nonopioid

Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Each person feels pain differently, even if the reason for the pain is the same. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, chest, pelvis, or you may feel pain all over.

There are two types of pain:

• Acute pain usually comes on suddenly, because of a disease, injury, or inflammation (irritation, redness, and/or swelling). It usually goes away when the cause is treated or healed, though sometimes it can turn into chronic pain.
• Chronic pain lasts for longer than three months or the time in which you should have healed. It can cause severe problems.

Pain relievers are medicines that reduce or relieve pain. There are many pain medicines, each with advantages and risks. Some are over-the-counter (OTC) medicines. Others are stronger medicines, which are available by prescription. The most powerful prescription pain relievers are opioids. They are very effective, but people who take them are at risk of addiction and overdose.

Because of the side effects and risks of pain relievers, you may want to try non-drug treatments first. If you need to take medicines, doing some non-drug treatments may allow you to take a lower dose.

Many non-drug treatments can help with pain. It is important to check with your health care provider before trying any of them:

• Acupuncture involves stimulating acupuncture points. These are specific points on your body. There are different acupuncture methods. The most common one involves inserting thin needles through the skin. Others include using pressure, electrical stimulation, and heat. Acupuncture is based on the belief that qi (vital energy) flows through the body along paths, called meridians. Practitioners believe that triggering the acupuncture points can rebalance the qi. Research suggests that acupuncture can help manage certain pain conditions.
• Biofeedback techniques use electronic devices to measure body functions such as breathing and heart rate. This teaches you to be more aware of your body functions so you can learn to control them. For example, a biofeedback device may show you measurements of your muscle tension. By watching how these measurements change, you can become more aware of when your muscles are tense and learn to relax them. Biofeedback may help to control pain, including chronic headaches and back pain.
• Electrical stimulation involves using a device to send a gentle electric current to your nerves or muscles. This can help treat pain by changing or blocking pain signals. Types include:
  • Transcutaneous electrical stimulation (TENS)
  • Implanted electric nerve stimulation
  • Deep brain or spinal cord stimulation
• Massage therapy is a treatment in which the soft tissues of the body are kneaded, rubbed, tapped, and stroked. Among other benefits, it may help people relax, and relieve stress and pain.
• Meditation is a mind-body practice in which you focus your attention on something, such as an object, word, phrase, or breathing. This helps you to minimize distracting or stressful thoughts or feelings.
• Physical therapy uses techniques such as heat, cold, exercise, massage, and manipulation. It can help to control pain, condition muscles and restore strength.
• Psychotherapy (talk therapy) uses methods such as discussion, listening, and counseling to treat mental and behavioral disorders. It can also help people who have pain, especially chronic pain, by:
  • Teaching them coping skills to better deal with the stress that pain can cause
  • Addressing negative thoughts and emotions that can make pain worse
  • Providing them with support
• Relaxation therapy can help reduce muscle tension and stress, lower blood pressure, and control pain. It may involve tensing and relaxing muscles throughout the body. It may be used with guided imagery (focusing the mind on positive images) and meditation.
• Surgery can sometimes be necessary to treat severe pain, especially when back problems or serious musculoskeletal injuries cause it. There are always risks to getting surgery, and it does not always work to treat pain. It is important to go through all the risks and benefits with your provider.

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Some opioids are made from the opium plant, and others are synthetic (man-made).

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

Opioids can cause side effects such as drowsiness, mental fog, nausea, and constipation. They may also cause slowed breathing, which can lead to overdose deaths. If someone has signs of an overdose, call 911. These signs may include:

• Very small pupils of the eyes
• Falling asleep or loss of consciousness
• Slow, shallow breathing
• Choking or gurgling sounds
• Vomiting
• Limp body
• Pale, blue, or cold skin
• Faint heartbeat
• Purple lips and fingernails

When using opioids, there is also a risk of opioid use disorder (OUD).

Opioid use disorder (OUD) means that you have a problematic pattern of using opioids. The pattern causes a lot of distress and impairment (meaning that it causes problems in and interferes with your daily life). Instead of OUD, sometimes people use the terms "opioid dependence" and "opioid addiction." Dependence means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm.

The risk of OUD is higher if you misuse the medicines. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

Opioid use disorder and overdoses are serious public health problems in the United States. As more people misuse opioids, more women are misusing opioids during pregnancy. This can lead to health risks for the mother and baby. The baby may be born with neonatal abstinence syndrome (NAS). NAS is a group of withdrawal symptoms that a baby has after being exposed to drugs during pregnancy.

Another problem with increased opioid misuse is that it can also lead to more heroin use. There are some people who switch from prescription opioids to heroin because heroin may be cheaper and easier to get.

There are effective medicines to treat OUD. Using medicines to treat OUD is called medications for opioid use disorder (MOUD). MOUD can help you stop using the drug, get through withdrawal, and cope with cravings. It is often combined with behavioral therapy and counseling. Having support from family and friends can also help.

There is also a medicine called naloxone which can treat opioid overdoses. It can reverse the effects of the overdose and prevent death if it is given quickly.

To prevent problems with prescription opioids, be sure to follow your doctor's instructions when taking them. Do not share your medicines with anyone else. Contact your doctor if you have any concerns about taking the medicines.

NIH: National Institute on Drug Abuse

Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Each person feels pain differently, even if the reason for the pain is the same. Pain may be sharp or dull. It may be mild or severe. Pain may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, chest, or pelvis, or you may feel it all over.

Pain can help alert you that there is a problem. If you never felt pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment. Finding out what's causing your pain will help your health care provider determine the best way to manage or treat it.

Patterns and types of pain are named based on how long and how often you have pain. These include:

• Acute pain usually happens suddenly because of a disease, injury, or inflammation (irritation, redness, and/or swelling). This type of pain is often sharp and acts as a warning that something is wrong. It usually goes away when the cause is treated or healed, though sometimes it can turn into chronic pain. Some examples of causes of acute pain include broken bones or dental issues.
• Chronic pain lasts for longer than three months or the time in which you should have healed. It can affect all aspects of daily life, including your mood and relationships. Some conditions that might cause chronic pain include arthritis or back problems.
• Episodic pain can happen from time to time and may occur with long-term medical conditions. Some conditions that might cause episodic pain include sickle cell disease or chronic migraines.

Pain may also be categorized by what is likely to be the cause of the pain. Pain may be described as nociceptive (caused by tissue damage or inflammation), neuropathic (caused by nerve damage), or nociplastic (caused by changes in how your nervous system processes pain).

Understanding what causes pain and why people feel it differently may be difficult. Often, it's easier to find the cause of acute pain due to an injury than the cause of chronic pain, or you may have an ongoing cause of pain, such as cancer.

In some cases, there is no clear cause. Environmental factors and psychological factors such as stress and beliefs about pain may affect the way you feel pain and respond to treatment.

You are the only one who knows how your pain feels. Your provider can best measure your pain by how you report it. They may ask you:

• Where is the pain in your body?
• How long have you had the pain?
• How does the pain feel, such as stinging, burning, or sharp?
• How often do you have pain?
• When do you feel pain, such as in the morning, evening, or all the time?
• What relieves the pain?
• How does pain affect your daily life?
• Is the pain mild, moderate, or severe?
• To rate the pain on a scale.

If the cause of your pain is unknown, your provider may also do a physical exam and order blood tests or other medical tests to help find the cause.

Pain is not always curable, but there are many ways to manage and treat it. Treatment depends on the cause and type of pain. Treatments may include medicines, such as pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.

Depending on the cause of your pain and your symptoms, your provider may recommend lifestyle changes. These may include suggestions for:

• Eating a healthy diet
• Adding exercise
• Losing weight
• Managing stress
• Improving mental health

NIH: National Institute of Neurological Disorders and Stroke