Drug-free Pain Relief: A Sardonic Review

As you probably know by now, the Centers for Disease Control and Prevention are preparing to release new guidelines to physicians on prescribing opioid analgesics. The gist: prescribe them a lot less, and in lower doses, because opioid pain relievers are addicting and killing patients.

Whether you agree with the CDC or not, the media has taken the “evil opioids” ball and run with it. Everyone from your grandma to this year’s presidential candidates are convinced that we must crack down on this dire menace to society. That we’re leaving legitimate chronic pain patients, who have never abused their opioid pain relievers and never will, to suffer debilitating pain and a much lowered quality of life doesn’t seem to matter much.

Instead of opioid analgesics that relieve pain quickly and easily, the CDC recommends that chronic pain patients should try non-drug pain relief options, such as cognitive behavior therapy, acupuncture, etc.

Of course, not one of these options (or “modalities,” as they’re known) will relieve the pain you’re suffering right now, at this moment. Not to worry. That doesn’t mean they won’t work at all.

In fact, many of these alternative pain relief methods can and do lessen pain to some degree. The big hitch: they take time, dedication, and lots of effort. But for your reading pleasure, and so the Powers That Be know we’re doing all we can to be good, aware, compliant chronic pain patients, I’m going to give you the run-down on these oft-referred-to alternatives to that small, white opioid pill. You know, the one that usually provides some measure of pain relief within minutes.

So you can get on with your life. Or sleep tonight. Or avoid suicide.

Cognitive Behavioral Therapy

This one is close to mine own heart, being the generally optimistic, positive idiot that I am. The Mayo Clinic states that CBT is a form of psychotherapy that “helps you become aware of inaccurate or negative thinking, so you can view challenging situations more clearly and respond to them in a more effective way.”

Simply put, it’s paying attention to your inner dialogue and re-vamping it toward the positive and away from the negative. Doing this can help you find the tools you need to cope with your fatigue and pain from rheumatoid disease. How? According to the American Chronic Pain Association, unhelpful thoughts and behaviors regarding your pain can lead to negative feelings, which in turn may increase your sensitivity to your pain. It’s a sort of vicious circle. CBT, they state, “includes a range of strategies aimed at enhancing coping skills, increasing confidence and self-efficacy for managing pain, and changing how individuals behave in response to pain.”

I know, it sounds, well, ridiculous. But for many people, it does actually work. It’s possible your insurance will cover the 10-20 sessions you’ll need to attend with a therapist.

Acupuncture

A 3,000-year-old technique of traditional Chinese medicine, acupuncture involves ultra-thin, metal needles tapped painlessly into the skin at various parts of the body. The intent is to direct an individual’s wayward chi,or life force, so that it runs as it should, thereby relieving pain.

Yes, it sound woo-woo (and it is), but often, amazingly, it works. I’ve tried it myself. The first time, it dramatically reduced the pain of a flare in my hands and feet for about 48 hours. The practitioner explained that while it wouldn’t cure my RD, periodic sessions would help to control the pain. Unfortunately, my health insurance wouldn’t cover it–and I couldn’t afford it on a small-town journalist’s salary–so I didn’t pursue acupuncture as a regular therapy. When I tried it again many years later, it had no effect at all on my pain, though I’ve no idea why not. Again, this therapy won’t have much effect on your immediate pain. But I’m a believer–it can work. It’s worth a try. And really, it is painless.

Your medical insurance might pay for it.

Physical Therapy

This is where you’re forced to visit an intimidatingly fit, enthusiastic, depressingly athletic person wearing fashionable workout clothes. This person puts you through a tortuous routine of painful exercises a couple of times a week for a month or two, but only after your insurance company has refused to pay for it twice and forced you to appeal and wait for weeks before finally giving in and approving it. Never mind what the doctor wanted for you, or how much pain you were in when it was prescribed, or that you’ve had to live daily with your pain, untreated, in the interim. Also, there’s Homework.

All together now: We Hate Physical Therapy.

However, once it’s approved and you live through the first three or four appointments–and you do the Homework–it can reduce and relieve some degree of your pain, depending on what’s causing it. Good luck.

Diet

There’s no doubt that eating a nutritious, healthful diet can help you cope with your RD, particularly if doing so helps you lose any excess weight you’re carrying around. Lightening the load on your weight-bearing joints may well decrease your pain (though it won’t happen fast).

Good nutrition is also important for heart health, cognitive function (your brain power) and your overall well-being. It can help prevent type 2 diabetes, improve bowel and kidney function, and lower your cholesterol levels and blood pressure. Really, what’s not to like, except you can’t have donuts?

Some people find that eliminating vegetables from the nightshade family–potatoes, tomatoes, and eggplants–helps their RD. Others swear that eliminating gluten helps relieve their pain. It’s worth a try, anyway.

The good news: You don’t need health insurance to eat a healthy, small portions of lean meat, tons of veggies, whole grains, beans, fruit, plant-based fats like olive and canola oil, and a little dairy here and there if you really must have it. The bad news: changing your diet won’t relieve your pain quickly or completely.

Exercise

You know the words: motion is lotion. They’re true, and I wish I could say that exercise was easy. It’s not, but moving your body in a fairly strenuous and sustained way really is good for rheumatoid disease and other types of arthritis. Like the other alternative pain relief options mentioned above, however, it will do nothing for your pain today. You’ll just have to live with it.

Still, if you exercise hard enough, your brain will release happiness chemicals called endorphins, similar to those it releases when you take that little white opioid pill, but a whole lot less of them. So pay attention, you might miss the good feelings while you’re struggling to catch your breath.

I’m being sarcastic. Forgive me? Exercise really is one of the best things you can do for yourself, even if it doesn’t relieve your pain today (or tomorrow, let’s face it). What it does do is strengthen the muscles that support your joints, helping you move more easily, with more confidence, and more safely. Weight-bearing exercises like walking also help build up weakened bones and prevent bone loss, two problems that are all too common among people with RD.

And of course, exercise does you a lot of good in other ways, as well, promoting heart health, increasing stamina and lung capacity, lowering cholesterol, burning off excess blood sugar and fat, and lightening up your mood. It doesn’t have to be hard, like Marine Corps calisthenics or killer spin classes at the gym. You don’t have to jog. Just take a fairly brisk walk for 30 minutes, five times a week. (Break your walk into two, 15-minute sessions, if you like. Works just as well.) Or ride a bike. Or swim. Maybe take tai chi or yoga classes. You can modify any of these activities to fit how your joints feel today, this minute. Hey, I swear, in time you’ll notice a difference–and it will be positive.

I want to be glad that the CDC is so concerned about my health. I want to be happy they don’t want me to become addicted to opioid pain medications and accidentally overdose myself and die. But since I’ve been taking these drugs off and on for nearly 30 years without harm, and since I’d never dream of abusing them or selling them on the streets, I wish they’d leave me–and other legitimate, responsible chronic pain patients–alone.

They won’t, though, so using my best CBT techniques, I’m going to be positive about how I’ll handle the RD flares that may be waiting in my future, without the helpful drugs that relieve my pain.  

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. Cognitive Behavioral Therapy. (2013, Feb. 21) Mayo Clinic. Retrieved on January 10, 2016 from http://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/basics/definition/prc-20013594
  2. Cognitive Behavioral Therapy. (n.d.) American Chronic Pain Association. Retrieved on January 10, 2016 from https://www.theacpa.org/treatment/cognitive-behavioral-therapy-cbt
  3. How Acupuncture Can Relieve Pain and Improve Sleep, Digestion, and Emotional Well-being. (n.d.) U. C. San Diego Center for Integrative Medicine. Retrieved on January 19, 2016 from http://cim.ucsd.edu/clinical-care/acupuncture.shtml
  4. CDC: Opioids Not ‘Preferred’ Treatment for Chronic Pain. (2015, Sept.) Pain News Network. Retrieved on January 10, 2016 from http://www.painnewsnetwork.org/stories/2015/9/16/cdc-opioids-not-preferred-treatment-for-chronic-pain
  5. How Much Physical Activity Do Adults Need? (2015, June 4) Centers for Disease Control and Prevention. Retrieved on January 10, 2016 from http://www.cdc.gov/physicalactivity/basics/adults/index.htm
  6. Healthy Eating. (2016, Jan.) HelpGuide.org. Retrieved on January 10, 2016 from http://www.helpguide.org/articles/healthy-eating/healthy-eating.htm

Comments

View Comments (6)
  • glad2bme
    3 years ago

    Amen to all of you who have posted so far! I go back to my doctor in two days and I am very fearful of the changes that he may make to my pain medications. I know it’s coming because last month when I drove the 2 hours one way to his office to pick up my monthly, already minimal prescription for a narcotic, I was given a letter and a CD to review about changes coming to all his patients at our next visit. Why is this happening to us? This disease sucks and pain meds have been my only hope to living a halfway decent existence. My 72 year old mother is on a stronger dose than I am everyday from residual pain due to back fusion surgery. Not that she doesn’t hurt, but I hurt worse all over my body every single day than she ever does. I am feeling so hopeless right now.

    All these rules are going to do is have the opposite effect, I think we will see an increase in suicides over the next few years, albeit not by narcotics but the hundreds of other ways to overdose or kill yourself. I think we will also see an enormous increase in alcoholism as this is a cheap, easy way to ease pain that cannot be controlled with a lower dose of narcotics. Alcohol abuse kills more yearly than narcotics have over all the years combined, but nobody seems to care about that because it brings in tons of tax dollars and keeps many people working (such as EMT’s, doctors, counsellors, stores, restaurants, bars, police, jails, etc). When did it become that money is more important than quality of life. Furthermore, some overdoses are accidental but I think that all those who have chosen to use narcotics to commit suicide would’ve just chosen a different way if it was not available, so I just doubt suicide rates will go down at all (or as predicted earlier, I honestly think they will go up). I also think we will see an increase in heroin use, theft, marijuana use in states like mine that it’s still illegal, alcohol poisoning and death by over consuming alcohol, overdosing of OTC pain relievers, more absences from work, and many more negative outcomes I have not even thought of.

    I am currently doing everything I can proactively to fight this for the chronically ill, but as I am one of them, I am very limited in what I can do. It’s going to take the people like some of the ones who commented here that are not chronically ill to step up and help when they can. I truly appreciate y’all posting on here on behalf of your family, friends, coworkers, etc. that you will watch suffer through this mess. When will the government get it, the so called “War on Drugs” started many years ago hasn’t worked and neither will this program. They just need to feel better about earning their crazy high salaries so they work diligently to find ways to do that on stupid stuff that they know little about and shouldn’t be in the business of making medical decisions for anyone but themselves!

  • Jillian S moderator
    3 years ago

    Glad2beme,
    Thank you so much for posting. I am sorry to hear that your doctor is making some amendments regarding your treatment. Our community understands your frustrations with the stigma surrounding narcotics. It is unfortunate that those who truly need it for pain management are being affected by those who are recreational abusers. Your points about seeking other means to mask the pain is very insightful and we are so glad to hear that you are advocating for those like you. We would love to hear more about what you have done so far and perhaps together we can brainstorm more ideas on how to bring this to light in the government.
    I also wanted to share another great article by Wren regarding narcotics that I think you will enjoy: https://rheumatoidarthritis.net/living/criminal-pain/
    Also, here is an article on advocacy that I am sure will resonate with you: https://rheumatoidarthritis.net/living/advocacy-glory/
    Thank you so much for being a part of our community- we are lucky to have you.

    Warmly,
    Jillian (Rheumatoidarthritis.net Team)

  • Kammies
    3 years ago

    I have been taking hydrocodone for 20 years now. I have had times when I did not need to take any but those times were few and far between. I am now getting very close to age 60 and my tolerance is not what it used to be. My strength is not what it used to be. I have lost some of my fighting spirit. But I have only ever taken the pain pills when I need them. Now, even on a rare “good” day, I will still take one 10 mg pill, approximately 12 hours apart. I started off with 5 mg but over the years I’ve built up a tolerance so I have had to increase to the 10 mg. Days when my pain is very bad, I take it with an ibuprofen. I worry more about the side effects from the NSAIDS than the Hydrocodone.
    Addiction does not equal abuse!

    I get very tired of people using the word “addicted”. There is a big difference between addiction and abuse. Addiction is more of an unfortunate side effect. If I do not take my night time med, I may have some withdrawal symptoms meaning a restless aching in my elbows that can become quite uncomfortable.
    This feels different than my RA pain. Does this make me take more and more of the opiates? No it does not. I take the medication for pain, not to get high. And I resent being lumped in with the drug abusers. Pain killers are not the only medication that people can experience withdrawl symptoms if they stop taking it all of a sudden.

    Doctors do need to be careful prescribing these meds. But those of us who suffer from chronic pain that is not ever going to get better, should not have to be treated like drug abusers. I know the dangers. I have people in my family who have become hydrocodone addicts and abusers. One moved on to heroin. It is a terribly dangerous drug in the wrong hands.

    I think that if our legislation and our healthcare professionals cannot differentiate the difference between addiction and abuse, that there is still a rocky road ahead of us who depend on these medications just to try and lead as normal of a life as possible.

  • Cindy Mears
    3 years ago

    Thank you Wren for your insightful and informative submission. I can offer a viewpoint as a former federal employee at The Dept of Health and Human Services and being married to a task force member of DEA. This campaign is frought with a lack of information, a need to demonize someone(s) and flat out stupidity.
    This campaign hurts invisible constituents. Unlike if they were to look at, oh let’s say, gun injuries. So they in combination with the DEA obtain an easy win.
    Let’s demonstrate our ability to organize. First, please, arthritis advocacy groups mobilize behind this one issue. Launch a strategic plan with a template that every single afflicted person can follow. And their family member. Enlist AARP. Mobilize NOW. Humanize the issue of pain relief with strategic branding that’s acceptable to the public at large. Engage Gloria Estefan, Jenifer Grey and every SINGLE public figure that can speak to this issue. Let the CDC and DEA know this drive by wont happen.

  • Dors
    3 years ago

    I do not have RA, but I have a friend I talk with every day that does. I also know others that have RA. This new ruling is enough to bring us bystanders to tears for our friends that even with opiates are still in pain every day. There has to be somebody with some reasoning in our lawmakers. There have to be categories. Sure if somebody broke their leg or just had surgery, watch for how long you give them pain medication. After healing their life will go back to “normal”. Unlike someone that has a disease that will never heal, someone who has no chance to go back to “normal”, someone that deals with some amount of pain as a constant background noise in there life. It is a serious issue of quality of life. Of can I get out of bed today, once my pain meds have kicked in or do I have to spend my day as a complete invalid? What is wrong with these law makers? If a person is in major pain every day who cares if they are hooked on their pain medications? They will never have even one carefree day and now we are going to add the stress of will I be able to get my medication again next month, will they keep to the dosage my body needs and is used to or will they cut it in half? Forget even tapering down – no, today we are going to treat you like a junky that just takes this stuff to get high. Do people with chronic diseases look high? Or do they look exhausted and tired. Tired of a life of pain!! Please let’s use some common sense!
    Please, I know you are too tired and worn out to fight the whole of government but get relatives and friends and your caring doctors to fight for you! Do not lay down and let somebody out there do this to you! Your whole quality of life is at stake!
    And you “somebodies” that make these cruel laws find some compassion and use your minds. As easy and as nice as it would be to lump all people into the same category, it’s not how it works! There are not that many chronic and majorly painful diseases out there that they can’t be listed as exceptions.

  • RHPass
    3 years ago

    this is my 6th start at a contribution to the discussion. it is my personal nightmare, and I know I am far from alone. being in pretty much constant pain for the past 18 yrs has not been a picnic. I just wish EVERY ONE of the people involved with the new rules, regs & suggestions spend a few days in the bodies of the people whose lives are affected by chronic pain before they start ruining our lives any further. these new standards are, for the most part,forcing me to have surgeries that could in reality be fatal. quite a price to pay by the patients.

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