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What a relief!

Alternatives to opioids to manage chronic pain.

Article Author: Cat Prisco

Article Date:

non-opioid alternatives

Dealing with body aches every day can be a real pain in the neck. If you’re one of the 50 million Americans who suffer from chronic pain, you know it can make daily activities like sleeping or walking feel unbearable. It can also take a toll on your mental health.

Fortunately, there are ways to find relief. Many times, chronic pain is treated with over-the-counter pain relievers or prescribed opioids. However, opioids can cause unwanted side effects such as gastrointestinal (GI) issues, impaired mental function and possible addiction.

Marylin James, DO, family physician with Baptist Primary Care, tries not to prescribe opioids unless a patient is suffering from acute pain, which is pain that feels severe or comes on suddenly.

“When we talk about overall quality of life, some people may not be fully functional while taking opioids,” said Dr. James. “Even more concerning, opioid use can lead to addiction or overdose.”

Non-opioid alternatives

Dr. James’ approach to pain management varies on a case-by-case basis. Her options generally include non-invasive surgical methods, therapy, healthy lifestyle choices, or a combination of treatments.

Non-invasive surgical methods are best for patients who have nerve root pain, which originates from a damaged nerve. Some options include:

  • Steroid injections: This therapy can include just steroids or a combination of steroids and numbing medication, such as lidocaine. It can be injected into various places on the body, including joints, areas along the spine, or the fascia (a thin casing of connective tissue that surrounds organs).
  • Radiofrequency ablation (RFA): A technique that uses electrical current to heat up a small area of nerve tissue to stop it from transmitting pain signals. It typically targets the facet joints, which are the connections between the bones of the spine.

According to Aaron Martin, DO, a non-surgical spine specialist with Jacksonville Orthopaedic Institute, steroid injections can be beneficial when pain is caused by inflammation and irritation of nerves, joints and tendons.

“This treatment allows us to deliver a powerful anti-inflammatory medication directly to the affected tissue,” he explained. “Compared to medications taken orally, these injections deliver concentrated treatment where it is needed while decreasing side effects in the rest of the body."

Pain relief from RFA could last between 6 and 12 months. During RFA, a thin needle is inserted into the targeted area, followed by a radio frequency rod. A numbing medication is applied to the area being treated so patients can’t feel the procedure, and some patients may be sedated. If anything, patients may only notice numbness or a warm sensation.

How long and how well the remedies work vary depending on the patient, the cause of his or her pain, and which body part is afflicted.

Therapeutic options

There are a variety of ways to manage chronic pain through therapy, including:

  • Osteopathic manual therapy (OMT): A hands-on method of diagnosing and treating musculoskeletal conditions, such as sciatica or temporomandibular joint (TMJ) dysfunction. It is only performed by doctors of osteopathic medicine (DOs), according to Dr. James. It can be administered through several different techniques, ranging from soft-tissue (gentle) to joint-focused (more intense).
  • Physical therapy (PT): Retrains the body to have optimal function and brain-muscle connection. It helps patients unlearn the bad patterns that may have led to the chronic pain. PT also helps train the brain to connect to and “wake up” muscles that haven’t been used much or have been used in the wrong way.

Dr. James cautions that mindset is most important when it comes to OMT. “If a person is closed off to it or expecting a 100% resolution of pain with one treatment, he or she is probably not the right patient for it,” she said.

As for PT, the goal is to teach patients certain types of exercises and stretches to perform at home. It’s important to continue these 2-3 times a week, even after the typical 6-8 weeks of formal therapy sessions. Otherwise, symptoms can relapse.

Dr. Martin explained joints and soft tissue in the back may become injured or irritated due to lack of proper joint/spine stabilization, improper movement patterns and poor posture. A physical therapist can identify these underlying weaknesses and teach you how to move better to improve strength.

“Proper therapeutic exercises, when performed consistently, can lead to significant improvements in pain, function and quality of life,” Dr. Martin said.

Mind and body

Maintaining a healthy lifestyle can go a long way in managing chronic pain. Some recommendations from Dr. James include:

Mental health plays a large role in managing chronic pain.

“When patients start emotionally beating up their body, thinking, ‘My body sucks,’ or, ‘I have a bad back,’ it’s all negative language associated with that part of the body,” she said. “Instead, I recommend they think of that part of their body as a little kid. How would a child feel if you talked to him or her that way? Would the child want to heal? Instead, choose kind words such as, ‘I see you, I hear you, I love you.’”

She adds when people suffer from chronic pain, they tend to move less and less. This can facilitate a process called sensitization, which lowers the threshold to trigger pain. That’s why exercise is so critical.

“Of course you should listen to your body and not do things that are very painful,” Dr. James said. “But you can try light, gentle stretches every day, or pick a time to do easy walks.”

When to see a doctor

Once you start to experience pain that just won’t seem to go away, the earlier you can see your primary care physician, the better. Proper pain management from the beginning will help with better outcomes.

“If you wait on something until it becomes chronic, it can become harder to treat,” Dr. James said “It’s better to come in earlier than try and tough it out and wait.”


If you’re experiencing acute or chronic pain that interferes with your daily life, make an appointment with a Baptist Primary Care physician near you by calling 904.202.4YOU. Your primary care physician can help guide you through the next steps. To learn more about services offered at Jacksonville Orthopaedic Institute, call 904.564.2000.

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