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Because of concerns with opioid medications, healthcare providers often recommend alternative treatments for pain relief. Both medication options and non-medication therapies can offer effective results.

Non-opioid medications and therapies are used for conditions, including:

  • Dental pain
  • Headache/migraines
  • Injuries, such as sprains/tendonitis
  • Kidney stone pain
  • Lower back pain
  • Minor postoperative pain

When opioid prescriptions are necessary, the medication should be used at the lowest, most effective dose for the shortest expected duration of pain. Examples of opioids include morphine, hydrocodone, oxycodone and fentanyl.

When controlling pain without the use of opioids, providers can turn to a wide range of solutions, including:

Medication

  • Acetaminophen
  • Lidocaine patches
  • Musculoskeletal agents
  • Topical capsaicin
  • Topical or oral non-steroidal anti-inflammatory drugs (NSAIDs)

Non-medication

  • Acupuncture - Thin needles inserted at specific points in the body relieve pain.
  • Heat - Reduces stiff joints and muscle pain by increasing blood flow and nutrients to the area. Ask your provider when to use heat and when to use cold compresses.
  • Ice - Relieves pain and reduces swelling. Use cold packs right after an injury to reduce inflammation.
  • Massage therapy - Relieves stress, anxiety and pain by relaxing muscles, tendons and joints
  • Spinal manipulation – A chiropractor, most often, applies a controlled force to a spinal joint to improve pain and function.
  • Transcutaneous electrical nerve stimulation (TENS) – A device sends mild currents that help relieve pain.
  • Yoga, tai chi and other exercises – These activities stretch and strengthen muscles through poses and movements.

Pain management for those 65 years and older

Adults 65 years and older have an increased risk of opioid and non-opioid side effects. Patients and providers should review risks and benefits, as well as pain goals when discussing treatment options.

You will need to consider:

  • Cognitive impairment
  • Drug-drug interactions
  • Fall risk
  • Use of shortest duration of therapy
  • Use of the lowest effective dose
  • Use, dose, and duration of medications, especially NSAIDs, TCAs, opioids, anti-seizure agents

Contact us at SQCN@sentara.com for more information.