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Managing Chronic Pain Without Opioids

October 15, 2017
Published in: Joint, Pain Management

Woman at a chiropractor to help with back pain

Nearly one in five adults experiences chronic pain that interferes with their daily activities. For many years, opioids have been used to treat chronic pain. However, in most cases, opioids are a poor choice for treating long-term pain. Tolerance and an opioid abuse epidemic are causing people to look for other options for treating chronic pain. Here are several safer alternatives for treating long-term pain.


PillsNonsteroidal anti-inflammatory drugs are rapidly becoming a first-line treatment for chronic pain. NSAIDS are a bit stronger than over-the-counter options like Tylenol. NSAIDS drugs like naproxen and ibuprofen can reduce the need for high opioid doses. Of course, NSAIDS do have a few risks. Complications like organ toxicity, liver, and kidney failure are possibilities. Opioids don't carry these risks.


Believe it or not, antidepressants that inhibit serotonin and norepinephrine effectively address nerve pain. Individuals suffering from ailments like fibromyalgia and diabetic neuropathy may find some relief with this medication option. Antidepressants that also address anxiety can be used for sleep issues. Furthermore, antidepressants carry fewer risks than opioids. For instance, antidepressants are helping people with chronic pain live fuller and more productive lives without having to worry about abuse or dependence.


Incredibly, a group of medications used to treat epilepsy has also been co-opted to treat chronic pain. These drugs soothe neuropathic pain by suppressing pain signals before they reach the brain. Although side effects with these medications aren't severe, they can include fatigue, drowsiness, and dizziness.


While steroids like prednisone may be effective for addressing pain from injured nerves, this medication is not without a downside. Pain can return with a vengeance if you stop taking them. Worse yet, joint destruction can be accelerated with these medications. Corticosteroids may have psychiatric and gastrointestinal side effects. These medications can also compromise the immune system.


Neurostimulators are FDA-approved for chronic pain and can effectively treat pain in the arms, legs, neck, or back. Neurostimulation makes use of strategically implanted electrodes to disrupt nerve pain signals. While not a cure for chronic pain, it does effectively mask pain signals before they reach the brain. Neurostimulators are being explored as treatments for migraines and cluster headaches. There is no risk of abuse or dependency with this treatment.

Alternative Therapies

Woman doing yoga in the parkAlternative therapies like acupuncture and massage are often combined with traditional therapies to take out pain with a one-two punch. Alternative therapies can be effective and safe for people of all ages. Even better, these strategies are often free of side effects. Although there is little research about alternative therapies, options are often more effective than no treatment, and just as effective as drugs for addressing chronic pain. Alternatives therapies are often prescribed when conventional treatments haven't helped.

Physical Therapy and Exercise

Gentle exercise has been shown to improve mobility and function in people suffering from chronic pain. Gentle movements have been shown to improve fibromyalgia, arthritis, joint pain, and chronic back pain. Tai Chi and yoga are popular gentle exercise options for people of all ages and fitness levels. Often after just a few short weeks of activity, pain levels are reduced or eliminated.

While opioids have been the go-to option for chronic pain for many years, this trend is changing. As federal regulations of opioids increase and doctors become more reluctant to prescribe opioids, alternative therapies are gaining momentum. It's important to be aware of all the options for addressing chronic pain. Advances in these alternative therapies are made every day, and additional options are in development.

If you need help managing you pain, the Pain Management Clinic can help. We focus on diagnosing the source of your pain, so we can develop a treatment plan directed specifically at your pain generators. Though we understand that medications can play a role in managing your pain, our primary goal is to reduce or eliminate dependence on oral medications by focusing on other modalities to treat your pain.