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For acute severe pain opioids make a lot of sense. They work quickly and well, and short-term side effects aren’t a significant issue.

However, for longer-term pain relief, opioids aren’t necessarily such a good idea. They have significant side effects and risks, and in many cases, researchers find that people who manage chronic pain with less opioid medication have better outcomes than those who rely more heavily on these potent drugs.1

  • In one study, researchers found that people using high doses of opioids for pain relief stayed off work 3 times longer than people who used lower doses.
  • In another study, researcher found that when people who had been long time opioid users received multidisciplinary pain treatment, tapering off opioids resulted in decreased pain and increased physical functioning.
  • Several studies have found a linear association between daily dose and overdose risk – the more you take each day, the more likely you are to overdose.

So then, if you need pain relief and you want to avoid or limit your opioid use, what are you supposed to do?

Well, by combining non-medication interventions with opioids you may find you can achieve acceptable pain management with a smaller daily dose – you may find that you can stop taking opioids completely or at least reduce your need.

So if you can achieve the same level of analgesia without opioids or on smaller doses, you eliminate or reduce troublesome side effects, risk of overdose, disability risks and addiction risks – and since many people find better long-term pain relief through self management strategies than with a medication centered approach, you really have little to lose and potentially much to gain with trying a comprehensive approach.

Here are some non-opioid pain management ideas to consider…

42 Non Opioid Pain Therapies

  1. Non opioid medications, such as NSAIDs, anticonvulsants, skeletal muscle relaxants, antidepressants and others.
  2. Topical creams or patches such as capsaicin therapy.2
  3. Topical lidocaine patches.
  4. Acupuncture or acupressure.
  5. Transcutaneous Electrical Nerve Stimulation (TENS).
  6. Spinal cord stimulation (an electrode implanted near your spinal cord can relax nerves that cause you pain).3
  7. Nerve blocks.
  8. Heat therapy.
  9. Cold therapy.
  10. Ultrasound.
  11. Splints.
  12. Strapping.
  13. Braces.
  14. Massage therapy and self massage.
  15. Steroids.
  16. Weight loss (if needed and will only relieve certain types of pain).
  17. Cognitive behavioral therapy.
  18. Education (not knowing what to expect or what symptoms truly mean increases stress and stress increases pain.)
  19. Psychotherapy (to alleviate co-occurring anxiety or depression).
  20. Acceptance and commitment therapy.
  21. Mindfulness meditation.
  22. Loving kindness meditation.
  23. Physical therapy.
  24. Strengthening exercises.
  25. Stretching.
  26. Learning and making use of pacing strategies.
  27. Improving nutrition or sleeping habits.
  28. Relaxation exercises (deep breathing exercises, progressive muscle relaxation, hypnotherapy and more.)
  29. Imagery exercises.
  30. Hydrotherapy.
  31. Distraction techniques.
  32. Biofeedback.
  33. Yoga.
  34. Hypnosis and self hypnosis.
  35. Aromatherapy.
  36. Laughter.
  37. Joint manipulation.
  38. Radiofrequency radioablation (deadening pain-causing nerves).4
  39. Pastoral therapy or spiritual exploration.
  40. Music, drama or art therapy.
  41. Social companionship (hanging out with people you enjoy or care about.)
  42. Desensitization (for neuropathic pain).5

This is far from a complete list of opioid alternatives for pain management. If you’ve had success with a pain management technique not on this list, please leave a comment below to share your knowledge and to extend this list of options.

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Page last updated May 07, 2014

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