Options for Managing Pain Without Opioids

A 2016 study found that 20.4 percent of Americans had chronic pain. For people living with this condition, prescription pain medicine can be a beneficial short-term treatment. However, as awareness of the risks—withdrawal, addiction and overdose—of opioids increases, the ability to manage pain without the use of narcotics is on the minds of many pain sufferers.

Narcotics & their risks

Narcotics, or opioids, are a group of drugs that relieve pain and dull the senses by binding pain receptors in the brain. They may also cause euphoria and narcosis (sleep or stupor). Examples of these drugs include oxycodone, hydrocodone, codeine, morphine, tramadol, methadone and fentanyl, as well as the illegal drug heroin. Narcotics are frequently prescribed for surgery, trauma or other medical conditions that cause severe pain.

Unfortunately, an estimated 21 to 29 percent of patients prescribed opioids for chronic pain wind up misusing them, and 8 to 12 percent develop opioid use disorder. Around 4 to 6 percent of people who misuse opioids eventually experiment with heroin. These tendencies and the prevalence of unpleasant side effects—including respiratory instability, mood disorders, constipation, nausea, allergic reaction and dangerous interactions with other drugs—are driving an increase in pain management without narcotics.

Alternative medications, treatments & lifestyle changes

Some over-the-counter medications can control pain better than one might imagine. Newer options (though not legal in all states) include medical marijuana and cannabinoids such as CBD oil. While the effectiveness of cannabis is still being studied, research suggests it can help reduce chronic pain, though CBD also has possible side effects.

If you generally don't like taking medication, plenty of alternative treatments are available. Transcutaneous electrical nerve stimulation (TENS) sends low-voltage electrical signals through a given area and temporarily stops pain by interrupting nerve signals or producing endorphins. Radiofrequency ablation uses radio waves to create an electric current that stops certain nerves from transmitting pain signals. There are also two forms of neurostimulation: spinal cord stimulation for pain in the back, arms or legs and dorsal root ganglion (DRG) for pain in the groin, feet, knees or hips.

Dry needling has been known to help with neuromusculoskeletal pain and movement impairments. In Osteopathic Manipulative Treatment (OMT) gentle pressure and resistance are applied to a patient's muscles and joints as they are stretched.

A pain pump, most commonly used for cancer patients, can deliver pain medication directly to the spinal cord without possible narcotic side effects such as euphoria and substance use disorder. Physical, occupational and rehabilitation therapy, all of which involve working with a professional therapist, can help reduce pain and improve function. In some cases, surgery can reduce symptoms, such as back pain caused by abnormalities.

Massage can be immensely helpful for people with muscle, joint or tendon pain. Although studies of the traditional Chinese practice of acupuncture are less conclusive, some evidence shows that the thin needles inserted into the skin to stimulate nerves, muscles and connective tissues can relax the body and reduce pain. Hypnosis has also been used to bolster the effectiveness of other pain management treatments by enhancing concentration and minimizing distraction.

If you want to try pain management techniques at home, research has shown that weekly yoga classes can improve mobility better than standard medical care alone. Just moving your body is beneficial; regular exercise increases the release of endorphins, which can improve mood and reduce pain. Just be sure to speak to your doctor about an exercise regimen that is safe for you. Heat and cold therapies can also be helpful. Heat is typically good for muscle pain or stiffness, and cold is used for acute injuries, pain, swelling and inflammation.

Tips for people managing pain

Integrative medicine for pain management is the practice of combining multiple forms of pain-reducing methods into your routine to get ample benefits. Speak with your doctor, a physician anesthesiologist or a chronic pain specialist to develop the best plan of action for you.

Living with chronic pain is a challenge to say the least, but even when it's difficult, try your best to stay positive. Studies indicate that an optimistic outlook on your treatment plan increases your odds of responding well to it.