Non-Opioid Treatment

Non-Opioid Treatment

Millions of Americans are in pain. Some suffer from chronic headaches or back pain; others are recovering from surgery, sports injuries or accidents. Every year, millions of prescriptions are written for pain medications — many of them powerful opioids that can cause side effects and lead to addiction.

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But there are many non-opioid treatments available for pain, including prescription and over-the-counter aspirin, ibuprofen and acetaminophen; nondrug remedies such as massages and acupuncture; and high-tech treatments using radio waves and electrical signals.

If you’re in pain and want to avoid taking opioids, a physician anesthesiologist can work with you to develop a safe and effective pain management plan.

A physician anesthesiologist can work with you to develop a safe and effective pain management plan.

What are some alternatives to opioids?

There are many non-opioid pain medications that are available over-the-counter or by prescription, such as ibuprofen (Motrin), acetaminophen (Tylenol), aspirin (Bayer) and steroids, and some patients find that these are all they need. Other people find relief with nondrug therapies that can be used alone or in combination with medications. These include:

  • Physical therapy – A physical therapist or physician who specializes in physical medicine and rehabilitation may be able to create an exercise program that helps you improve your ability to function and decreases your pain. Whirlpools, ultrasound and deep-muscle massages may also help.
  • Acupuncture – You may find relief from acupuncture, in which very thin needles are inserted at different places in your skin to interrupt pain signals.
  • Surgery – When other treatments aren’t effective, surgery can be performed to correct abnormalities in your body that may be responsible for your pain.
  • Injections or nerve blocks – If you are having a muscle spasm or nerve pain, injections with local anesthetics or other medications can help short-circuit your pain.

Many patients also find relief from massages and other relaxation techniques, as well as biofeedback, where you learn to control involuntary functions such as your heart rate.Nurse assisting elderly patient with walker

What high-tech methods might help relieve chronic pain?

Some patients with chronic pain simply will not find relief with non-opioid medications or treatments like physical therapy. For them, there are new techniques being developed that may relieve their pain and, in some cases, keep it from coming back.

Some of the latest high-tech methods for relieving chronic pain include:

  • Radio waves  Radiofrequency ablation involves inserting a needle next to the nerve responsible for the pain and burning the nerve using an electric current created by radio waves. This short-circuits the pain signal. Pain relief can last for up to one year.
  • Nerve blocks Using X-ray imaging, pain medicine physicians can inject numbing medication that blocks or dampens pain, and might even stop chronic pain from developing. The location of the injection depends on the source and type of pain. For example, pain in the arm or face can be relieved by blocking nerves in the neck. Relief may require a series of injections and repeated treatment.
  • Electrical signals  Transcutaneous electrical nerve stimulation can provide short-term pain relief, especially for various types of muscle pain, by sending low-voltage electrical signals from a small device to the painful area through pads attached to the skin. While researchers aren’t sure why it works, they think it may either interrupt the nerve signals to the brain or stimulate the production of “feel good” endorphins, the body’s natural painkillers.
  • Spinal cord stimulation  When other methods fail, a pain medicine specialist might recommend spinal cord stimulation (SCS), which uses a pacemaker-like device that replaces the pain with a more tolerable sensation, typically a tingling or massage-like feeling. The physician implants the device in the lower back, attaching it to tiny wires that are located in the spinal canal. When patients feel pain, they can use a remote control to send signals to the painful area. This technique can help with back pain as well as neuropathy — nerve damage in the legs that causes numbness and pain — which is common in people with diabetes. New forms of SCS show promise in relieving pain without the tingling.
  • Pain pumps  Special pumps can be implanted to allow a patient to push a button and deliver pain medications to their spinal cord, bringing relief without the side effects that often come with taking these drugs by mouth. Patients can also get a psychological boost by having direct control over their pain. These spinal drug pumps are used most often by people with cancer pain, but also by patients with other types of pain who had side effects when taking the medication orally.
  • Future solutions  One of the most promising research areas involves harvesting stem cells from a patient’s bone marrow and injecting them into an area, such as the lower back, that has become painful because tissue has deteriorated. The hope is that the stem cells will build new, healthy tissue and relieve the pain for good.



Patient who went under anesthesiology.

Physician anesthesiologists can change lives. “If I didn’t have a physician anesthesiologist on my medical team, I predict that right now, I would still be overweight, inactive and clinically depressed.” – Kathleen Callahan, chronic pain patient