Mind & Body
Managing Pain without Medication
7/4/2018 10:42:27 PM
Pain management

In the United States, pain is the most common complaint that leads patients to seek medical care. While over-the-counter pain relievers and other conservative measures are usually adequate to make a mild headache or muscle ache feel better, chronic headaches, back pain, surgery recovery, sports injuries, and accidents usually require physician care for pain management. To help alleviate and manage pain, patients often receive prescription medications — many of them powerful opioids. While opioids are appropriate for the management of acute pain in the short term, their role in the management of chronic pain is very problematic.

An opioid is a type of pain medication that can have serious side effects if used correctly, incorrectly or for prolonged periods of time. Typical side effects include drowsiness, nausea, vomiting, constipation, endocrine abnormalities, psychological issues, and actually can lead to increased pain. Prolonged use increases the risk of tolerance, dependence, and addiction. 

Although opioid use for acute/postsurgical pain and palliative care is accepted, the controversy continues concerning their long-term use for the treatment of chronic pain. Dr. Joseph Crookshank III, MD, board certified Interventional Pain Management Specialist and Anesthesiologist with the Center for Orthopedics, an affiliate of Imperial Health, seeks to provide other options. These options include non-opioid based multimodal treatment as an alternative, and in most cases, preferred, option to treat chronic pain while avoiding the unfavorable side effect profile of opioids.

"The primary goal of chronic pain treatment is to maximize function while providing true, long-term pain relief,” says Dr. Crookshank. "Ideally, this is accomplished by treating the multiple causes of chronic pain directly, which decreases a person’s reliance, or chance of reliance, on powerful opioids. The non-opioid multimodal therapy model uses a combination of non-narcotic pain medicines, physical therapy, psychology and procedures to treat the whole person and the pathology. I practice these methods with a focus on improving and restoring functionality, quality of life and ability to perform activities of daily living as quickly as possible without the reliance on medications.”

Dr. Crookshank says these goals are achieved through the use of minimally invasive, outpatient interventions. The spectrum of potential interventions includes everything from injections to the implantation of spinal cord stimulators. "These treatments are tailored for each patient to help optimize chronic conditions in an effort to help restore a patient’s quality of life.” 

He describes the building blocks of multimodal methods and how they work with your body:
  • Interventional pain management uses minimally invasive "interventions” to block the formation, production, propagation, and transmission of pain signals to the brain through methods including injections, nerve blocks, spinal cord stimulation and kyphoplasty. These treatment strategies allow for selective targeting of injured and painful body areas, while minimizing complications such as infection, bleeding, recovery time, and further injury.
  • Behavioral and psychological approaches for addressing pain focus on the mind-body relationship and consist of techniques including relaxation and stress reduction training, cognitive behavioral therapy (CBT), communication skills and flare management.
  • Complementary therapies include passive modalities such as acupuncture/accupressure, hypnosis, occupational and physical therapy, massage, and transcutaneous electrical nerve stimulation; and active modalities such as relaxation, biofeedback, deep breathing, guided imagery, distraction and visualization.
The bottom-line is non-opioid pain treatment should be a first-line approach whenever possible after the initial injury or trauma is addressed, adds Dr. Crookshank. "We’ve had great success using multimodal methods to help people return to a productive life.” 

For more information about pain management using these treatments, call Dr. Crookshank at Center for Orthopaedics,(337) 721-7236.
Posted by: Haley Armand Tarasiewicz | Submit comment | Tell a friend

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