Dennis J. Bonner, MD

Non-Opioid Medication

Non-opioid Medications for Pain Management

Non-opioid Medications for Pain Management

 
 

Pain management medication is a simple way to get relief from pain and have a better healthy life. There are several types of pain, and their treatment varies depending on their nature.

Pain management depends on the kind of medication you may prefer. Opioid or non-opioid medication will decide your course of action with its consequential results.

In order to suggest why non-opioid medication may be a better pain management plan than opioid medication, we need to know about opioid medication. It will help you to understand the importance of non-opioid treatment to cure pain.

What are Opioids?

Opioids are drugs that come from poppy plants; they work on the brain to give different effects, including relief from pain.

Opioids will simply block the communication between your body and brain. In the short term, people will feel happy or “high,” and this feeling may lead to its addiction. Its worst side effects include slow breathing, constipation, nausea, and confusion.

While opioids relieve you from pain, they do not qualify as other painkillers such as Tylenol, aspirin, etc. Instead, common opioids include OxyContin, fentanyl, Vicodin, and a synthetic opioid, which is twice more potent than morphine.

This may give you a reason to understand why non-opioid treatment is better than an opioid-based treatment.

Non-Opioid Treatment

You may find non-opioids for reducing pain, such as over-the-counter medicines, like ibuprofen, acetaminophen, aspirin, etc. 

Other non-opioid treatments or non-drug remedies include acupuncture, massage, electrical methods, radio waves, and adjuvants.

Alternatives to Opioids

Today, many non-opioid pain remedies are available like ibuprofen, Tylenol), steroids, and aspirin. 

For some people, all these may look sufficient. But for others, it may not work; for such people, there are different non-drug therapy sessions. They may opt for therapy or combine some medication with it for better results. 

Physical therapy 

You can perform physical therapy under the guidance of a physician or a physical therapist. They will plan an exercise routine for you that may help decrease your pain. Additionally, you can opt for whirlpools, muscle massage, and ultrasound techniques to get positive results for curing pain.

Acupuncture

It involves needling your different body parts through your skin to prevent pain signals. This may help reduce your pain, eventually. No medicine means no fear of side effects.

Surgery

Surgery is the last resort to address your pain condition when all medication methods and medicine fail to respond to your pain. It deals with correcting the abnormalities in your body that may be causing pain in your body.

Injections or nerve blocks

Injections are another method to relieve your nerve pain or muscle spasms under local anesthesia.

Non-opioid Methods for Chronic Pain Management

There are options that, alone or in combination, may help manage your pain.

1.    Cold and heat

Heat enhances your pain threshold and relaxes muscles. Muscles get relaxed due to the steam effect.

Cold is useful to relieve pain after an injury. It lowers muscular spasm and inflammation. It’s a speedy form for recovering from pain. 

2.    Exercise 

You may combat pain by exercise to stay healthy. It’s also effective for a fluent joint motion that may also be good for your lower back pains and arthritis.

3.    Weight loss

Many pain conditions can immobilize you from certain physical activities and result in weight gain. Exercise offers many health benefits, and losing weight may be just one of those benefits. So exercise on a daily basis, little or more, depends on you.

4.    Physical and Occupation Therapy

Both therapies may help you regain your moving and walking ability. Occupational therapy works extensively to improve your ability to perform daily chores like dressing, eating, moving around, and bathing.

5.    Iontophoresis 

It’s another form of electric stimulation that may reduce inflammation, getting pain relief eventually.

6.    Ultrasound 

It makes sound waves travel into your tissues to help steady your blood circulation and decrease your inflammation at the same time. Thus, it helps in enhancing the healing process.

7.    Cold laser therapy 

Some medical facilities call it low-level laser therapy and use it to minimize pain effects. In this process, the cold laser will release pure light on solo-wavelength that will penetrate your injured or affected area. This will reduce inflammation encouraging tissue repairing.

High-tech Methods to Relieve Chronic Pain

Many patients may not find relief in non-opioid medication or treatment. For them, there are other new techniques that may help them in coping with pain. These methods may prevent the recurrence of pain.

Radio waves

Radiofrequency involves injecting a needle next to the nerve that may be causing pain. Radio waves burn this nerve by electric current. Its impact may last for a year or so.

Nerve blocks

This process uses X-ray images to identify the pain-area and source of damage. Your physician will inject numbing medicine in that area to block the pain. It may even block its recurrence. 

However, it may require a series of visits to the physician and repeat the treatment depending on your body response.

Electrical signals

TENS or Transcutaneous Electrical Nerve Stimulation is another electrical current method. It sends very low volt electric signals from its device to the painful body area through several pods linked to your skin. It has good results for all types of muscular pain. It interrupts nerve signals to the brain, or it stimulates the very presence of “feel good or happy” endorphins –these are your body’s natural painkillers.

Spinal cord stimulation

Spinal cord stimulation is the last option when all other methods fail to get pain relief, and the physician will recommend SCS.

It’s a method that involves implanting a small device in your lower back area, connecting it to a net of wires leading to your spinal cord. It replaces the pain with some more tolerable sensation like a tickle or massage-like feeling. The patient can use this device whenever pain surfaces. However, SCS helps relieve pain with tickling or tingling feelings.

It is excellent for patients with neuropathic conditions and numbness in limbs that is common with diabetics.

Pain pumps

Pain pumps are innovative in a way that patient feels differently while dealing with the pain without a medical help call. These are mostly in use for cancer-pain patients.

Special or specific pumps can get an implant that allows the patient to push a button to get the medication in case of pain. It’s a self-administering method. Pressing the button will shift or move the medicine from the pump to the spinal cord.

Non-opioid Medications

NSAIDs –Non-Steroidal Anti-Inflammatory Drugs

Ibuprofen, aspirin, naproxen, etc., are NSAIDs. These drugs weaken the level of prostaglandins (produced during inflammation), relieve pain, and lower redness. These NSAIDs inhibit COX2 that is vital for prostaglandins synthesis. 

You have to be careful when administering their dose with diabetics, elderly people, and people with asthma condition. 

Paracetamol (or Acetaminophen) 

Paracetamol carries antipyretic and analgesic character. It will not interfere across COX2 and components of inflammatory symptoms like redness and swelling.

Mild pain may be easy to cure effectively using paracetamol. 

Pain Management: Non-Opioid Medications

Acute Pain Management

Acetaminophen

People often use it to relieve the pain of mild-to-moderate levels and moderate-to-severe pain. Its IV (intravenous) form is also effective. 

IV acetaminophen has shown a high treatment level to reduce pain in comparison to placebo. IV acetaminophen should be good for patients who avoid oral intake of medicine. 

IV Ibuprofen

Ibuprofen IV form is there since 2009. IV ibuprofen has shown great results in reducing mild to moderate and moderate to severe pain. You may carefully administer it after diluting the product and then infuse it in a time of over 30 minutes.

Chronic Pain Management

A manifold approach may be ideal for pain management, particularly chronic pain. Some non-opioid medication types are good for use for both nociceptive and neuropathic pain.

Anticonvulsants

Gabapentin and pregabalin have efficacy and generalization for dealing with various neuropathic pains. 

In the early phase, , you should not exceed Gabapentin’s recommended dosage, i.e., 300 to 500 mg per day, to avoid any side-effects like dizziness. There are other anticonvulsants like lacosamide, lamotrigine, carbamazepine, topiramate, etc., that will help if the patient shows no improvement with other pain-reducing agents.

Serotonin and Norepinephrine Reuptake Inhibitors

It is good for managing diabetic peripheral neuropathy and musculoskeletal pain. 

You may see duloxetine as good for alleviating chronic pain and improving depression. It’s a typical dose for acute or severe pain conditions. 

Adjuvant Medication

It’s another effective solution that helps in treating or managing pain effects. Adjuvant medication includes antidepressants and anticonvulsants.

Their further division is corticosteroids, neuroleptics, and other medications with smaller adjuvant ability. Adjuvant drugs enhance or further the effects of pain management medicines. Adjuvant medication’s response is of optimal level when there's evidence of lower opioid response presence.

Conclusion

A medicine or drug that is not an opioid may have a more lasting effect. Manage your pain treatment using the non-opioid medication as they reduce your pain without getting a sleepy body or mind.