America is undergoing an opioid epidemic and as a result we are seeing many changes take place. These changes urge physicians, pharmacists, and even insurance companies to be more skeptical and deliberate about whom to prescribe opioid medications, the dose, and for how long. The overall concern is the addiction risk, but there is also concern that long-term use of opioids to treat chronic neck or back pain can worsen the pain with time.
How can opioids increase pain over time?
When an individual takes opioid medication over a long period of time, he may increase his sensitivity to pain. This is called as opioid-induced hyperalgesia. Although the exact mechanism on how this sensitivity developed is still being debated, scholars agree that it involves multiple factors.
Moreover, the amount of time opioid-induced hyperalgesia takes to develop vary from person to person. It is suggested that taking large doses of opioids for many months increases the risk of developing sensitivity. Recent evidence shows that the condition was developed within a month in many cases.
What are the differences between opioid tolerance and hyperalgesia?
Opioid Tolerance and Opioid-induced Hyperalgesia have a lot of similarities. With Opioid tolerance, your body has developed a tolerance for the opioid. It needs a heavier dose to get over the pain relief. So, if you have developed opioid tolerance, then your body will feel an increase in pain, even though the medication dosage has remained steady.
Hence, it is very important to regularly communicate with your doctor and inform the doctor if you notice even the slightest increase in pain or any other unusual side effects. Because if the doctor is alerted at an early stage, he or she can monitor the situation and suggest a change in medication or dosage to handle the situation.
Alternative treatment options
As we can, you can't use opioids as a long-term painkiller option. As it can increase chronic pain in your back and neck. Hence, the patient should look for alternative treatment options to manage their chronic pain. Some of these treatment options are:
- Transcutaneous electrical nerve stimulation (TENS)
- Exercise to maintain motion and release endorphins
- Cognitive-behavioral therapy to develop coping techniques
- Manual (massage) or topical (heat or cold) therapies
- Relaxation and meditation techniques to distract the brain from pain
Your doctor might also consider NSAIDs, CBD, or medical marijuana if it's legal in your state.
In many cases, doctors would still recommend opioid for short-term pain relief if the risk is likely to be undermined by the benefits. In such cases, your insurance company may contact your doctor to approve the use beyond a week considering the risk.
Other than this, we suggest that you carefully read the medication labels and follow the doctor's directions consistently for your own safety.