Man sitting on couch with back pain.
January 7, 2016 | by The Polyclinic

The following is part one of a two-part series on pain management without the use of opioids explaining what chronic pain is and the importance of managing pain in a variety of ways. In part two, we discuss additional ways that specialists at The Polyclinic are helping patients manage pain.

More than 100 million Americans suffer from some form of chronic pain, according to the Institute of Medicine of The National Academies. Further troubling is the rising long-term use and misuse of opioid pain prescription medications, first promoted for treating chronic pain in 1996.

Medical use of opioids grew quickly. By 2012 more than 9 million Americans reported long-term use of opioids for chronic pain management. While opioids are useful in lower dose for short-term relief of acute pain, long-term use can lead to dependency, reduced efficacy, and significant side effects that reduce quality of life, according to research from the University of Washington School of Medicine’s COPE for Chronic Pain Program.

The bottom line: Chronic pain must be managed in a variety of ways.

What is chronic pain?

Chronic pain is broadly defined as any pain that persists beyond the expected time of recovery; it is often resistant to initial treatments. Pain caused by arthritis, cancer, and the nervous system, as well as low back pain and headaches commonly results in chronic pain. Unfortunately the incidence rates of these issues increase as we age. If you suffer from post-traumatic stress disorder (PTSD), anxiety or depression, you may be at higher risk for chronic pain. Optimizing treatment for these issues can help relieve that pain.

Pain is a natural part of life. While complete resolution of pain is often not possible, there are many ways you can work with your provider to effectively live with chronic pain without depending upon opioids.

At The Polyclinic our specialists are helping patients manage pain without opioids in a variety of ways.

10 Ways to Reduce Pain Without Opioids

  1. Exercise regimens. A physical therapist works with you to tailor an exercise program that addresses your issue in an individualized manner. The Polyclinic’s Physical Therapy department is often a patient’s first stop after consulting with their primary care physician. “It’s not about exercise for fitness; it’s about exercise to solve a problem,” says Dechie Bello-Rapoport, physical therapist. Physical therapists teach patients exercises, model them in clinic, and equip patients to practice at home. “We teach a patient how to move to alleviate pain,” says Bello-Rapoport.

  2. Physical and environmental assessments. Repeated activities performed incorrectly or with the wrong equipment are a major cause of discomfort and injury. Our physical therapists can assess physical elements such as posture and ergonomics and equipment that may include running shoes, desk chair or bicycle. “We are like detectives in simulating the environment that causes the patient’s pain,” says Bello-Rapoport. After an individual assessment, the PT teaches you correct and less harmful ways to perform your work or sport to prevent re-injury.

  3. PRICE. “The most important way to manage acute pain is to reduce inflammation and swelling,” says Dr. Jeremy Johnson of the The Polyclinic’s Sports Medicine department . “A great acronym to remember how to do this is PRICE.”
    • Protection: Protects the injured area from weight-bearing activity with a splint, crutch, walking boot or scooter.
    • Rest: Avoid activities that cause pain.
    • Ice: 20 minutes on, then 30 minutes off.
    • Compression: Ace bandages for managing swelling.
    • Elevation: Legs keep above hip; arms above heart.
  4. Medication: Centrally-acting anti-depressants. Anti-depressants can help stabilize the emotional response to pain, which in turn allows for other treatment to have more effect. “Centrally-acting anti-depressants can be effective for treating chronic low back and knee pain, neuropathic pain and fibromyalgia in many patients,” says Diana Ferdana, nurse practitioner in The Polyclinic’s Physical Medicine department.

  5. Lumbar braces.Many patients who seek care in physical medicine complain of chronic lumbar back pain. Even after trying non-surgical interventions, patients may still experience pain in the lower back when performing specific activities, such as vacuuming, washing dishes, or cooking a meal. A medical-quality lumbar brace can make a difference in function and quality of life. Lumbar braces should be medically fitted and used only as instructed by your doctor to avoid weakening core and lumbar muscles.
  • Part Two: Additional Ways to Manage Chronic Pain Without Opioid Pain Medication
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