“You can’t talk about pain without addressing the use of opioids, because of their potent ability to reduce pain,” said Yili Huang, DO, board certified pain management anesthesiologist and director of the Phelps Pain Center .
Opioids can be effective for acute pain, such as that resulting from an injury or surgery, but they should only be used for a period of 3-7 days. They may also be helpful in providing comfort as part of palliative care or to diminish pain caused by cancer, but beyond that, there is very little room for long-term opioid use. Opioids have not only been shown to be ineffective for chronic musculoskeletal pain, nerve pain or inflammatory pain, but patients are at risk for becoming reliant on them.
Opioids affect the brain, not the pain
Opioids don’t target the underlying reason for pain; rather, they affect the brain, blocking the message that pain is passing through. There are multiple receptors for pain, so while the brain on opioids might not register it, the actual source of pain is still there. As time goes on, opioids become less effective because the source of pain will knock on that door harder and harder until the pain is felt, resulting in a need for more opioids. This creates tolerance.
Pain stays as more problems arise -- click here for more information
Fortunately, there are other options for treating pain. These alternative methods, which target the pain signal closer to the source, should be considered before opioids are prescribed. Minimally invasive, image-guided treatments can put medication exactly where it is needed. If there is nerve pain anywhere in the body or the spine, a nerve block can be injected directly into the point where the pain originates. Painful nerves can even be safely burned or frozen. In addition, nerves causing the pain can be stimulated to turn off the painful signal.
There is a new treatment for chronic pain that involves the Dorsal Root Ganglion (DRG). The treatment involves the placement of electrodes and a stimulation device that send impulses to a specific part of the DRG, blocking pain signals from reaching the brain. As a result, the brain doesn’t “feel” the pain.
Phelps Hospital is one of the first in the region to offer Coolief, which may be used to safely burn painful nerves that transmit the pain of knee arthritis prior to knee replacement surgery to improve post-operative recovery, pain and therapy.
“There are situations where opioids are appropriate, but they should not be the first treatment,” said Huang. “I think outside the box so that most times, my patients get relief without touching opioid pain medications.”
To read the full article in Phelps Today, click here .
If you are interested in learning more about opioid addiction, please join Phelps Hospital on May 3 for a discussion with Dr. Mark Russakoff, psychiatrist and Dr. Yili Huang, pain management specialist, titled How to Help with Opioid Addiction, Friends, Family, Self . Register today!