When it comes to treating chronic pain, pain lasting longer than 3 months or past the time of normal tissue healing, there are a lot of opinions, ideas and misinformation out there. While there is still much to be studied about the treatment of chronic pain, we do have data to help dispel common myths about chronic pain treatment.
While many patients would hope finding the right medications alone would completely relieve their chronic pain, that is often not the case. The American Chronic Pain Association states that perhaps the best that medication, injections or surgery has done so far, or can ever do for you, is give 25 to 30 percent relief of chronic pain.
For further relief, there are many pain management techniques and self-care skills that can be utilized and/or learned. Some techniques change the way the brain processes pain, like cognitive behavioral therapy (CBT), relaxation techniques, guided imagery, and mindfulness . While other techniques focus more on physical aspects such as point massage, which may help release painful “knots”. Optimal chronic pain management takes a team effort, between the individual and health care providers, to treat the multiple drivers of chronic pain.
Many people believe that because a doctor has experience, education and expertise, they should rely on them to provide a protocol for pain management. While doctors may be experts on diagnosis, disease and treatments, the patient is the expert on their own goals for life, healthcare and certain information about their body that can influence their care.
For instance, a patient would know and should communicate if they are feeling depressed. Chronic pain and depression often go together, and each can make the other worse. Working together with your healthcare provider to decide on the best treatment for you, taking all important factors into consideration, is an optimal approach to pain management.
While taking more medication may seem to work for acute pain, taking more than a doctor has prescribed can actually cause problems instead of working better. Taking more medication can lead to increased side effects or adverse effects from the medication. For instance, taking more of an opioid than recommended or combining opioids with other medications without a doctor’s consent can lead to serious health complications, like respiratory depression.
When it comes to long term opioid use, some studies suggest taking less over time while trying alternative therapies, such as non-pharmacologic and self-management strategies, may actually in some cases help with pain, function and quality of life.
Pain medications mainly help the symptoms of pain. Rather than focusing on trying to mask the pain, some emphasize trying to correct the cause of pain as much as possible. If something has been identified as contributing to pain that can be corrected, like losing weight to lighten load on some joints or releasing muscle knots through massage, then efforts focused on correcting the cause of pain rather than just taking more medication may be helpful.
Prolonged use of opioids may result in problems including hyperalgesia (increased pain sensitivity), hormonal effects (decreased testosterone levels), impaired sleep patterns, constipation, dizziness and drowsiness. The prolonged use of opioids can cause tolerance and physical dependence, which are different than addiction. However, opioids can lead to addiction. Addiction to opioids, also known as opioid use disorder, is not from moral failure - even moral people can become addicted to opioids.
Addiction is a primary, chronic disease of brain reward, motivation, memory, and related circuitry where an individual continues to crave and use the drug, despite harm. While there are risk factors for some people to be at higher risk for addiction, it’s important to weigh the potential risk versus benefit for all medications and they need to be taken responsibly and seriously.
To reduce the chances of addiction or problems with opioids, you should take opioids only for as long as your doctor or nurse prescribes and only at the dose he or she recommends and never take opioids that were not prescribed to you. If the problem you were taking the opioids for gets better or the medications are no longer being used, make sure to dispose of them safely and do not keep unnecessary opioids around the house.
While pain medications do come with risks, there are certainly times when they should be used. When it comes to taking medications, it’s important to make decisions about continuing, changing or stopping them based off of an understanding of the potential for both benefit and risk. Medications should only be used if the benefits outweigh the potential harms or risks. Pain management regimens can be individualized to the patient and sometimes multiple medications aimed at more than just one pain-causing factor may need to be used together.
Misinformation about pain medications and chronic pain can be detrimental to your health. It’s important to speak with your healthcare provider before beginning, ending or attempting a new treatment regimen. In cases where you have questions regarding your prescription medication, drug interactions or side effects an IWP Pharmacist can assist you. Visit our Contact Us page to reach out to a Pharmacist directly.