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Opioid medications are among the most powerful pain relievers available and can be effective in managing severe short-term pain and cancer pain. However, side effects including nausea, vomiting, sleepiness, constipation, and dizziness leading to falls are common. Opioid addiction and death from overdoses are very serious issues that can occur with the use of opioids. If pain episodes can be managed using pain medications other than opioids, side effects and addiction risk can be minimized.
What evidence would support this?
A recent medical study revealed that in the emergency department, ibuprofen and acetaminophen (over-the-counter pain relievers) were shown to be as effective in managing moderate to severe short-term pain as opioids. Of the 104 study participants, only about 18% required an opioid due to failure of the ibuprofen/acetaminophen to manage the pain.
How does this apply to me?
There are many scenarios of moderate to severe short-term pain that can be successfully managed with ibuprofen/acetaminophen, without any need for opioids. In many cases, addiction to opioids often begins with short-term use of opioids. If opioids can be avoided altogether, serious side effects, as well as addiction and death from overdoses can be avoided. In most cases, acute pain episodes are time limited, and many patients can successfully get through the episode by taking over-the-counter pain relievers instead of opioids.
The people in the study aren’t like me and my pain is different.
The study patients had pain due to acute injuries involving their extremities (i.e. arms and legs), but it would be medically reasonable to apply the same concepts to many other conditions such as acute low back pain and other bodily aches and pains. It is important to note that severe pain, such as pain due to surgery or cancer, may require treatment with opioids. Furthermore, different types of pain (i.e. nerve pain) may respond better to other non-opioid, prescription pain medications.
What do I do if over-the-counter pain relievers aren’t working for me?
The first place to start is by visiting your primary care provider to make sure that there is not an underlying medical issue that is causing your pain, that might require a different treatment other than taking pain relievers. If there are no worrisome underlying conditions, then your primary care provider can refer you to the Pain Medicine Clinic, which can offer the full spectrum of treatments available. The treatments might include medications, physical therapy, cognitive behavioral therapy, injections, or possibly implanted devices to help manage the pain.
Helpful Links:
- Request an appointment
- Home Remedies: Self-care approaches to treating pain
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I agree with you tynne. Most if not all doctor's are young enough not to have experienced chronic pain. They really can't sympathize with you. Have you talked to a pain management doctor about trying a pain pump? I see a lot of people on this site haven't gotten significant relief with a pain pump. I believed Medicare will cover it. I to at 75yo have tried just about everything. I'm going to talk to my pain management doctor about one soon.
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1 ReactionThank you, Martyk. I hope whatever pain you are experiencing that you can find something to lessen your suffering.
At 72, the Neuro Surgeon said I was too old for a pain pump. I have a stimulator which has proven to be useless for relieving pain. Try locating an in-hospital clinic (not a pain mgt office) to obtain a script for something stronger than OTC pain reliever. You may have sign an agreement, outlining the medication use requirements and limitations.
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1 ReactionCorrection. I believe a lot of people say on this site, that they got significant pain relief with a pain pump.
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2 ReactionsI'm sorry to hear the SCS wasn't helpful and that you were told that you were to OLD to try a pain pump. Perhaps you should see another neurosurgeon or pain management doctor to get another opinion. My pain management doctor does prescribe Oxycodone. Good luck and God Bless.
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2 ReactionsHello
I just saw this comment about devices, and I have an interstim device located in my lower back; it is the second one I have had. It is a neurostimulator that helps me urinate. Because I have lost over 35 pounds, the device now protrudes from my back, and since I sleep on my back, the pain when I wake up is relentless. My urologist has offered to remove the device, but because it works so well, I will keep it intact. I use ice every morning, as well as prescribed pain medication. Because of my stomach/liver issues, I cannot take Ibuprofen or Tylenol. While I am attempting to use less of the opiates, it is difficult because the pain is always present.
You are correct that patients need to be aware of the issues associated with the implantable devices. The first one I had was in 2018, the second one in August 2022. The second one allowed me to have the MCRP the doctor wanted in order to further study my liver/pancreas. I am lucky that I have not had any broken leads or things of that nature, but I never anticipated the pain that would be associated with this weight loss. No back fat at all.
Sorry to hear that. I had a SCS Boston Scientific implanted in the area 2 1/2 years ago. I had it removed 2 months later because I was getting a lot of parathesia in the toes of my right foot. It did help reduce he pain in the toes but I couldn't take the parathesia. Perhaps I should have given it more time. The battery/generator did not cause any pain where it was implanted. Maybe at first it did but not for long. I guess I have a little bit more of a cushion there. The Boston Scientific representative told me recently that the devices they use now do not cause any parathesia. Have you talked to your doctor about a pain pump?
Thank you @martky. I have discussed a pain pump as well as pain patches with my doctor, but he is reluctant to prescribe either. I have been on a pain patch in the past, and that was very helpful. I went off the pain patch and switched to methadone because of the Medicare Donut Hole. I am no longer taking methadone, and now just using the Norco. While I have been encouraged to wean myself off of this medication, it is difficult because of the pain associated with the interstim device. Sometimes I do use Advil even though I have been told not to, because ibuprofen does help. However, I also know that the ibuprofen is bad for my stomach as I have had bleeding in my stomach in the past as a result of using too much ibuprofen. Ice has become my best friend these days.
I too have a lot of numbness and tingling in both legs and feet if I sit too long, but have been told that this is a result of all of the weight I have lost as a result of my liver problem. My neurologist has ordered me a donut pillow, which I need to follow up on. As a result of the numbness/tingling I probably spend more time standing than I want to. I am an artist and while I used to sit and do my work, I notice now I am standing more than 80 percent of the time, and this has created a host of other issues.
So you still have the interstim device. Are you referring to what they call a SCS...spinal cord stimulator still implanted even though it is not helping you but causing a problem?
replying to @martky, Yes it is a spinal cord stimulator. It is helping a great deal as I do not have to use catheters, which created a whole host of problems. The weight loss has caused the device to protrude from my back. I sleep on my back, and once I am asleep it is as though I am in a coffin. I don't move. Thus the reason I wake up with back pain everyday. A pressure relief mattress was provided, and that did help with the pain from the device, but the mattress itself was uncomfortable to say the least.