Pain is complicated and doctors, researchers, and physical therapists like myself don’t know everything about pain.
However, if you have listened to me speak in the past you are probably not surprised to hear me say pain meds are not a good option for managing chronic pain (which is defined as pain lasting more than 1 year).
When I talk about pain meds I’m talking about Opioids and Narcotic pain medications like Hydrocodone, Oxycodone, Vicodin, Norco, Percocet, Morphine, and even Tramadol.
Before I explain why these types of hardcore pain meds are not a good strategy to control pain let me say:
Pain meds do have their place.
They are good for managing short term severe acute pain such as after surgery or a broken bone or for managing pain due to an illness like cancer.
However, for most sources of pain, using opioids or narcotic pain medications may do more harm than good.
Side Effects from Opioids and Narcotics are Serious.
Many opioids and narcotic medications can cause:
- Altered mental states
- Drowsiness and sleepiness
- Constipation
- Overdose
- Dependency
- Addiction
I’ve heard several people try to make the argument: “Well if pain pills can get rid of my pain, I’ll take my chances with the side effects.”
In fact, I particularly remember one patient of mine – let’s call him Jim – that to this day continues to stick into my mind.
Jim was a 75-year-old male that was suffering with back pain for years.
His doctor had started him off with a low dose of Hydrocodone and he was sent for injections.
I tried to educate him about the side effects but he said, “I’ll take my chances.”
Sure, taking your chances with side effects makes sense if the pain meds actually worked long term to manage your pain. The problem is they aren’t very good at managing pain long term.
Opioids and Narcotics slowly lose their effectiveness. The longer you use them, the less they help.
As a result, you have to take a higher dose or switch to a stronger prescription (meaning more side effects).
This cycle continues until you are taking dangerous amounts of pills, your chronic pain is not managed, and you are most likely dependent and/or addicted.
Let me explain it in a different way.
Imagine that you had an alarm on your house that you could turn on if you needed help.
Let’s pretend that you didn’t have another way of communicating your need for help except your alarm which had a volume dial.
Now, imagine that your house was being broken into. You turn on the alarm loud enough to call for help.
The robber realizes that you had sounded the alarm, so he goes over to the alarm speaker and throws a thick blanket over it.
The blanket will keep your neighbors from hearing the alarm. Now you are thinking, the threat is still there, but nobody will hear the alarm.
What would you do next?
You would probably turn up the volume on the alarm so that you neighbors could hear it.
Pain meds are like the thick blanket: They mask the pain but do not address the cause.
Therefore, your brain interprets that there is still a threat and will turn up the volume on your pain levels so that you will address the cause.
Now your alarm/pain is turned up so high that if you stop taking the pain meds, the alarm will be so loud you won’t be able to stand it.
Your best chance at relieving chronic pain is to stop treating the symptoms with pain medication and instead address the root cause.
With a detailed evaluation, a physical therapist can identify the cause and get you on the path to a healthier and more active life with less pain.
Paid meds will only mask the pain.
Remember Jim, the gentleman I told you about earlier?
I lost touch with him for several years after he decided to “take his chances.”
However, a year and a half ago our paths crossed again.
He had been hospitalized several weeks for pneumonia and was referred for physical therapy at Natural Fit Therapy for strengthening.
Not only was he weak from being in the hospital, his back pain was at the worst it had been in years. Over the years his doctor, as well as the recent doctor in the hospital, had increased his dose of pain meds. He was now taking the max dose of hydrocodone 4x per day.
He was constipated, lightheaded from all the hydrocodone, and his pain still wasn’t well controlled.
The pains meds helped at first but now he hated how they made him feel and his pain was still there.
Physical Therapy can help you identify and resolve the root cause of your pain.
We worked together over the next several months using a combination of manual therapy, exercises, stretching, and pain education.
We were able to find the root cause of Jim’s pain (weak hips, a weak core, and tight hamstrings) and begin a comprehensive program to reduce his pain.
Over the next several months, working with Jim and his doctor, Jim was able to reduce his hydrocodone from 4x per day to only taking 1 hydrocodone most nights, but none during the day.
Weaning off pain medications is not an easy task and not everyone has as successful results as Jim.
However, when I asked Jim if he would “take his chances on side effects” if he was to go back in time knowing what he knows now, he said, “No way! I thought there was no other way to control my pain and I didn’t realize that the meds would become less effective over time.”
If you have specific questions about how to find a better solution for your (or your loved one’s) chronic pain, please reach out to us and schedule a free phone consultation with. one of our Doctors of Physical Therapy and we’ll be happy to answer your questions.
Wishing you pain-free days,
Dr. Ryan Seifert, PT, DPT
