Doctors urged to prescribe fewer painkillers: Here's what to take instead

Amid a national wave of opioid addiction, doctors are likely to start prescribing fewer narcotic painkillers, so many non-addicted pain patients may see their dosages reduced as a result.

Millions without addiction issues suffer from chronic pain and rely on strong medication to help them live and work. Reducing the medication they need may seem unfair, but there’s no easy choice in the battle against America’s surging opiate addiction problem.

About 1.9 million Americans are addicted to prescription pain relievers, which is often a precursor to heroin addiction, according to the American Society of Addiction Medicine (ASAM). Prescription narcotics have become harder to get due to statewide registries, and heroin is much cheaper. As a result, 4 out of 5 new heroin users report having started out misusing prescription painkillers like OxyContin and Percocet, according to ASAM.

In the face of the rising epidemic, the Centers for Disease Control and Prevention (CDC) has issued new guidelines for doctors who prescribe pain medications. Specifically, the CDC calls on doctors to prescribe the lowest effective dosages first, taper back dosages as soon as pain starts to subside and evaluate patients every three months for misuse.

If you suffer from chronic pain, a doctor’s evaluation could mean a lower dosage of your regular drugs, and one possible result is worsening pain. Depending on your type of pain and its source, you may be able to help manage it with one of these alternatives.

NSAIDs and aspirin

Nonsteroidal anti-inflammatory drugs can be an acceptable option for chronic pain. Some are available by prescription, but many effective varieties are found over the counter in drugstores, including ibuprofen, aspirin and naproxen. Acetaminophen (Tylenol) is not an NSAID but has a similar pain-reducing effect.

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Which is right for you will depend on the nature of your pain and whether you have any kidney or liver conditions, says Dr. Amir Rafizad, pain medicine physician with Hoag Orthopedic Institute in Irvine, California.

“As helpful as NSAIDs are in medicine, they can lead to gastrointestinal bleeding, cardiovascular disease and renal damage if not monitored properly,” says Rafizad. In this regard, he adds, there are times when narcotics are safer than NSAIDs. Talk to your doctor about a healthy balance between pain medications and whether you should try a prescription NSAID.

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Certain exercises may be able to relieve your symptoms, especially if your chronic pain is in your joints or back. Walking, strength training, yoga and swimming are all low-impact exercises that can strengthen your muscles so they’re strained less day to day, helping you feel less pain.

Exercise also releases feel-good chemicals in the brain that help relieve pain on the spot. If you have serious knee or hip pain, you’ll want to check with your doctor about which types of exercise will help or harm your joints.

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Widely touted as a holistic procedure that works, acupuncture can provide relief from certain kinds of chronic pain, according to some studies; other studies show no benefit. Rafizad says that while acupuncture can indeed provide relief to some, “more often than not, the benefits dissipate a few days after treatment, and repeated treatments are needed to maintain the effect.”

Acupuncture appears to have few side effects, so many doctors like Rafizad don’t mind their patients using it as a complement to medical pain therapy. Some health insurance plans cover acupuncture, but many do not cover any alternative therapies, and something like acupuncture can get expensive over time. To know whether your insurer will help pay for acupuncture, check your insurance benefits summary and get your doctor’s referral, if needed.

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Chiropractors are nonmedical professionals who work to improve body function and pain measures by aligning the spine. Seeing a chiropractor for your pain may help if you have certain conditions.

If your pain derives from soft-tissue conditions such as bursitis or tendinitis, or from spasmodic conditions like cervical dystonia, a chiropractor may be able to help you, Rafizad says. However, he cautions that, like acupuncture, chiropractic care should be used as a complement to your medical care and not as a replacement.

Pain-coping methods

Perception of pain changes from person to person. To cope with pain and help lessen its impact on your daily activities, try mindfulness meditation, prayer, relaxation techniques or biofeedback, says Rafizad. While none of these methods should replace your painkillers, they may help you better tolerate your pain.

Some people also find relief from transcutaneous electrical nerve stimulation machines, which use electrical pulses to prevent pain signals from reaching the brain. TENS units are available for under $50 online, and consist of a small machine with adhesive electrodes you stick near the pain site. Research findings are mixed on whether TENS units work long-term for pain or just reduce it while the machine is in use.

Chronic pain can be highly disruptive to your life, and it’s tempting to leap at possible solutions. But it’s important to run these options by your doctor. Doing so will help ensure you get the right relief for your individual pain.