Fact or Myth: Treating Chronic Pain Without Opioids..Does It Work?

By: Marco Verch Professional Photographer and Speaker

 

It is no surprise that medication can be used for pain relief. How many of use an Advil or Tylenol every once in a while for a headache or joint pain? At times, just rest, ice or a heating pad will do the job. Unfortunately, for people dealing with chronic pain it’s not that easy. Until the recent opioid crisis, many people used opioids as the main way to treat their pain. From a legal standpoint, there are now stricter laws on what types of conditions they can be used for. Even though opioid use has led to many addictions and deaths, the law restriction makes it a lot harder for people who are actually dealing with chronic pain. Many doctors have chosen not to prescribe opioids because of drug abuse. So where does this leave those who need them for chronic pain? While some may not be open to it right away, research and medical professionals report that there are successful alternative ways to treat chronic pain aside from using only opioids.

For instance, the video below explains that hospitals are adapting alternative treatment methods for cancer patients dealing with chronic pain.

Massage and Healing Touch For Chronic Pain

By: Collin Parker

FACT: Regarding the video above, recent evidence from Gentile, Boselli, O’Neill, Yaguda, Bailey-Norton and Eaton (2018) suggest that using alternative methods like oncology massage and healing touch can reduce pain in cancer patients. The term “integrated oncology” refers to the widespread shift of using a combination of typical treatments and alternative therapies to target the mind, body and spirit of patients fighting cancer. Although the Centers for Disease Control (CDC) did not apply regulated guidelines of opioid use to cancer patients, The National Comprehensive Cancer Network (NCCN) and The American Society of Clinical Oncology (ASCO) have created guidelines focusing on the value of treatment approaches that are not geared only towards opioids (Gentile et al., 2018).

Since previous research exists only with smaller samples sizes (no more than 165 participants), researchers used a sample size of 572 cancer patients. They received one therapy session of oncology massage or healing touch. Healing touch focuses on regaining energetic balance within the body through light touch or hand sweeping motions. The idea is that any bad health has caused this energetic imbalance in the body (Gentile et al., 2018). Through healing touch, creating equal amounts of energy in the body helps to manage/alleviate pain. Oncology massage involves applying pressure at different areas of the body. Their pain was assessed before and after. Results showed that after both therapies, more than half of the patients reported significant pain relief as compared to before therapy (Gentile et al., 2018).


Addressing Pain: Mind, Body & Soul

The outcomes of using opioids are more negative than not. The video below represents the goal of focusing on an approach that looks at the whole person and not just providing opioids for neck, lower back pain, headaches or other muscle/joint pain conditions. For many patients, there are other areas of their life that can contribute to the pain.

FACT: Mehl-Madrona, Mainguy, and Plummer (2016) provide supporting evidence that pain can be deep-rooted in all aspects of life. Unlike cancer, the Centers for Disease Control placed regulations on use of opioids for other types of pain. With focus on treating the whole person (holistic approach), Mehl-Madrona et al. (2016) used psychological and behavioral treatment, mindfulness and physical exercise (also know as complementary and alternative medicine therapies) to treat chronic pain. Individuals experienced less pain, less need for opioids and better quality of life. Mehl-Madrona et al. (2016) used group medical visits (GMV) as their method for pain management. Patients could only receive opioid refills if they were willing to attend the group sessions. A nurse, behavioral health specialist and doctor specializing in behavior led the groups. There were 12 participants in a 2-hour group session. Within the groups, there were restrictions placed on obtaining medication. Opioids were monitored closely to make sure they were being used properly and refilled at the appropriate time. Patients continued group visits for almost 7½ months (Mehl-Madrona et al., 2016).

Goals of the group medical visit:

  • Understand benefit of complementary and alternative (CAM) therapies
  • Become aware of harmful effects of opioids for pain management and possibly reduce amount of opioids used per day
  • Improve quality of life
  • Use CAM therapies as apart of lifestyle
  • Be responsible for own health

Group included the following:

  • Talking circle (sharing of any personal feelings, life experiences, pain, and moods)
  • Physical activity (yoga, stretching, yoga, quigong, t’ai chi or authentic movement)
  • Mindfulness or visualization
  • Behavioral therapy goal and discussion
  • Homework assignments issued at the end of the session
  • Consistently reminding patients that use of opiates can enhance pain and are not an effective method of pain management.

By 7 months, healthcare professionals found that there were improvements in many of the group members. Out of 42 patients, 8 stopped using opioids, while 18 decreased the amount. It is reported that group members overall mood/attitude changed as compared to the beginning of the study. They had less pain with a better sense of quality of life and negative effects of relying only on opioids to manage pain. Some participants chose to continue group medical visits up for 19 months (Mehl-Madrona et al., 2016).


Can Tai Chi and Exercise A Day Make the Pain Go Away?

By: Boris Thaser

Chronic pain can also be improved by increasing physical activity. Some might assume that this can contribute to the pain. However, the video below explains that Tai Chi is used to treat chronic pain conditions like fibromyalgia.

FACT: According to Sawynok (2018), physical exercise is effective in treating chronic pain conditions like fibromyalgia. Aerobic exercise is a common treatment method suggested for pain management in patients with fibromyalgia. Between the years of 2010 and 2017, Tai Chi became more widely recognized as an alternative physical exercise approach. Alongside meditation and yoga, Tai Chi is considered a mindful exercise. When comparing both exercises, Sawynok (2018) found Tai Chi to be more effective than aerobic exercise. Additional evidence suggests Tai Chi is useful in treating other chronic pain conditions like low back pain and osteoporosis. In the current study, there were 226 participants split into 5 groups. Four groups performed a Tai Chi regimen for 12 or 24 weeks one or twice a week along with home exercise for 30 minutes a day. Participants performing aerobic exercise were expected to do so twice a week for 24 weeks (Sawynok, 2018).

           Group 1: Tai Chi once a day; 12 weeks; 30 minutes at home

            Group 2: Tai Chi twice a day; 12 weeks; 30 minutes at home

            Group 3: Tai Chi once a day; 24 weeks; 30 minutes at home

            Group 4: Tai Chi twice a day; 24 weeks 30 minutes at home

            Group 5: Aerobic Exercise twice a day; 24 weeks

Participants completed a questionnaire specific to assessing Fibromyalgia (Fibromyalgia Impact Questionnaire Revised) before and after 24 weeks. The questionnaire reviewed overall well-being: pain, depression fatigue, anxiety, physical function morning tiredness and job difficulty (Sawynok, 2018). The results demonstrated that participants that performed Tai Chi had more benefits than those who performed aerobic exercise. All 226 participants had improved pain. They were able to lessen their amount of opioids used by the end of the study. Although one was found to be more effective than the other, the point here is that physical exercise is found to be effective in treating chronic pain (Sawynok, 2018).


So here’s the point…

For those reading this and dealing with chronic pain I understand that it’s not always that simple. Not everyone’s pain can be treated by methods other than medication. But there’s one thing everyone should know: Opioids are NOT the ONLY way to treat chronic pain. Other ways exist and have been effective in individuals who have tried them. This is promising. Not only can these alternative pain management therapies treat the specific point on your body, but they can address other areas in your life that you may not realize are adding to physical pain. Trying some alternative methods can help to decrease the dosage of opioids prescribed. The idea is to avoid the “quick fix” mentality with opioids and view pain with a more holistic approach. Only a few alternative treatment methods were named today. However, there are many to choose from. None of the studies found that participants reported complete relief from pain. But, if your pain could be more manageable and offer an improved quality of life isn’t that something you would want?  Consult with your doctor regarding referral to a pain management specialist for more information about options that work best for you. 

References

Anderson, K. [Cancer treatment of America, CCTA]. (2015 August 18). 3 alternative options for pain management [Video File]. Retrieved from https://www.youtube.com/watch?v=sjEXT_Lwvog

Gentile, D., Boselli, D., O’Neill, G., Yaguda, S., Bailey-Dorton, C., & Eaton, T. (2018). Cancer Pain Relief After Healing Touch and Massage, The Journal of Alternative And Complementary Medicine. 24(9&10), p 968-973. DOI: 10.1089/acm.2018.0192

Mehl-Madrona, L., Mainguy, B. & Plummer, J. (2016). The Journal of Alternative and Complementary Medicine, 22(8), p. 621-626. DOI: 10.1089/acm.2015.0212

Sawynok, J. (2018). Benefits of Tai Chi for fibromyalgia. Pain Management, 8(4), p. 247-250. DOI: 10.2217/pmt-2018-0021

UCLA Health. (2017 September 13). Managing Chronic Pain Without Narcotics [Video File]. https://www.youtube.com/watch?v=SkAqOditKN0

WCVB Channel 5 Boston. (2018 April 19). Tai chi workout may make chronic pain easier to manage [Video File]. Retrieved fromhttps://www.youtube.com/watch?v=iatP4Ml9gNw

4 thoughts on “Fact or Myth: Treating Chronic Pain Without Opioids..Does It Work?”

  1. Hey!! great job on your blog I really enjoyed reading it, I was alittle curious as I did something similar but discussed CBD for inflammation and chronic pain. I am personally a believer in trying alternative routes for most medical management conditions but obviously do not discount medications. I had never heard of oncology massage until your blog, I will be researching it more. Curious in your research did you ever come across reiki for pain management? I know that it is used in burn centers and with pains who have chronic pain, was just curious what you had come across in terms of cancer. I enjoyed how you had videos to break up the page and reading, it had a very easy flow and explained each topic clearly. The images were appropriate and the first one with the pills in a hand was powerful, as opioid use have become an epidemic almost and kills a lot of people annually due to addiction. The lifestyle changes and incorporation of tai chai for example, psychology and treating the mind as well are key, depression with terminal diseases and chronic pain greatly effects treatment outcomes. Great post!!

  2. I really liked your blog post. I’ve heard from a lot of people how exercise can help people suffering with chronic pain, but I’ve never really done research on it. I think this is such an important topic, especially with the current opioid epidemic. The study you included on exercise for people with fibromyalgia was very interesting to me.

  3. Hi, this was a great post. I think with the prevalence and harmful effects of opioid use in the U.S. information about holistic treatment options needs to be more available in the mainstream media. Your post was well organized and informative. Addressing such a critical topic shows compassion and the true sprit of an aspiring health care professional. Well done!

  4. This blog was so informative and so well organized! I love learning about alternative methods to pain meds, and actually just recently learned about an oncology massage from a seminar I attended. Your blog was really easy to understand but also did a great job of educating. The tai chi video was also a great addition to your blog! Awesome job!

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