Pain, whether it is from surgery, injury, or chronic, can curtail daily activities. Pain can also cause frustration, annoyance, and a feeling of not wanting to do anything at all. When you are also in substance use recovery and need to manage pain, it may seem like there are no substitutes for prescription pain relievers. However, there are options to consider instead of opioid analgesics.
The physical feeling of pain stems from the communication between the nerves, brain, and spinal cord. There are several different types of pain, which all depend on the underlying cause. Also, you could feel more than one type of pain at the same time, which can be very challenging to manage or describe to your doctor or professional substance use professional. Let’s look a little further into the types of pain.
Types of Pain
Acute Pain – This is short-term pain that can come on suddenly with a specific cause. Acute pain lasts for fewer than six months and fades as the underlying cause is treated. It can be sharp or intense pain at first but generally improves and goes away in time. Common causes for acute pain are surgery, broken bones, cuts, burns, labor and childbirth, dental work.
Chronic Pain – This type of pain lasts for more than six months, and even when the original injury is healed. It can last for months to years and range from mild to severe on any day. Chronic pain is very common, affecting 50 million people in the U.S., per the Centers for Disease Control and Prevention. There can be different causes for chronic pain and sometimes, no cause at all. Chronic pain that is not treated can curtail daily activities. There are few kinds of common chronic pain:
- Frequent headaches, migraines
- Low back pain
- Nerve damage pain
- Arthritis pain
- Fibromyalgia pain
- Tense muscles, limited mobility, and lack of energy can also come with chronic pain.
High-Impact Pain – The National Institutes of Health reported that more than 10 million people have what is called high-impact chronic pain (HICP), which is characterized by pain lasting more than three months or longer and with at least one major activity restriction, such as not being able to do housework, unable to go to work, or not be able to take care of themselves. HICP can result in prescription medication abuse, which can lead to dependence and addiction. It can be very difficult to engage in the activities that someone without high-impact chronic pain can do. This can cause a person to be very stressed, anxious, and depressed. If in addiction recovery, HICP can lead to relapse. Chronic pain is no joy to live with, and high-impact pain can make life downright miserable. Fortunately, there are alternatives to prescription pain relievers that could make a real difference for you.
Nociceptive Pain – Nociceptors are commonly referred to as your “pain receptors.” They are free nerve endings located throughout the body, including your muscles, joints, bones, skin, and internal organs. They are vital in how you feel and react to pain. Their primary function is to respond to damage to the body by transmitting signals to the brain and spinal cord. This is how the pain from any cause is messaged from the body to the brain. Injury or inflammation of any type can cause nociceptive pain, and it can be either acute (short-term) or chronic. It can also be tagged as somatic or visceral.
Visceral Pain – This type of pain stems from damage or injuries to internal organs. It can be felt in the trunk of the body, which includes the pelvis, abdomen, or chest. Visceral pain is usually described as aching, pressure, cramping, or a squeezing sensation. It can cause other symptoms, too, like irritable bowel syndrome, gallstones, or appendicitis.
Somatic Pain – Somatic pain comes from the stimulation of pain receptors in the tissues. It includes skin, muscles, connective tissues, joints, and bones. It can be described as a constant aching or gnawing feeling and can be superficial or deep. Somatic pain can be easier to pinpoint than visceral pain. There are different types of somatic pain, including:
- Skin scrapes, cuts, or burns
- Strained muscles
- Bone fractures
- Cancer that affects the skin or bones
- Joint pain, including pain from arthritic bones and joints
- Connective tissue diseases, like osteoporosis
Neuropathic Pain – This kind of pain stems from damage or dysfunction of the nervous system. It can result in a dysfunctional or damaged misfire of pain signals. It seems to come out of nowhere. There are several common causes of neuropathic pain. These are:
- Central nervous system disorders (multiple sclerosis, Parkinson’s disease)
- Chronic alcohol consumption
- Facial nerve problems
- Carpal tunnel syndrome
- Spinal nerve inflammation or compression
- Chemotherapy drugs
Managing Pain Without Prescription Painkillers
Pain is a personal experience that is different for everyone. What could be very painful for one person might be less painful for another. How you feel pain depends on varying factors, like overall physical health and emotional health.
There are many different ways to manage pain without the use of prescription opioids. You may find that one or all are effective in helping to alleviate pain. For instance, taking acetaminophen before engaging in physical therapy exercises is an effective way to reduce pain from surgery or injury. Yoga and meditation can be effective in alleviating chronic pain.
Below, we look into the different ways of managing pain without prescription painkillers.
Physical therapy – Physical therapy can be one of the most effective ways of managing long-term, chronic pain or pain from injury or surgery. It improves strength, making you feel stronger, feel and move better. Physical therapists look for areas of weakness or stiffness in places where the pain is. Those areas are treated with specific exercises to ease the pain and improve mobility. You will most likely be doing low-impact exercises that raise your heart rate and are easy on the joints, such as walking on a treadmill or using an exercise bike. Strength exercises are also an important part of PT as they work on the core of the body and muscles using resistance bands, doing lunges and squats, and maybe push-ups, according to WebMD.
Exercise – Exercise is a great way to treat pain. There is a diverse range of exercises you can do to reduce chronic or joint and muscle pain. Walking for 30 minutes a day three to five days per week can increase endurance, heart health, and strength. Start slowly and work up to a longer, faster pace. Swimming, water walking, and other in-pool exercises can help with flexibility, mobility, weight loss, endurance, heart health, and more. Stretching exercises are essential to ease pain in the neck or lower back and are great to relieve stiffness and tension.
Yoga – Yoga connects the mind and body. It consists of three main elements: breathing exercises, physical postures, and meditation. It can help improve flexibility, lessen chronic pain, and reduce inflammation. It has also been effective in lessening pain perception and interference. Yoga may decrease your pain perception by disconnecting the negative feelings from the pain you might have. Practicing yoga is known to lessen neck pain and improve mood. It can also help change your outlook on life to a more positive one. If you were to try yoga and stick with it, it could be quite beneficial to you in several ways, such as mood improvement, improved flexibility, and reduced chronic pain and stress.
Massage therapy – Therapeutic massage is also a beneficial way to relieve pain without prescription medication. However, this is not the type of massage that is relaxing. Massage therapy’s primary focus is to relax painful muscles, tendons, and joints, relieve anxiety and stress, and stimulate nerve endings. Massage entails using different degrees of pressure from light to hard. Some people really benefit from deep tissue massage, which is very firm pressure, while others find it painful. Therapeutic massage for pain does not have to hurt to be effective. It is up to you to let the massage therapist know what type of pressure will be best for you.
Meditation, relaxation, deep breathing – Meditation is the practice of focusing your attention on one thing for a specific period of time. Stress kicks off the release of stress hormones that cause inflammation and increase pain in your aching joints. Meditation eases you into a quiet, calm state of mind, so your body isn’t triggering the release of stress hormones.
Mediation also releases the body’s natural pain relievers, endorphins, which in turn causes your muscles, tissues, and joints to be more relaxed, according to the Cleveland Clinic. Meditation has also been known to raise your pain tolerance, lower hypertension (high blood pressure), and deepen your respiration rate. There is a myriad of meditation-related exercises with music on the web. Try to find one that you like the best and give it a go for a few weeks.
Relaxing and deep breathing will help you breathe easier, relax more, and feel less pain. When you feel pain, you will have a tendency to hold your breath, freeze up, contract the muscles, and breathe more shallowly. Deep breathing releases the hormones nitrous oxide in the blood, which reduces tension in the body’s connective tissues and muscles.
Chiropractic Care – Chiropractic care is commonly related to body structure and works to help manipulate your spine so that your body is in correct alignment. Millions of people find pain relief from visiting a chiropractor. It can alleviate low back and neck pain; get rid of tension headache pain, migraine headache pain, shoulder pain, sacroiliac joint, and knee pain. When your body is adjusted, and your spine is in line, you might feel relief from the chronic pain caused by the conditions previously mentioned. Many health insurance plans cover chiropractic visits but with a limited number.
Acupuncture – Acupuncture is a traditional Chinese medicine that is supposed to rebalance the flow of energy through your body. It entails an acupuncturist inserting very thin needles through your skin at specific points on your body. It is most regularly used to treat pain. Western practitioners of acupuncture view this form of medicine as a way to stimulate nerves, muscles, and connective tissue and that it can boost the body’s natural painkillers. It is used to help with headaches, low back pain, osteoarthritis, next pain, menstrual cramps, and other ailments.
Cold and Heat – Localized pain, like that from an injury or surgery, can be reduced when you apply cold and heat to the area. This is a common practice that athletes use to recover from injuries and hard workouts that are backed by science. Cold and hot compresses help reduce inflammation and swelling. The heat stimulates the nerves and pain receptors, resulting in a release of endorphins, the body’s natural opioid. The rule is 15 on for both heat and cold compresses, followed by 15 minutes off.
Alternative to Opioid Pain Relievers
Non-steroidal anti-inflammatory drugs (NSAIDs): These are commonly taken to relieve pain when you do not or cannot take opioid analgesics. NSAIDs can be over-the-counter (OTC) options, like ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve), or prescription celecoxib (Celebrex) and others. NSAIDs hinder specific enzymes in the body called cyclooxygenase (COX), including COX-1 and COX-2. By blocking them, NSAIDs reduce pain and inflammation resulting from surgery or injury, as indicated by the Mayo Clinic. There are some risks when taking these for an extended time, like elevated blood pressure, stomach pain, nausea, and ulcers. Overall, they tend to work well for pain relief.
Acetaminophen: Acetaminophen is a common OTC pain medication used to treat mild-to-moderate pain. Tylenol is the most known this type of pain reliever. It works on pain but not on inflammation. Researchers think that it may block COX-3. Acetaminophen is generally considered a safer alternative to NSAIDs because it does not cause stomach pain or thin the blood. However, it can lead to liver or kidney damage if taken for a long time.
Glucocorticoid steroids: Glucocorticoid is a man-made glucocorticoid that is steroids occurring naturally in the body. They are beneficial in disrupting inflammation. This is done by the drug moving cells to suppress proteins that are the cause of inflammation. Some of the more commonly known glucocorticoid steroids are cortisone, prednisone, triamcinolone, and others.
Antidepressants: Antidepressants can reduce pain, and more so, chronic pain. Chronic pain can cause depression, and antidepressants may alleviate depressive symptoms. Anti-seizure medications are also good. Both types of medicines can help relieve chronic back pain, fibromyalgia, and diabetic neuropathy. It takes antidepressants a few weeks before they start working, but anti-seizure medicines start right away, quieting pain signals from nerve cells.
Anticonvulsants: The nerve-calming qualities of anticonvulsants can reduce the stabbing, shooting, or burning pain from severe nerve damage. Nerve conditions such as complex regional pain syndrome (CRPS) are usually managed by using gabapentin or pregabalin. Pain this bad can cause an individual to contemplate suicide. Anticonvulsants such as those might be helpful to manage pain.
Beta-blockers: Beta-blockers can help with many medical problems, like blood pressure, migraines, tremors, and pain. They block specific hormones in the nervous system, most notably, adrenaline. Adrenaline and noradrenaline prepare the muscles in the body for exertion, which is a vital aspect of responding to danger. If the levels of these two are too high, you could have a rapid heartbeat, heart palpitations, higher blood pressure, anxiety, and excessive sweating, according to Medical News Today. Beta-blockers may be prescribed to treat chronic pain from fibromyalgia.
You may try one of many of these with advice from your physician to help reduce pain.
How to Manage Chronic Pain in Recovery
There are some good options for managing pain in recovery. If you are still in addiction treatment, it is most likely that the medical and substance use professionals have worked with you to find the most effective ways to reduce the physical pain you feel. You may be involved in cognitive behavioral therapy, mindfulness therapy, and other forms of non-pharmacological therapies, as noted by this Substance Abuse and Mental Health Services Administration (SAMHSA) report.
If you have completed substance use disorder treatment and are home, the natural ways of dealing with chronic pain mentioned above might help. Those are:
- Physical therapy
- Mindfulness, deep breathing, relaxation exercises
Any activities that improve your mental health help ensure the body functions at its best to combat fatigue, illness and alleviate chronic pain without the use of prescription painkillers.
Pain management that is complicated with a substance use disorder or a history of it needs to be treated with a variety of alternatives to prescription opioids. It is best to discuss your concerns and the options with your physical and mental health providers.
Pain Management After Surgery or Injury
Pain management after surgery or injury is a legitimate concern. Most often, patients are given a prescription opioid in the hospital and sent home with another prescription painkiller, usually an opioid. However, it is important to be clear that doctors usually begin to wean the patient off of the opioid as soon as possible while still in the hospital or outpatient surgical center. They then might be sent home with a prescription with another painkiller, although the amount of the drug is for seven days and no longer.
The U.S. has tightened opioid prescriptions significantly in recent years. This has led some patients to find other ways to obtain painkillers, such as going to a pain management practice, using someone else’s prescription pain relievers, or buying them on the street, which is dangerous.
Prescription painkillers are meant to treat pain for a short time but are widely abused due to the effects they can cause. Some common painkillers are morphine, oxycodone, Oxycontin, hydrocodone, Vicodin, methadone, meperidine (Demerol) Darvocet, though it is not prescribed much anymore, fentanyl, which is not very often prescribed, Percocet, Suboxone, and Tramadol. Most of these are prescribed for moderate-to-severe pain.
They can also be misused by taking them too often or in higher doses for the effect of feeling “high.” It is vital to know that even if you take one of these opioids for legitimate pain relief, the possibility for tolerance, dependence, and addiction is real. Tolerance occurs when the body gets used to the drug, requiring more of it to feel the same effects as when originally taken. Dependence is signified when you start to feel withdrawal symptoms if you stop taking the opioid(s). Addiction is compulsively seeking out, obtaining, and using the drugs despite harmful consequences.
If you think you are addicted to prescription painkillers, give us a call. We can help you safely stop abusing them and get you on your personal road to recovery in managing pain in recovery with them.
People with a substance use disorder and who are in recovery, active or long-term, will need to find and use alternatives to prescription opioid analgesics. If you feel that your pain is too intense to manage without medication, and you have been engaged in non-pharmaceutical methods of pain reduction and get no relief, please contact your physician and ask for help.
If you are struggling with prescription pain medication addiction or have relapsed, we at California Highlands Addiction Treatment can help you stop abusing opioids and other drugs and learn successful ways of preventing relapse. Addiction is a disease that affects the mind, and it is treatable. Pain, chronic or acute, can derail your recovery and life. Get a handle on how to manage it when in recovery with us.