Issue link: http://viewer.e-digitaledition.com/i/872903
NON-PHARMACEUTICAL RECOMMENDATIONS TO ALLEVIATE CHRONIC PAIN TYPICALLY INCLUDE THESE OPTIONS: M I N I M I Z I N G O P I O I D M E D I C A T I O N A D D I C T I O N R I S K S When a patient's chronic pain level warrants the prescription of opioid-based medications, doctors generally follow federal and state guidelines like those listed below to minimize the risk of addiction: • Using the lowest effective dose of immediate-release opioids for the shortest possible time [Centers for Disease Control and Prevention (CDC)] • Conducting quarterly evaluations of patients to check for dose escalation (CDC) • Continually moving toward reducing or discontinuing the drug (CDC) • Using an electronic prescription system that can readily identify when, where and to whom opioid-based prescriptions are written and filled (New York State law). WEIGHT LOSS AQUA THERAPY PHYSICAL THERAPY (PT) FLEXIBILITY EXERCISES ELECTROCONVULSIVE THERAPY TAI CHI ACUPUNCTURE SURGERY is often one of the most effective non-medication solutions to improve chronic pain. "While many treatments only manage pain, in certain cases weight loss has the potential to reduce the pain significantly," Dr. Jafari says. Weight loss reduces the amount of pressure felt in the joints and muscles of the knees and back, which are often sources of chronic pain. It can also reduce the risk of inflammation, which often causes pain due to the effect that swollen tissues have on nerves. Additionally, weight loss is often recommended to help manage type 2 diabetes, which can cause diabetic neuropathy—a type of chronic pain triggered by nerve cell damage resulting from high glucose levels in the body. like stretching, yoga and tai chi are also believed to help reduce chronic pain by alleviating stress sometimes associated with recurring headaches and by strengthening muscles that can help better support painful joints. "Tai chi is an excellent example of what we call 'moving medication,'" says Dr. Jafari. "It's recommended by many pain specialists." programs can help patients improve strength and flexibility in muscles and joints associated with post-injury pain, joint pain or surgical pain. Physical therapists can also help teach patients proper body mechanics—how to sit, stand or complete tasks in a way that lessens pain. or water exercise can help build muscle strength without impacting painful joints. uses carefully placed electric shocks to cause neurochemical and neurophysiological effects in the body that help alleviate pain in some patients. which works by placing hair- thin needles into the body at prescribed points, is designed to ease chronic pain by affecting neurotransmitters that send pain signals back and forth within the body. This therapy works for some people, helping to alleviate chronic pain caused by headaches, muscle spasms, faulty joints, diabetic neuropathy, and pain associated with tumors or surgical procedures. When other measures fail, surgery may offer a solution in some instances of chronic pain. For example, decompression surgery may help alleviate nerve pain, while osteotomy (a procedure to repair bone) and arthroscopy (minimally invasive procedure to see inside the joint to diagnose and potentially repair problems) may help chronic joint pain. Surgery to remove a cancerous or benign growth may alleviate pain that is being caused by a tumor pressing against bone or an internal organ. Various surgical spine procedures and joint replacement procedures eliminate chronic pain in some patients. "I recommend that anyone who lives with chronic pain consult with their doctor to determine the best treatment options for the underlying cause of their pain," says Dr. Jafari. "A treatment plan involving several options can help manage pain in a way that greatly improves quality of life while diminishing the risk of treatment-related drug addiction." P H Y S I C I A N RE F E R R A L / / 718 . 49 9. C A RE 9