Chronic pain is a syndrome that may or may not have some underlying findable cause, such as back pain, neck pain or headaches. Most patients suffering from chronic pain will not require imaging acquisition via an MRI, as the findings rarely influence treatment of the pain source. However, in an instance where the source is difficult to pinpoint, serious, and actionable—such as a tumor or herniated disc—further investigation to determine the need for surgical intervention may be done by way of ordering an MRI.
The way in which chronic pain is addressed and treated has changed considerably over the last six months, influenced by new research and findings, as well as the opioid epidemic. The new thought process on prescription and use of opiate and narcotic pain medicines has been influenced by research finding that the use of such actually increases pain sensitivity and worsens symptoms, despite patients experiencing temporary symptom relief. The addictive potential of opiates is very high, as exhibited by the recent spike in deaths, emergency room visits, and accidental overdoses, all of which account for more deaths in the United States than car accidents. If a patient is actively taking one oxycodone tablet a day, there is an undeniable underlying risk, as avid users may accidentally forget the initial administration of the drug, or feel their pain warrants more, and end up overdosing by taking an additional tablet.
Patients suffering from both mental illness and chronic pain and are actively taking medication for both should proceed with caution. Class drugs called benzos that have ativan, valium, klonopin, or diazepam in their name are worsening the danger and life–threatening effects of opiates. Patients currently prescribed narcotic medications for anxiety or muscle relaxation should cease the use of said medication and seek a new alternative through advising by their primary care physician. If patients would rather eliminate the use of opiate pain medication, as the potential risks greatly outweigh the benefits, abrupt stoppage will lead to a short period of withdrawal symptoms, potentially three to five days. However, slowly tapering off the dosage is no longer required or necessarily recommended, as there are medications that will alleviate the withdrawal symptoms, such as flu–like symptoms, nausea, aches, jitteriness, and more. At Colorado Primary Health Care, we encourage patients to use non–narcotic pain medication for chronic pain management. There are medications like oral antidepressants, anti–seizure medications, anti-inflammatory medication, and topical medications and gels, that will assist in easing chronic pain.
Chronic pain can come with a heavy influence on mental health. Review of mental health in relation to anxiety or depression as a result of chronic pain is imperative. Patients suffering from such should seek an evaluation and help from their primary care physician. Other recommended treatments include physiological counseling, acupuncture, chiropractic treatment, massage therapy, tai chi, and yoga, among others, as they are all safe ways to try and cope with chronic pain in a healthy way.
For many years, it was a common thought that prescription opiate medications significantly aided chronic pain relief, but now we know that the risks outweigh the benefits. Not only do these medications cause long–term cognitive issues, but the potential for chronic fatigue and—more importantly—accidental overdose is enormous. A new nationwide recommendation has been made that requires patients on chronic narcotic prescriptions to undergo monthly drug screens via urine samples, along with prescriptions adjusted to nothing more than a monthly filling at a time.
If you are seeking help in getting off of opiate medications, contact Colorado Primary Health Care today to come up with a plan to regain control of your health.