What is Non-Opioid Treatment?
The United States is in the middle of an opioid epidemic on-par with some of the worst drug scourges in its long history. Physicians, activists, and lawmakers across the country are doing everything they can to combat the spread of opioid addiction and overdose deaths. Right here in the state of Florida, House Bill 21, a new law that went into effect on July 1st, has significantly changed how physicians prescribe narcotics to their patients and the types of treatments they can offer them. Under the new law, providers are limited to prescribing three-day supplies of narcotics, unless certain specific exceptions are met that allow a provider to prescribe longer-term prescriptions, up to seven days. The only exceptions to these prescribing limitations are for pain stemming from cancer, terminal illness, palliative care, or traumatic injuries with an Injury Severity Score higher than 9.
Pain Consultants of West Florida has always incorporated a number of non-opioid therapies that can be used alongside or in place of narcotic pain medication. These treatments can be used to control a variety of ailments and are all proven to have equal or, in some cases, greater efficacy than narcotics alone. Some of the most common non-opioid therapies we offer are:
Working with a physical therapist can help develop strength and coordination, reduce or eliminate pain, and improve your ability to function and carry out activities of daily living (ADLs). A physical therapy regimen will include stretching, strengthening and cardiovascular exercises aimed at strengthening the muscles, tendons and joints around and injury and correcting movement patterns that may have been adulterated by pain. The beauty of physical therapy is that these programs are often designed with longevity in mind, so you can continue to build on the foundation built in rehabilitation in your home or gym by simply sticking with your exercises after you’ve been discharged.
There are a variety of interventional injections that could provide relief from your pain in lieu of opioid medications. Examples of these injections include corticosteroids, epidurals, hyaluronic acid or facet injections. Also, spinal injections such as epidural, facet, radiofrequency and spinal cord stimulation, as well as, non-spinal injections that include PRP, Nerve Blocks, and Radiofrequency ablations.
A chiropractor is a medical professional who focuses on treating disorders of the musculoskeletal system through manual manipulation, meaning they physically move the body to eliminate pain and increase mobility. They do not prescribe medication of any kind, but rather focus on harnessing the power of manual therapies like spinal manipulation, mobilization, massage, and other adjunctive therapies to provide relief. Chiropractors can treat a wide variety of conditions and have had great success in managing musculoskeletal injuries without narcotic pain medication.
Transcutaneous electrical nerve stimulation (TENS) is an opioid-free treatment modality that harnesses the power of electrical impulses to relieve pain. It is a very low-risk, noninvasive treatment that uses electrodes (pads) place on directly on the skin to conduct electrical impulses to the site of injury. It is believed that TENS treatment works by essentially overstimulating the sensory nerve fibers around the injury, preventing pain signals from being processed by the brain, which leads to temporary pain relief.
Pain is, at its core, an incredibly complex and intricate reaction of the nervous system to internal and external stimuli. At times, there are psychological factors that compound a patient’s pain or make it more resistant to traditional treatment methods. In these cases, it is often advisable to pair traditional approaches to pain management with psychiatric care, in an effort to impact the psychological factors making the patient’s pain less treatable.
There are a number of non-narcotic pain medications that patients can buy over-the-counter (OTC) or with a prescription that are highly effective in controlling pain. The most common example is nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin and naproxen, which can be purchased OTC or at higher strengths with a prescription. If NSAIDs do not offer lasting relief for your pain, there are other options, such as muscle relaxers or anti-epileptic medications like gabapentin that offer stronger relief for chronic pain. Finally, tricyclic antidepressants have been shown to help alleviate chronic pain, partially neuropathic chronic pain, although the pathways through which these medications reduce pain are still not fully understood.