What is the Definition of Chronic Pain?
Chronic pain is a type of pain that continues or becomes worse over a long period of time, often beyond the normal healing time for an injury or illness. It can last for several months to many years and often affects physical and emotional well-being. Chronic pain can be continuous or intermittent and can range from mild to severe.
It’s often associated with conditions like arthritis, fibromyalgia, migraines, and nerve damage, among others. It’s important to note that chronic pain can also exist without any readily identifiable cause, making both treatment and pain management more complex. Chronic pain can have a serious impact on a person’s quality of life. This is especially true when the chronic pain sufferer does not have adequate relief or their pain is preventing them from doing things they used to enjoy.
The Challenge of Pain Management and Opioids
Opioids are the oldest and most effective category of analgesic (pain relieving) medications yet developed by humankind. For short-term moderate to severe pain, they remain a popular choice among healthcare professionals. However, there is no denying that the addictive nature of opioids makes their use problematic, to say the least. America’s OxyContin crisis was a tragic reminder of this, as is the ongoing fentanyl problem.
When it comes to chronic pain, opioid painkiller use is even trickier. The reason why is easy to understand. Opioid dependency, like any other addiction, is not the result of a lack of discipline or willpower. Opioid addiction is also not a moral failing. It’s a disease. The fact is that any person who uses opioids regularly for a period of more than a few weeks will develop a physical dependence upon them. This means that regardless of their psychological relationship with the drug, if they stop suddenly, they will experience uncomfortable physical withdrawal symptoms.
Which Conditions Are Associated With Chronic Pain?
Chronic pain includes a complex and wide-ranging set of symptoms. There are many potential causes for pain that persist for months or years. Unfortunately, the causes of chronic pain aren’t always immediately apparent. In some cases, extensive testing and even visiting multiple experts for different opinions may be necessary to narrow down a cause and work towards effective treatment.
There are a few conditions that are often associated with chronic pain, they include:
- Sports or Work Injuries: Muscle strains and injuries generally heal and improve with time, but sometimes more serious injuries or those that involve joints and ligaments or repetitive motion may persist.
- Chronic Back Pain: This can be due to conditions such as herniated discs, spinal stenosis, or degenerative disc disease.
- Complex Regional Pain Syndrome (CRPS): A form of chronic pain that usually affects an arm or a leg and typically develops after an injury, surgery, stroke or heart attack.
- Migraines: Chronic headaches that can cause severe throbbing pain, usually on one side of the head.
- Osteoarthritis: A degenerative joint disease that can cause chronic pain in the affected joints.
- Rheumatoid Arthritis: An autoimmune disease characterized by inflammation of the joints and surrounding tissues.
- Fibromyalgia: A condition characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues.
- Neuropathy (Peripheral or Diabetic): Damage to the peripheral nerves often resulting in chronic pain, particularly in the hands and feet.
- Endometriosis: A painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus.
- Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain and sometimes pelvic pain.
Managing Chronic Pain Without Opioids or Narcotics
As challenging as chronic pain and pain management can be, there are good reasons to have hope on this front. The opioid addiction epidemic in America has driven demand for non-narcotic and non-opioid pain medications. There has been a great deal of research and development done over the past two decades alone and it is yielding real results.
We may still be some years away from replacing opioids entirely, especially for severe short-term pain or palliative care – but there are many alternatives to opioids for treating chronic pain that didn’t even exist 20 years ago. If you or someone you love is living with chronic pain and opioid dependence is a concern, consider talking to your doctor about some of these alternatives.
Some non-narcotic chronic pain treatments include:
- Anticonvulsants: Medications originally used for epilepsy, such as gabapentin (Neurontin) and pregabalin (Lyrica), can be helpful for managing chronic pain.
- Antidepressants: Believe it or not, certain types like tricyclic antidepressants can be effective in treating nerve pain. For patients who also have a mood disorder, they may provide additional relief.
- Trigger Point Injections: Trigger point injections with medications like lidocaine or bupivacaine can provide temporary relief from muscle knots that cause pain.
- Corticosteroids: Corticosteroids can be especially effective at relieving acute pain flare-ups from chronic pain conditions like rheumatoid arthritis.
- Topical Analgesics: These include pain relieving creams, ointments, and patches that can relieve pain when applied to the skin.
- Transcutaneous Electrical Nerve Stimulation (TENS): TENS treatment involves using a medical device to send low-voltage electrical currents through the skin to alleviate pain.
- Physical Therapy: Physical therapy is a proven, natural solution for many chronic pain conditions and unlike medications, there are no side effects or downsides.
- Massage Therapy: Regular massage can help reduce muscle tension and chronic pain. Many health insurance plans provide coverage for massage therapy for chronic pain as well, so ask your doctor or insurance company about this option if you’re interested.
- Acupuncture: This ancient Chinese practice is proven to be effective in managing certain types of chronic pain. Some health insurance plans will cover acupuncture for chronic pain when it’s considered “medically necessary”.
Final Thoughts on Managing Chronic Pain Without Opioids
For people who live with chronic pain it can be challenging to find pain management solutions that avoid narcotic medications and dependence or addiction to opioids is a serious concern. Luckily there are more and better non-opioid pain management options than ever before.
The tremendous demand for safer ways to manage chronic pain has led to substantial investments in research and development of new medications and non-pharmaceutical treatments. We are hopeful and optimistic about the future of pain management for chronic pain.
We would also like to note that there are some concerns that some of the anticonvulsant medications listed above, like Neurontin, may have limited potential for abuse, so they are not always an ideal choice for someone in recovery. Talk to your doctor about this if that is a factor for you or your loved one.
Cottonwood Tucson: Treatment for Substance Use and Mood Disorders
Cottonwood Tucson has been the southwest’s premier mental health treatment center for over 25 years. If you or someone you love is living with chronic pain and has developed an opioid use disorder as a result, we are here to help. You and your loved ones deserve the very best care available and that’s precisely what Cottonwood Tucson provides.
The Cottonwood Tucson campus sits on 35 beautiful acres in the Sonoran Desert foothills. If you or someone you love could benefit from the exemplary care and innovative treatment Cottonwood is famous for, reach out to us anytime, 24 hours a day at (888) 433-1069.