Pain Management Without Opioids? It Isn’t Easy

Burning, aching, pinching, stabbing — no matter how it takes hold, pain can quickly put the brakes on an otherwise productive day. Estimates are that 20% of the population of the United States lives with chronic pain. And 8% live with "high-impact chronic pain." Couple this with an opioid epidemic that has doctors rethinking their strategies for prescribing the most effective pain medications, and you have a recipe for a people in pain. Not everyone can take opioids, either, and this too can make pain management tricky.

The Problem With Opioids

Millions of people in the United States rely on opioid medications to manage their pain. Up to 29% of these people misuse their prescriptions, and up to 12% develop opioid use disorder. Undoubtedly, this can crumble lives, and it’s turned deadly for hundreds of thousands of people who were merely trying to eliminate their pain.

According to the CDC’s most recent estimate, 41 people die each day due to prescription opioid overdoses. Doctors are being urged to be tougher on their pain patients, forcing many to look for alternatives. The good news: it’s difficult, but it’s not impossible to manage some types of pain without opioids.

Alternative Pain Relievers

The Henry Ford Center recommends exercise and physical therapy among a handful of alternative approaches. Physical exertion might seem counterintuitive to treating pain, but it can improve circulation, reduce stiffness and improve overall discomfort. People with conditions like rheumatoid arthritis and fibromyalgia could find exercise particularly beneficial. Tai chi, gentle yoga and water aerobics are all great exercise choices.

Physical therapy uses a combination of approaches that include exercise, physical manipulation, strength training and patient education. A good physical therapist will help their patients strengthen and condition their bodies while offering strategies to aid in long-term recovery. Physical therapy typically requires a doctor’s referral but as an alternative to opioids, it has found many advocates.

Mindfulness as a Pain Reliever

A shift in mindset can help some people learn to process their pain differently, reducing its power. Studies have shown mindfulness meditation can significantly reduce pain perception. Researchers point out that pain is more than a simple sensory response — it’s cognitive and affective as well. When it’s bad enough, physical pain can feel like an emotional experience. And learning to navigate these tides can help many pain patients to find a sense of acceptance despite the pain.

In some cases, a person’s thoughts and emotional reactions may either feed or stifle pain. Mindfulness may redirect a user’s thoughts or it may relieve pain through dissipation of the sensation. This doesn’t rid the sufferer of their physical problems but rather it puts those sensations in a different perspective. Buddhist monks have been using mindfulness to overcome pain for thousands of years, with some demonstrating remarkable results.

Does Acupuncture Relieve Pain?

Acupuncture is the ancient Chinese art of using needles to stimulate and balance the natural flow of energy, or “chi,” running through the body. Some attribute the positive effects of acupuncture to the presence of endorphins — natural painkillers the body may produce in response to the needles. Regardless of the mechanism, according to the National Institutes of Health, acupuncture has proven itself many times over as a useful approach in controlling many types of pain.

The TENS unit, a form of muscle stimulation, has also shown great promise in treating pain with some hailing it as the needle-free acupuncture. Moreover, a TENS unit can be used at home without the need for expensive appointments. 

Non-Opioid Medications for Pain Relief

Opioids aren’t the only medications that can help with pain management. Effectiveness can vary depending on the type of pain and the individual, but some have found the following options helpful:

• NSAIDs and acetaminophen work well to reduce mild to moderate levels of pain. These medications can come with some serious side effects of their own, however, so they may not always work best for long-term pain management.
• Topical analgesics go directly to the source of the pain. There are numerous compounds that can do this, including capsaicin, menthol, lidocaine and other medications, with some being more effective than others. Topical NSAIDs may be more effective than other analgesics of this type.
• Herbal supplements may also be helpful. The AARP recommends fish oil, ginger, turmeric and methylsulfonylmethane (MSM) to reduce chronic pain. CBD, one of the non-psychoactive compounds in cannabis, could also be a practical alternative.

Pain management without opioids may be possible, depending on the type of pain. And for many pain sufferers, it might take sifting through a few different options to find the right one. Some people already taking opioids may need help shifting to a different way of approaching their pain. A doctor can help opioid users wean off of the medication if that's advisable. Obviously, it can be worth the effort if an alternative works without the dangers of opioids. But the reality is, no one should live in pain needlessly. There's no scorekeeping system that awards those who suffer the most. And there is no weakness in seeking help.

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