Over the last two decades, the rise of opioid prescriptions as a treatment for chronic pain have risen exponentially. Initially found to be both safe and effective, the medical community later learned that these medications not only resulted in additional and lasting impairments, but were less effective at treating several types of pain than initially believed. Facing down a mounting number of opioid overdoses each year, prescribing opioids began to fall out of favor.
In 2016, this was made a special issue by the CDC triggering the creation of extensive resources for pain management systems that no longer relied on opioid medications. As the community begins to transfer to safer and less addictive methods of pain management, many consumers want to know what other medications might take the place of these once-standard drugs.
In the article below, we will briefly explain why opiates work for some kinds of pain in addition to the many other options in existence to get similar, or better, relief through different means.
How Opioids Work
When experiencing pain, it normally originates from one of two sources: nerve pain and tissue pain. These different origins cause the body to respond differently to medications, meaning that not every pain medication is effective in treating every kind of pain.
Historically, opioids are only effective at relieving pain caused by tissue damage but are generally far less effective against nerve pain. As many types of chronic pain are a result of inflamed nerves, this results in opioids being a sub-par treatment to chronic pain.
This is because opioids target the opiate receptors in the brain to numb pain, rather than managing pain at the source of the nerve or tissue creating the discomfort. This “opioid effect” is what acts as the main habit-forming quality in these medications, potentially building a physical dependency on the substances when used over a long period of time.
Treating Chronic Pain Without Opioids
There are several effective non-opioid treatments for chronic pain currently in use. While some are newer prescriptions, others are familiar over-the-counter medications you may already have in your cabinet.
Simply choosing a different prescription medication is a common alternative to opioids, especially in the times following surgery or for patients with pain that is not made better by other methods. The following prescription categories are popular for use as non-narcotic painkillers:
Tricyclic Antidepressants: This is the most common class of antidepressants used for the treatment of pain, especially that which is caused by nerve irritation. Other antidepressants such as SSRIs and SNRIs may also be used but are less common for this purpose.
Generally, these medications will take up to a week to begin initially easing the pain with the full effect of pain relief taking place 2 to 3 weeks after beginning the medication.
Anticonvulsant Medications: Used typically for disorders involving seizures, this category of medication works by blunting the pain signals transmitted by over-sensitized nerve endings. While anticonvulsants historically came with a list of side effects, newer medications have reduced this problem.
Muscle Relaxants: These medications work by providing low-grade sedation to the nervous system to dull any persistent musculo-skeletal pain. However effective, relaxants are habit-forming and are generally used for a short time only after over-the-counter options have failed.
As with any pain medicine, talk to your doctor about potential drug interactions and any dietary restrictions that may result from your new prescription.
Over the Counter
Depending on the origin or your pain, some of the strongest non-narcotic pain killers are actually over-the-counter medications. These are best used for tissue damage related pain. Some medications in this category include:
Keep in mind that most of these medications are Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). As such, be sure to check for any drug interactions that may occur if you take other medications.
Finally, many individuals find alternative treatments helpful when dealing with chronic pain, especially as an additional aid to prescription medications.
Physical Therapy: A physical therapist takes a body-centered approach to managing pain. This is done through careful movement routines that are used to stretch and strengthen muscles. This creates support around the spine and other joints, thus reducing pain.
Furthermore, a physical therapist can build lost endurance for clients who have a challenging time completing daily tasks. One example of this is using physical therapy to regain the ability to walk and move normally after knee surgery.
Occupational Therapy: Not to be confused with physical therapy, occupational therapists take a wider treatment approach to managing pain. While these interventions include ways to manage the symptoms of physical pain, they also span to treating underlying emotional difficulties that may result after injury, surgery, and loss of normal functioning.
Acupuncture and Massage: These two treatments are most commonly used for additional pain relief and self care for individuals suffering from chronic pain. In the case of acupuncture, clients may also elect to treat other commonly co-occurring symptoms such as nausea and stress.
Contacting a Pain Management Expert
No matter what option you choose, long term pain and long term medication consumption have their own adverse side effects and impact on your physical and mental health. Finding the right pain relief is important, but it’s a decision that must be made with the care and cooperation between you, your doctor, and other individuals that may become part of your treatment team.
The Arizona Pain and Spine Institute boasts a full team of seasoned professionals who specialize in minimally invasive and clinically proven modalities to help manage both long and short-term pain. We make a point to stay on the cutting edge of new technologies to help reduce pain and increase quality of life.
Contact us at (480) 986-7246 for more information on the service we provide, find which doctor is right for you, and get on the path to discussing your next treatment options.