Chronic pain is one of the most common reasons that people seek medical treatment, and a 2016 Center for Disease Control and Prevention (CDC) analysis found that 50 million Americans suffered from chronic pain, with 19.6 million of those falling in the category of “high-impact” chronic pain. Chronic non-cancer pain is defined as “any painful condition that persists for at least three months and is not associated with malignant disease.” This pain can interfere with daily activities, have a negative impact on quality of life and significantly decrease physical function.
Opioids are commonly prescribed for chronic non-cancer pain despite the fact that they show few long-term benefits and present the potential for serious, adverse effects. In recent years, there has been an increase in opioid-related deaths and unintentional overdoses. Given their limited efficacy as a long-term treatment and the serious risks that they present, the use of opioids for the treatment of chronic non-cancer pain should be limited, should only be part of a multimodal treatment plan and should be carefully monitored.
Chronic Non-Cancer Pain Guidelines
In an effort to reduce opioid misuse and overuse, in 2017 the CDC published a Guideline for Prescribing Opioids for Chronic Pain. The guidelines provide recommendations for providers who prescribe opioids to patients outside of cancer treatment, palliative care and end-of-life care. According to these guidelines, opioids should only be used for the treatment of chronic pain:
- When alternative treatments cannot be used or have not provided adequate pain relief AND
- Pain adversely affects the patient’s quality of life and ability to function AND
- The potential benefits of opioid use outweigh the potential harms AND
- The provider has discussed all risks, benefits and alternatives with the patient
Even in these limited situations, the guidelines clearly advice that opioids should only be continued if and when there is a well-documented benefit after a trial period.
Treatment of Chronic Non-Cancer Pain
Treatment options for chronic non-cancer pain generally fall into 6 categories: pharmacologic, physical medicine, behavioral medicine, neuromodulation, interventional and surgical. The best patient outcomes are often the result of multiple approaches used in conjunction with one another. As a rule, medication should not be the sole focus of the treatment plan and should only be used, as needed, in conjunction with other treatments.
Patients with chronic pain need ongoing evaluation, education and support. Additionally, it’s important to ensure that patients set reasonable expectations for their progress. For example, while current treatment models only average a 30% reduction in chronic pain, such a reduction can significantly improve a patient’s quality of life.
Opioids are often prescribed as a way to treat chronic non-cancer pain with limited results and exposing patients to substantial risks. At Glaser Pain Relief Center, we offer patients comprehensive treatment plans that combine a variety of treatments including physical therapy, lifestyle modifications, and a number of cutting-edge, minimally invasive procedures. If you are suffering from chronic pain, contact us today to schedule an evaluation so that we can create a safe and effective treatment plan to help relieve your pain as soon as possible.