Our approach to pain management is both simple and effective. We use a combination of medication and therapies to help our patients live as pain free as possible. In all cases, we seek better results, faster. This means that we carefully assess each patient, and determine what the best treatment options will be for everyone who comes to us for services. We then continuously monitor progress, introduce new, breakthrough techniques, and work together with patients to meet objectives. For all patients, the point of all this is a better life.
Painkillers for Chronic Pain
We regularly use painkillers to assist our patients. But as with all medications, we take a very careful approach. This is so important that the U.S. Centers for Disease Control have actually issued guidelines for prescribing a specific class of painkiller referred to as “opioids.” These are not the only way to treat chronic pain, but they can be highly effective, especially when managed carefully, under the supervision of a physician, and in combination with other therapies.
We have many years of experience treating both acute and chronic pain, so we’ve become quite familiar with the most common types of sports injuries, work and accident-related injuries, and the diseases and conditions that can cause long-term pain. Because of this, we tend to know what works fairly quickly after gathering a patient history, and have a good basis from which to start for any course of treatment. At the same time, the general guidelines that we referred to are a good thing to keep in mind if you are about to start your pain management journey.
A summary of the CDC’s recommendation for the use of opioids in pain management follows. We use these guidelines when prescribing pain killers and use a mix of medication and other therapies as part of most treatment plans. This gives our patients the best possible chance of meeting their goal of living their lives fully without being overly limited by pain.
CDC Opioid Guideline Summary
- If opioids are used, they should be combined with nonpharmacologic therapy and nonopioid pharmacologic therapy, as appropriate.
- Before starting opioid therapy for chronic pain, clinicians should establish treatment goals with all patients, including realistic goals for pain and function.
- Before starting and periodically during opioid therapy, clinicians should discuss with patients realistic benefits of opioid therapy and patient and clinician responsibilities for managing therapy.
- When starting opioid therapy for chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release/long-acting (ER/LA) opioids.
- When opioids are started, clinicians should prescribe the lowest effective dosage.
- Long-term opioid use often begins with treatment of acute pain. When opioids are used for acute pain, clinicians should prescribe the lowest effective dose of immediate-release opioids and should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids.
- If benefits do not outweigh harms of continued opioid therapy, clinicians should optimize other therapies and work with patients to taper opioids to lower dosages.
- Clinicians should review the patient’s history of controlled substance prescriptions using state prescription drug monitoring program (PDMP) data to determine whether the patient is receiving opioid dosages or dangerous combinations.
- When prescribing opioids for chronic pain, clinicians should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.
- Clinicians should avoid prescribing opioid pain medication and benzodiazepines concurrently whenever possible.