Are there non-opioid alternative methods to fix chronic pain?

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Are there non-opioid alternative methods to fix chronic pain?

Pain is associated with various diseases and injuries, and patient should receive appropriate pain treatment at firsts. Opioids are not the first-line therapy for chronic pain except cancer treatment, palliative care and end-of-life care. Evidence suggests that non-opioid treatments can provide relief to those suffering from chronic pain and even are safer.

Thus, there are limited number of options for the treatment of chronic pain. Moreover, physicians are increasingly using opioids to treat chronic pain and the widespread use of the drugs has resulted in epidemic of opioid overdose.

Opioid medications can provide short term pain relief but these treatments fail to provide adequate pain relief in long run. Opioids decrease pain by blocking neurotransmitter release at nociceptors. Tolerance may develop over time which leads to escalation of dose, higher doses contributes to the release of inflammatory cytokines from glial cells inducing hyperalgesia.

Researchers of Tulane University are developing a pain treatment that can provide effective analgesia. They are investigating endomorphin analogs that may offer alternative to opioids for pain control. These analogs relieve pain by binding to the μ-opioid receptor, endomorphin induce analgesia with few side effects. This research could help making endorphin analogs as the new medications for pain management.

Spinal cord stimulation (SCS) may be a standard treatment for patients with chronic pain in their back and limbs who have not found pain relief from other treatments. Dorsal Root Ganglion (DRG) Stimulation has been shown to have reduced pain and is particularly useful in treating focal areas of pain. Further, new high-frequency (HF10, 10 kHz) form of spinal cord stimulation therapy has the capacity to deliver more effective pain relief without any unwanted side effects. HF10 Therapy is approved for chronic intractable pain of the trunk or limbs. Although promising, closed-loop SCS currently evaluated in clinical trials.

As per Joel Katz, PhD of York University in Canada, “Psychotherapy has been shown to play a major role in treating chronic pain”. A variety of psychotherapeutic techniques may be offered in the treatment of the pain. Cognitive Behavior Therapy (CBT), Mindfulness-based Stress Reduction (MBSR), and Acceptance and Commitment Therapy (ACT). “Even though the main objective of these forms of psychotherapy is not to reduce the intensity of pain but to improve quality-of-life, coping, and in general to contribute to a more meaningful life, pain intensity may also improve,” he said.

The best approach to preventing acute pain from becoming chronic. Most people who experience depression, pre-existing pain, or severe acute pain are linked to a high risk for chronic pain due to nervous system sensitization. However, Toronto General Hospital in Canada became the first centre to implement psychotherapy which aimed at preventing chronic postsurgical pain.

Clinical Pain Advisor
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