For years, opioids were the main option for treating moderate to severe pain. They can be effective, but the opioid crisis has proven that these drugs can also be dangerous. If you take them, you run the risk of serious side effects and addiction.
Health care providers and researchers have been looking for safer ways to treat pain. Today, you have more options than ever that can give you relief while lowering the risks that come with opioids.
"The future of pain management is moving away from opioids and toward safer, more effective alternatives," said Nolan Fisher, DO, a physical medicine and rehabilitation specialist with Banner - University Medicine. People have access to a growing number of options.
Key trends driving change
There are a few factors behind the growing number of options for pain relief, including:
- Changes in recommendations: Stricter guidelines for prescribing opioids encourage trying other treatments.
- Advances in research: Studies on nerve stimulation and mindfulness are expanding pain management options.
- Demand: More people are looking for natural, non-addictive ways to manage pain without opioids.
Non-opioid medications for pain relief
"Opioid medications have undesirable side effects which has led to them falling out of favor for anything but acute pain," Dr. Fisher said. But opioids and surgery aren’t the only ways to treat pain. You can manage many conditions with other medications that have a lower risk of addiction.
"Alternative pain management methods are an important change in how treating pain has evolved over the past 20 to 30 years," Dr. Fisher said. These options include methods that focus on long-term health instead of just short-term relief.
Many of these new options either decrease inflammation or interrupt pain signals. They include:
- NSAIDs (nonsteroidal anti-inflammatory drugs): Over-the-counter (OTC) and prescription medications like ibuprofen and naproxen help reduce inflammation and pain.
- Acetaminophen (Tylenol): This is often used for mild to moderate pain but you should be careful with it to avoid liver damage.
- Antidepressants and anticonvulsants: Medications like amitriptyline, gabapentin and pregabalin can help with nerve-related pain, migraines and fibromyalgia. "Medications that alter chemicals such as serotonin and norepinephrine can help with how our body processes pain," Dr. Fisher said. "Other medications can alter how our nerves respond to pain."
- New non-opioid treatments: Researchers are studying new pain-relief medications that target pain pathways differently than opioids.
Medical cannabis: What to consider
Some studies suggest that medical cannabis, particularly CBD (cannabidiol) and THC (tetrahydrocannabinol), may help reduce pain and inflammation. However, more research is needed.
"The labeling of cannabis as a schedule 1 drug meant that there was little research done on it for pain relief up until recently," Dr. Fisher said. "While I have a few patients who use cannabis for pain relief, I encourage people to try more targeted and better-researched options."
“Our treatment options are always evolving as more research is done. My opinion may change later but based on my current understanding of the available research, I do not recommend cannabis as a replacement for other pain-relieving treatments,” he said.
Non-drug approaches to pain management
You can manage many pain conditions without medication. Alternative therapies like these are gaining popularity, especially for chronic pain.
- Steroid injections: "Corticosteroid injections have been used for over 70 years for a reason — they work," Dr. Fisher said.
- Physical therapy and exercise: Strengthening muscles and improving flexibility can help reduce pain over time. "Physical therapy has been shown over and over again to decrease pain and increase function," Dr. Fisher said.
- Mindfulness and meditation: Practices like deep breathing and guided imagery can help you manage your perception of pain.
- Acupuncture, massage and chiropractic care: These treatments provide relief for some pain conditions.
- Topical treatments: Creams, ice, heat and massage can provide temporary pain relief.
- Neuromodulation: Spinal cord stimulation, dorsal root ganglion stimulation and peripheral nerve stimulation can help disrupt pain signals. "This is a way for us to prevent painful signals from reaching the brain," Dr. Fisher said. "We do this by putting a small implantable device along those nerves."
Be cautious if you’re considering treatment with stem cells. "I get a lot of questions about stem cells as a treatment for pain," Dr. Fisher said. "Unfortunately, the evidence doesn’t show them to be as effective as other options. Before you spend thousands of dollars on stem cells, exhaust your other options and ask about what research shows is effective for your issue."
Integrative medicine and pain management
"Treating pain is unique compared to other areas of medicine," Dr. Fisher said. "Lab results and imaging findings make fields like cardiology and oncology more objective. With pain, we are unable to feel what the patient is feeling."
Integrative medicine combines conventional treatments with alternative approaches to create a comprehensive pain management plan. This strategy can include a mix of medications, therapy and lifestyle modifications to provide pain relief.
If you’re interested in exploring integrative medicine, here are some tips:
- Talk to your provider: A health care provider can help guide your treatment options and make sure you use alternative therapies safely.
- Personalized plans work best: No single treatment works for everyone — finding the right combination is key.
- Stay informed: As research continues, new pain management options will likely become available.
- Don’t overlook the basics: "Nothing in medicine can replace diet, exercise and sleep," Dr. Fisher said. "Improving these three areas will help every aspect of your health, including pain."
The bottom line
Alternative pain management options are growing, giving you more choices other than opioids to manage pain safely and effectively. Non-opioid medications, holistic approaches and other treatments are all options today.
“Our goal is to help relieve your pain and restore your function, so you can live life to its fullest. As technology advances, we will continue to use more targeted treatment options to do this,” Dr. Fisher said.
If you’d like to find out more about the pain management options that may work for you, talk to your health care provider or reach out to an expert at Banner Health.
