Treatments to Relieve Chronic Pain

Pain that won’t go away is more than frustrating. It can be harmful to your health and well-being. It can keep you from getting a good night’s sleep, eating right and exercising. It can affect your mood and work and can keep you from spending time with your friends and family. If you’re one of 100 million Americans with long-term pain, also called chronic pain, you know how debilitating and frustrating it can be.

Every year, millions of prescriptions are written for pain medications — many of them powerful opioids that can cause addiction and other side effects. But there are many other treatments available for pain instead of opioids.

Opioids

Opioids are strong pain medications. They can help if you have severe short-term (acute) pain — like pain after surgery or for a broken bone. They can also help you manage pain if you have an illness like cancer. If you have cancer, you should speak to a doctor who specializes in pain medicine, such as a physician anesthesiologist, about which opioid or alternative treatment is best for you.

Opioids are powerful drugs, but they are usually not the best way to treat long-term (chronic) pain, such as arthritis, low back pain, or frequent headaches. If you take opioids for a long time to manage your chronic pain, you may be at risk of addiction. Before taking opioids for chronic pain, you should talk to your doctor about other options. Here’s why:

Opioids have serious side effects and risks.

Over time, your body gets used to opioids and they may stop providing pain relief as well. To get the same relief, you may need to take more and more. Higher doses can cause serious side effects, including:

  • Breathing problems and a slow heart rate, which can be deadly
  • Confusion and mental disturbances, like moodiness or outbursts of temper
  • Constipation

Opioids can be very addictive.

Up to one in four people who take opioids long-term become addicted. Worst of all, in 2017, data showed that 115 Americans die from an overdose of opioid painkillers every day, and hundreds more go to the emergency room.

Other pain treatments may work better and have fewer risks than opioids.

Talk to your doctor about trying these treatments before opioids:

  • Over-the-counter medicines:
    • Acetaminophen (Tylenol and generic)
    • Ibuprofen (Advil, Motrin IB, and generic)
    • Naproxen (Aleve and generic)
  • Non-drug treatments:
    • Exercise, physical and/or massage therapy
    • Counseling
    • Acupuncture
    • “Cold” therapy, known as cryotherapy
  • Interventional therapies:
    • Steroid injections
    • Radiofrequency ablation (using heat to target certain nerves)
    • Neuromodulation (nerve stimulation)
  • Other prescription drugs (ask about risks and side effects):
    • Anti-seizure drugs

Most insurance companies and Medicare will cover these treatments, but you can verify with your provider.

What should you do if your doctor prescribes opioids?

Talk to your doctor about side effects, risks, and addiction — and make sure that you watch for them too. Things to look out for include unusual moodiness or outbursts of temper, cravings and unusual risk-taking. Take your medication as prescribed by your doctor and make sure you store and dispose of your opioids carefully:

  • Take your opioids exactly as your doctor prescribes and never share them with anyone else.
  • Store your medications in a place where children or others cannot access them.
  • Dispose of your expired, unwanted, and unused medications safely. The best way to do this is through local “take back” or “mail back” programs and medication drop boxes (located at police stations, Drug Enforcement Agency collection sites or pharmacies).

Ask your doctor about naloxone

Naloxone, or Narcan®, is a rescue drug for opioid overdose that has saved thousands of lives. It’s an injection or nasal spray that is used to reverse the effects of an opioid overdose. Naloxone should be administered as soon as possible by someone witnessing an overdose to quickly restore normal breathing. Opioid overdoses are usually accidental but can happen to anyone. If your doctor prescribes you opioids, ask if you should also get a prescription for naloxone.

This report is for you to use when talking with your health care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2018 ABIM Foundation. Developed in cooperation with the American Society of Anesthesiologists.