. in Scottsdale, Arizona.
  3. Chiropractic treatments. One study found that people were 55% less likely to fill a prescription for an opioid if they received chiropractic care.
  4. Acupuncture. Research published in the Journal of Pain found acupuncture is an effective treatment for headache and musculoskeletal and osteoarthritis pain. 
  5. Physical therapy. Physical therapy can build your strength and range of motion, treat inflammation, and help make your central nervous system less sensitive to pain signals.
  6. Stress management. For many people, chronic pain can be linked to life stresses, past trauma, suppressed emotions, and mental health conditions, Clarke says. “When these stresses are uncovered and treated, the chronic pain actually can be relieved.”
  7. Yoga therapy. This method uses postures, breathwork, meditation, movement, mindfulness, and lifestyle adjustments to address pain, according to Sarah Cummins, a pain care yoga instructor and founder of Waterfall Yoga.
  8. Massage. Massage can be especially useful for chronic lower-back pain. 
  9. Cognitive behavioral therapy. “CBT helps to address the thoughts, emotions, and behaviors related to having the pain, set realistic expectations regarding the pain, develop coping skills to deal with the pain, and manage the stress related to having the pain,” says Rikki Goldenberg, a licensed mental health counselor at Golden Sky Counseling in Boca Raton, Florida, who specializes in working with people who have chronic pain. 
  10. Mindfulness techniques. “Meditation, body scans, and deep breathing are incredibly effective in helping people to manage pain. By relaxing the mind and body and creating acceptance, and ultimately reducing stress, we can prevent some of the negative effects that stress has on the mind and pain receptors, Goldenberg says.
  11. CBD. There’s still not a lot of research behind the use of CBD for pain relief, but many people feel it helps. People also often use CBD to alleviate anxiety and to sleep better — two conditions that are often linked with chronic pain.
  12. Heat. Heat can be especially helpful in relieving arthritis pain. 
  13. Lifestyle changes. Making healthy changes to your diet, exercise routine, sleep patterns, alcohol and substance use, and stress levels can help. 
•December 30, 2019