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Non-opioid options for managing chronic pain

Patients taking prescription opioid drugs have to switch to other pain relievers when they cut down or stop taking opioids. The following options that alone or in combination may be helpful.

Cold and heat

Cold can be useful to relieve an injury pain, decrease inflammation and muscle spasms, and speeds up recovery. Heat raises your pain threshold and relaxes muscles.

Exercise

Physical exercises and activities , despite some pain, can play a helpful role for people with some of the more common pain conditions, including low back pain, arthritis, and fibromyalgia.

Weight loss

Many painful health conditions are worsened by excess of weight. It makes sense, then, that losing weight can help to relieve some kinds of pain.

Physical therapy (PT) and occupational therapy (OT)

PT helps to restore or maintain walking ability. OT helps improve your ability to perform activities of daily life, such as dressing, bathing, and eating.

Transcutaneous electrical nerve stimulation (TENS)

This technique employs a very mild electrical current to block pain signals going from the body to the brain.

Iontophoresis

This form of electrical stimulation is used to deliver medications into areas of pain and reduce inflammation.

Ultrasound

This therapy directs sound waves into the targeted tissue. It is sometimes used to improve blood circulation, decrease inflammation, and promote healing.

Cold laser therapy

Cold laser therapy, also called low-level laser therapy, is FDA-approved to treat pain conditions. The cold laser emits pure light of a single wavelength that is absorbed into an injured area with the object to reduce inflammation and stimulate tissue repair.

Mind-body techniques

Mind and body are a large and diverse group of procedures which help healing patients in new and different ways along with minimal medication. They are administered or taught by a trained practitioner. Examples include,
  • Meditation.
  • Mindfulness.
  • Progressive muscle relaxation.
  • Breathing exercises.
  • Hypnosis therapy.
  • Yoga and tai chi.
This is a form of exercise that is the sum of body movement, mental focus and controlled breathing to build strength and improve balance, flexibility and general health.

Biofeedback

This technique with the help of electrical sensors helps people take control of their own body responses, including pain.

Therapeutic massage

Therapeutic massage may relieve pain by manipulating soft tissues and muscles, tendons, and joints; relieving stress and anxiety; and possibly impeding pain messages to and from the brain and increase blood and lymph circulation to bring a sense of calm.

Chiropractic

This technique is based on adjustment of spine and other parts of body with the object to correct alignment problems, ease of pain and help the body to self-heal.

Acupuncture

Acupuncture is a treatment inserting extremely fine needles into the skin at specific points on the body. It is purposed to relieve pain by releasing endorphins, the body’s natural painkilling chemicals. It may also influence levels of serotonin, the brain transmitter which plays a role in mood, emotions etc.

Psychotherapy

These professionals can offer many avenues for pain relief and management. For example, they can help change negative perceptions about your pain that may be interfering with your ability to function well in life, work, and relationships. Seeing a mental health professional does not mean the pain is “all in your head.”

Pain-relieving devices

A range of assistive devices can help support painful joints, relieve the pressure on irritated nerves, and soothe aches and pains. They include splints, braces, canes, crutches, walkers, and shoe orthotics.

Topical pain relievers

These medication-containing creams, sprays and ointments are applied to the skin. They may be used instead of or in addition to other treatments.

Over-the-counter medications

Pain relievers anyone can buy without a prescription, such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn) can help to relieve mild to moderate pain.

Herbal or nutritional pain relievers

There is little scientific evidence supporting their effectiveness for pain relief.

Non-opioid prescription drugs                          

Certain medications can be very effective for treating condition-specific pain. Examples include triptans for migraine headaches and gabapentin (Neurontin) or pregabalin (Lyrica) for nerve pain.

Corticosteroid injections

Used occasionally, corticosteroid injections can relieve pain and inflammation caused by arthritis, sciatica, and other conditions.