Drug free solutions to pain management
A lived daily experience of ongoing pain affects the lives of millions of Australians both directly and indirectly. For pain sufferers keen to reduce dependency on pharmaceutical drugs to manage pain, what are the alternatives?
Acute pain is often caused by physical trauma that damages your body and goes away as your body heals. With the right treatment plan in place to heal the cause of the pain, acute pain is a negative life event, but a short term one. Persistent pain or chronic pain is a far more complex experience and it can often be challenging to identify the source of the pain, complicating treatment options. The intensity of the experience can have profound impacts on sufferers’ daily lives.
“About 65 percent of people with chronic pain report interference with daily activities including sleep, sex, work, exercise and routine self-care, which can have a negative effect on personal relationships, social interactions and lifestyle.”
– Pain Australia.org.au
Current statistics are elusive or have not attracted the funded required recently, but in 2007 it was estimated that around 3.2 million Australians experienced chronic pain. The proportion of people experiencing persistent or chronic pain increases markedly in the over 65 age group.
Prescription of pain reduction medication has increased twenty fold since 1987 (as reported in Australian Government Department of Health Opioids Roundtable Outcomes Statement in 2016).
“In 2014, almost 3 million people in Australia were prescribed at least one opioid under the PBS or Repatriation PBS (RPBS). The most common prescriptions were for paracetamol with codeine (more than 1.7 million patients), followed by oxycodone (around 1 million patients). Utilisation is highest in older age groups. ...defined daily doses (DDDs, as defined by the World Health Organization) have increased approximately 20-fold since 1987.”
- Australian Government Department of Health, Opioids Roundtable Outcomes Statement, 2016
That doesn’t account for pain sufferers buying over the counter pharmaceutical drugs such as codeine products. The Therapeutic Goods Association (TGA) recently announced its decision that codeine products become prescription-only drugs as of February 2018.
Opioids act directly on your brain or nervous system to relieve you of some or all of the pain. Unfortunately, this relief can also become a problem in itself. Long term use of many pain relief medications can cause a physical dependency as your body builds up a tolerance to the dosage. Pain relief may be effective as you increase the dosage, but side effects such as constipation and drowsiness add to your daily burden. Crucially, pain medication does not actually fix the source of the pain and can even exacerbate it, if improving your physical condition is not a part of an overall treatment plan.
As with any physical or mental condition a multi-disciplinary approach, with medical practitioners working alongside multi-disciplinary allied health practitioners will give an optimal prognosis for the sufferer. It doesn’t take medical qualifications to understand that identifying and addressing the source of the pain, is the most effective way to design a treatment plan to alleviate it.
There lies the problem. The complexity and cost of making such an approach available to 3.2 million Australians has perhaps contributed to explosion of pain relief medication consumption.
Non-pharmacological chronic pain specialists and pain clinics are emerging but not at a rate to accommodate millions of sufferers.
To minimise the impact of pain on your life, here are some drug free alternative approaches to explore. Please ensure to work with your trusted medical adviser to explore how to go about reducing pain medication as you explore other treatment options.
Diarise your experience for a more targeted diagnosis
Keeping a detailed diary of your daily pain experiences can help you communicate clearly and concisely with your medical or allied health professional. Living with chronic pain can have you living each day feeling like your head is in a thick fog. It can cloud the way that you present your symptoms to your doctor. Here are some online tools to help you track your daily experience so that you can give your medical and health advisors a very clear picture of your experience.
Review your lifestyle to ensure you’re optimising your daily life
Chronic pain can motivate a cycle of unhealthy living. When you feel exhausted, making healthy food choices and committing to regular exercise can feel like an added burden. If you’re eating poorly and not exercising, you’ll feel lethargic, and down the spiral you go. Studies have shown that your sensitivity to pain increases when you’re sleep deprived. Make sure the following essential good health factors are in check:
- adequate and quality sleep each night
- healthy food choices make up the majority of your daily diet
- regular exercise is a part of your weekly routine
- you’re drinking sufficient water, and being sensible with your caffeine and alcohol intake.
Learn new ways to move and keep your posture strong
When you live with persistent or chronic pain, you might benefit from learning new ways to move that will minimise how much you hurt. Keeping your posture strong will ensure that your body is supporting your core well, so that you don’t trigger new sources of pain. Here are some practices you may want to explore further:
Osteopathy, physiotherapy, physiotherapists, myotherapists, occupational therapists, exercise physiologists and chiropractors are all health disciplines that may be able to offer postural and movement techniques to reduce your pain.
Cognitive Behaviour Therapy can help shift the way you view and cope with your pain
While your pain and discomfort is real, cognitive behaviour therapy (CBT) can help you change the way you think about your pain levels and enhance coping skills. Pain causes stress, and CBT can help change the way you manage the stress that stems from your pain.
Pain clinics offer a holistic pain reduction solution
A Pain Clinic offers pain management programs to bring multiple disciplines together to help you reduce your pain. A program may include some or all of the following specialists – psychologists; physiotherapists; pain specialists; neurosurgeons; spinal surgeons and occupational therapy. A pain clinic will also offer a medically supervised medication reduction plan and review any physical aides you’re using that may be impacting negatively on your pain management.
Disclaimer: the author of this article is not medically qualified to provide advice on chronic pain. This article is based on online research. Always consult with a medical professional before undertaking any new treatment plan.
Helpful online resources
What is pain? - Pain Australia
Pundendal Nerve - a lived experience blog
health.gov.au > Opioids Roundtable Outcomes Statement
The high price of pain: the economic impact of persistent pain in Australia; a report by Access Economics Pty Limited for MBF Foundation in collaboration with University of Sydney Pain Management Research Institute