Pain can impact nearly every aspect of your daily life from cleaning the house to going to work or playing with your kids. In fact, 100 million Americans suffer from chronic pain, which is pain lasting 3-6 months or longer. Most often, chronic pain is treated using prescription opioids. To help treat your pain with a non-opioid solution, consider these tips.
5 Tips for Coping with Chronic Pain
(Family Features) Pain can impact nearly every aspect of your daily life from cleaning the house to going to work or playing with your kids. In fact, according to the Institute of Medicine, 100 million Americans, or more than 30 percent of the population of the United States, suffer from chronic pain, which is pain lasting 3-6 months or longer.
Most often, chronic pain is treated using prescription opioids. However, the National Institutes of Health estimates 2 million people in the U.S. suffer from substance use disorders related to prescription pain relievers, while 60 people die every day as a result of opioid overdoses, according to the National Safety Council.
"The country is facing intertwined crises of opioid misuse and chronic pain management. Non-opioid, non-pharmacological treatments such as acupuncture and other similar interventions can be essential in handling patients' pain management as a complement to lessen dependency on opioid prescriptions and serve as a more effective holistic therapy for chronic pain," said Dr. Kory Ward-Cook, chief executive officer of the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). "The care provided by NCCAOM National Board-Certified Acupuncturists is essential in continuing the movement toward greater integrative and complementary pain care, especially as a non-pharmaceutical alternative to harmful opioid prescriptions."
To help treat your pain with a non-opioid solution, consider these tips:
Set Goals for Yourself
Use Relaxation Techniques
Consider Non-Pharmaceutical Treatment Options
Focus on Nutrition
Keep Track of Progress
Photo courtesy of Getty ImagesSOURCE:
National Certification Commission for Acupuncture and Oriental Medicine
To help shed light on the growing national problem with opioid drugs, Dr. W. Michael Hooten, a Mayo Clinic anesthesiologist and Pain Clinic specialist, lends his expert insight on what people need to know about opioids.
(BPT) - While a decade ago you may not have heard much about opioids, today they make headlines daily. The nationwide epidemic crosses generations and socioeconomic lines, and it's affecting your family, friends and neighbors.
"Opioids have long been used clinically to treat pain, but prior to the 1990s they were primarily reserved for patients with a limited life expectancy, such as for someone with cancer or in a hospice setting," says Dr. W. Michael Hooten, a Mayo Clinic anesthesiologist and Pain Clinic specialist. "The potential problems associated with long-term use were secondary considerations."
To help shed light on this growing national problem, Dr. Hooten lends his expert insight on what people need to know about opioids.
Opioids are prescribed for various reasons
Opioids are used to treat a variety of pain disorders. While they are commonly prescribed after an operation, opioids are also used to treat a host of chronic pain conditions including musculoskeletal, abdominal, pelvic, and neuropathic pain.
Length of use varies
"Following surgery, up to one in four patients may use opioids longer than anticipated," says Dr. Hooten. "How long, exactly, depends on several clinical factors."
He notes that after an operation, a patient might use opioids to manage acute pain for three to five days.
"When opioids are used for acute postoperative pain, patients should try to use the lowest possible dose." After this short time period, opioids should be replaced with non-opioid pain medicines including Tylenol scheduled to be taken every six hours."
There are alternatives for pain management
There are many alternative options for chronic pain. Dr. Hooten suggests talking with your doctor about:
* Non-opioid analgesics (non-opioid pain medications).
* Interventional treatments such as image-guided spine injections or nerve blocks. * Acupuncture.
* Low-impact exercise such as walking, yoga, Pilates. Consider working with a physical therapist to develop a structured exercise program.
* For advanced pain treatment, spinal-cord stimulation can disrupt the pain stimuli and provide sustained pain relief.
* Work with a pain psychologist who can help teach individuals how to use specialized behavioral and cognitive techniques that could lead to improvements in daily functioning and quality of life.
Opioids can be deadly if misused
"Approximately 90 people per day die in the U.S. from a prescription opioid and/or an illicit opiate overdose," says Dr. Hooten. Many of those are accidental overdoses. “People who take prescription opioids will inadvertently mix them with benzodiazepines (e.g., Valium and Xanax). Dr. Hooten warns that these two drug classes should never be taken together, as the combination can suppress the central nervous system and put the individual at risk of an accidental overdose.
Addiction can happen to anyone
As Dr. Hooten notes, “No one plans to get addicted, but it happens. Using opioids requires a high level of vigilance for the signs and symptoms of addiction."
There are many signs of over-reliance or misuse that families should be aware of. These include an increased preoccupation with the drug, concern about the timing of the next dose or refill, hiding use of the drug, and signs of intoxication like slurred speech and excessive sleep.
If you notice these warning signs, alert your loved one about your concerns. "This might be enough to prompt a change," says Dr. Hooten. "Otherwise relay this information to the prescriber and tell them what’s going on. They can take the correct next steps."
For more information on pain medication and alternatives, or to make an appointment, visit www.mayoclinic.org.
(BPT) - Opioids often are the go-to pain killer for everything from back aches and injuries to post-surgical pain, as evidenced by the more than 300 million prescriptions written each year. While they can help with moderate to severe short-term pain, opioids are not without risk. Because they have significant side effects, including an increased risk of addiction and overdose, the American Society of Anesthesiologists suggests those who take opioids ask some tough questions — including if it is time to consider alternatives.
Kathleen Callahan understands the dilemma. She suffers from a condition that causes painful cysts that required multiple surgeries resulting in post-surgical and chronic pain for which she took opioids for years. Despite being on a high dose of opioids, she still had chronic pain. So she turned to Anita Gupta, D.O., Pharm.D., a physician anesthesiologist who specializes in pain medicine.
“When I was on opioids long-term I couldn’t function, couldn’t be involved in my children’s lives and my work was suffering,” said Kathleen. “Dr. Gupta helped me manage my pain so life is livable. Now I exercise, go out with friends and go to my kids’ activities.”
“Kathleen and I had some difficult discussions. I didn’t think the medications were helping her anymore and I was truthful with her,” said Dr. Gupta. “She asked some hard questions, and I helped her move forward and cope with her pain. Since she’s been opioid-free Kathleen is vibrant and energetic. She has her life back.”
If you are taking opioids or your physician has prescribed them, the American Society of Anesthesiologists suggests asking yourself (and your physician) some tough questions:
* Are opioids affecting my quality of life? Opioids have many side effects, ranging from severe constipation, mental fogginess and nausea to depression. Kathleen said she was “exhausted, cranky, depressed, constipated and gaining weight.” She realized the side effects of opioids were worse than the pain itself, motivating her to seek other options.
* What are my concerns about taking opioids — or stopping them? With the media attention surrounding opioid risks, many people worry they:
- are being judged by others
- may become addicted or overdose
- won’t be able to control their pain if they stop taking opioids
Ask your physician about obtaining naloxone, a drug that can reverse an overdose. If you take opioids when you don’t have pain or use more than directed, you may develop a dependence. Talk to your physicians about alternatives to manage your pain.
* Is it time to consider other methods of pain management? Opioids are most effective in the short term. If they are taken for chronic pain, they should be part of a “multimodal” plan that includes other methods of pain management, including:
- Injections or nerve blocks, which can short circuit muscle and nerve pain.
- Electrical stimulation and spinal cord stimulation devices that send electrical impulses to block pain.
- Physical therapy, which strengthens muscles to improve function and decrease pain. Whirlpools, ultrasound and massage can help, too.
- Alternative therapies, such as acupuncture, biofeedback, meditation, deep breathing and relaxation, which help you learn how to ease muscle tension.
* What type of physician can best help manage my pain? If you have severe or ongoing pain, be sure to see a physician who specializes in pain management, such as a physician anesthesiologist. These specialists have received four years of medical school and additional training in a medical specialty, followed by an additional year of training to become an expert in treating pain. They have the expertise to best help you manage your pain.
“If I was still on opioids I would be overweight, inactive, not involved in my children’s lives and depressed,” said Kathleen. “When you have a physician like Dr. Gupta who you trust and who shows you there’s another way, it’s just amazing. It’s night and day.”
For more information, download ASA’s Asking the Hard Questions About Opioids. To learn more about the critical role physician anesthesiologists play before, during and after surgery, visit www.asahq.org/WhenSecondsCount.
America is in the midst of an ongoing opioid epidemic affecting families across the country. Reports show that there are almost 80 opioid-related overdoses a day, amounting to more than 28,000 deaths annually. Accordingly, it is increasingly important that responders understand how to prevent death from overdose, including knowing how to use naloxone, the opioid overdose reversal medication.
Overcoming the Opioid Epidemic
(Family Features) America is in the midst of an ongoing opioid epidemic affecting families across the country. Reports show that there are almost 80 opioid-related overdoses a day, amounting to more than 28,000 deaths annually.
This figure continues to climb as over 2.1 million people in the United States suffer from substance use disorders related to prescription opioid pain relievers, according to the National Institute on Drug Abuse. Additionally, the rise of synthetic opioids like fentanyl, W-18 and carfentanil are threats to those already using opiates as the epidemic worsens.
Where do opioid overdoses occur?
Data from the Centers for Disease Control shows that 77 percent of opioid overdose related deaths occur outside of a medical setting and 56 percent occur in private homes, meaning family or friends must often be the first to take action in an emergency situation. Accordingly, it is increasingly important that responders understand how to prevent death from overdose, including knowing how to use naloxone, the opioid overdose reversal medication.
What does naloxone do?
Naloxone, the antidote that reverses an opioid overdose, works by neutralizing the opioid receptors in the brain, allowing an overdosed person to breathe again moments after it is administered. It’s been used in ambulances and hospital settings for decades and is now available for people to use in their homes or other remote areas.
According to the Centers for Disease Control and Prevention, more than 10,000 reversals of overdoses with naloxone are conducted by non-medical bystanders. Without having a solution in the hands of those closest to opioid-related overdoses, lives are left hanging in the balance while waiting for emergency medical services. However, there is an FDA-approved naloxone nasal spray designed for use by laypeople, like friends and family, who are not medically trained. It’s needle-free and requires no training or assembly to use while providing a strong enough dose to help reverse opioid-related overdoses. Naloxone is only effective in opioid-related overdoses and does not affect a person without opioids in their body.
What can you do?
A majority of states have issued standing orders for FDA-approved naloxone products, which permit pharmacies to dispense the nasal spray without a physician’s prescription. If you or someone you know is susceptible to an opioid-related overdose, whether caused by illicit drugs, like heroin, or prescription painkillers, it is important to prepare for an emergency overdose situation. By having naloxone on hand, you can save a life when every second matters.
Learn more about naloxone at getnaloxonenow.org.
Photo courtesy of Getty ImagesSOURCE:
With concerns mounting about the prevalence of opioid use and abuse in the U.S., a new study validates the effectiveness of acupuncture and other non-drug health therapies for pain. The National Institute of Health’s National Center for Complementary and Integrative Health compiled evidence on how complementary health therapies – including acupuncture, yoga, tai chi, massage therapy and relaxation techniques – are effective in treating chronic pain.
Effective, Opioid-Free Pain Management Options
(Family Features) New research is giving pain sufferers a dose of good news. With concerns mounting about the prevalence of opioid use and abuse in the U.S., a new study validates the effectiveness of acupuncture and other non-drug health therapies for pain.
The National Institute of Health's National Center for Complementary and Integrative Health compiled evidence on how complementary health therapies - including acupuncture, yoga, tai chi, massage therapy and relaxation techniques - are effective in treating chronic pain.
The top five pain conditions commonly treated in primary care settings - back pain, osteoarthritis, neck pain, severe headaches and migraine, and fibromyalgia - were evaluated. The study showed that acupuncture in combination with yoga is the most effective therapy for back pain and acupuncture with tai chi is the most effective treatment for osteoarthritis pain in the knee.
"As addictions to, and deaths from prescription opioids such as oxycodone, hydrocodone and methadone continue to rise, raising awareness on complementary and alternative pain therapies like acupuncture is more important than ever," said Kory Ward-Cook, Ph.D., Chief Executive Officer of the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). "The research from National Center for Complementary and Integrative Health brings greater attention to the use of acupuncture to treat and relieve chronic pain."
Experts in the field are pointing to the study, which was published in the "Mayo Clinic Proceedings" journal, as a pivotal opportunity in shifting how patients explore treatment for their pain management. The findings support the benefits of non-drug approaches to help those with chronic pain more safely manage their conditions without the harmful side effects of opioids.
The study explored seven widely-used non-drug treatments:
Acupuncture: Using practices derived from traditional Chinese medicine, practitioners stimulate specific points on the body, most often by inserting thin needles through the skin. Nationally Board-Certified practitioners, whose credentials can be verified through the NCCAOM, are affirmed to have the education and training necessary to competently deliver acupuncture therapy. To learn more or find a NCCAOM board-certified practitioner in your area, visit nccaom.org.
Spinal manipulation or osteopathic manipulation: This approach involves applying controlled force from hands or a device to move a joint past its normal range of operation with the goal of improving health.
Massage therapy: Using hands (or sometimes forearms or elbows), therapists manipulate muscles and soft tissue to relieve tension and pain.
Tai chi: These mind and body practices involve a series of postures and movements integrated with mental focus, breathing and relaxation techniques.
Yoga: A generally low-impact approach to physical well-being, yoga spans physical postures, breathing exercises and meditation. Practicing certain sets of yoga poses may help reduce pain.
Relaxation techniques: There are several types of relaxation techniques, including meditation, that strive to bring the body to its natural state with slower breathing, lower blood pressure and a feeling of increased well-being.
Natural product supplements: Certain dietary supplements such as chondroitin, glucosamine, methylsulfonylmethane (MSM), S-adenosyl-L-methionine (SAMe) and omega-3 fatty acids are commonly used to help treat inflammation often associated with pain.
"Opioids are dangerous, highly addictive and do not treat chronic pain - only mask it," said Bill Reddy, Director of the Integrative Health Policy Consortium and a NCCAOM-certified and licensed acupuncturist. "To solve the opioid epidemic, we must apply the most powerful, innovative approaches to address the root cause of pain within the human body."
Photo courtesy of Getty Images
With sales of prescription opioids nearly doubling since 1999, America is in the midst of an opioid epidemic. Rather than opting for pain medication – which can cause side effects such as depression, overdose and addiction – physical therapists can provide a safer alternative. With physical therapy, patients get to play an active role in their recovery.
Fixing the Pain Problem
Safe, effective options for long-term treatment
(Family Features) America is in the midst of an opioid epidemic. Sales of prescription opioids have nearly quadrupled since 1999. According to the Centers for Disease Control and Prevention, in 2012 alone enough opioid prescriptions were written for “every American adult to have their own bottle of pills.”
Prescription opioids – medications that reduce pain by interrupting pain signals to the brain – only mask the sensation of pain, and they come with side effects including depression, overdose and addiction, plus withdrawal symptoms when stopping opioid use. Pain relief doesn’t have to come in a bottle, however. Physical therapists can provide a safe, drug-free alternative for treating pain.
When to Choose Physical Therapy
The American Physical Therapy Association, through its national #ChoosePT campaign, is reminding patients that they have the right to choose their method of pain treatment. Physical therapists treat pain through movement and patients get to play an active role in their recovery.
Based on the CDC guidelines, patients should choose non-opioid alternatives, such as physical therapy, when:
The risks of opioid use outweigh the rewards. “Experts agreed that opioids should not be considered first-line or routine therapy for chronic pain,” according to the CDC. “Given the substantial evidence gaps on opioids, uncertain benefits of long-term use and potential for serious harm, patient education and discussion before starting opioid therapy are critical so that patient preferences and values can be understood and used to inform clinical decisions.”
Physical therapists can play a valuable role in the patient education process, including setting realistic expectations for recovery with or without opioids. As the guidelines note, even in cases when evidence on the long-term benefits of non-opioid therapies is limited, “risks are much lower” with non-opioid treatment plans.
Pain or function problems are related to low-back pain, hip or knee osteoarthritis or fibromyalgia. The CDC cited “high-quality evidence” supporting exercise as part of a physical therapy treatment plan for those familiar conditions.
Opioids are prescribed for pain. Even in situations when opioids are prescribed, the CDC recommends that patients should receive “the lowest effective dosage” and opioids “should be combined” with non-opioid therapies, such as physical therapy. Clinicians should continue opioid therapy only if there is “meaningful improvement in pain and function that outweighs risks to patient safety.”
Pain lasts 90 days. At this point, the pain is considered “chronic” and the risks for continued opioid use increase. An estimated 116 million Americans are living with chronic pain, but the danger of masking pain with prescription opioids is clear. More than 165,000 people in the United States have died from opioid pain medication-related overdoses since 1999, and every day more than 1,000 people are treated in emergency departments for misusing prescription opioids.
1. Pain is output from the brain. While researchers used to believe that pain originated within the tissues of the body, newer evidence indicates that pain does not exist until the brain determines it does. The brain uses a virtual “road map” to direct an output of pain to tissues that it suspects may be in danger. This process acts as a means of communication between the brain and the tissues of the body to serve as a defense against possible injury or disease.
2. The degree of injury does not always equal the degree of pain. Research has demonstrated that people experience pain in individual ways. While some people experience major injuries with little pain, others experience minor injuries with a lot of pain.
3. Diagnostic imaging (MRIs, X-rays, CT scans) results may not show the cause of pain. A 2015 study in Spine, which analyzed MRI results of more than 1,200 individuals ages 20-70 who had no symptoms of lower-back pain, found that 87.6 percent suffered from bulging discs. Even most subjects in their 20s had bulging discs – 73.3 percent of males and 78 percent of females, respectively.
4. Psychological factors, such as depression and anxiety, can make pain worse. Pain can be influenced by many different factors, such as psychological conditions. A recent study in the Journal of Pain showed that psychological variables that existed prior to a total knee replacement were related to a patient’s experience of long-term pain following the operation.
5. Your social environment may influence your perception of pain. Many patients state their pain increases when they are at work or in a stressful situation. Pain messages can be generated when an individual is in an environment or situation that the brain interprets as unsafe. It is a fundamental form of self-protection.
6. Understanding pain through education may reduce your need for care. A large study conducted on military personnel demonstrated that those who were given a 45-minute educational session about pain sought care for lower-back pain less than their counterparts.
7. The brain can be tricked into developing pain in prosthetic limbs. Studies have shown that the brain can be tricked into developing a “referred” sensation in a limb that has been amputated, causing a feeling of pain that seems to come from the prosthetic limb – or from the “phantom” limb. The sensation is generated by the association of the brain’s perception of what the body is from birth (whole and complete) and what it currently is (post-amputation).
8. The ability to determine left from right may be altered when you experience pain. Networks within the brain that assist you in determining left from right can be affected when you experience severe pain. If you have been experiencing pain and have noticed your sense of direction is a bit off, it may be because the part of the brain that details a path to each part of the body may be impaired.
9. There is no way of knowing whether you have a high pain tolerance or not. While some people claim to have a “high tolerance” for pain, there is no accurate way to measure or compare pain tolerance among individuals. While some tools exist to measure how much force you can resist before experiencing pain, it can’t be determined what your pain “feels like.”
If you or a loved one needs help managing pain, talk with your health care provider about safe alternatives to opioids. Additional information on the #ChoosePT campaign, including a pain self-assessment that patients can use to facilitate conversations about their care, is available at MoveForwardPT.com/ChoosePT.
Photo courtesy of Getty Images (female physical therapist with seated male patient)
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