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Beyond Opioids: Safe, effective treatments for 4 common types of pain

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If you need to flinch all day long before arthritis, back pain, recent surgery, or severe headache, your doctor may suggest you use a strong opioid medicine. However, this is not your only option, and it should not be your first.

Almost a third of adults aged 50 to 80 say they have completed such a recipe within the last two years, according to a July survey conducted by the University of Michigan.

These medicines can be risky: up to a quarter of people who take opioids on a long-term basis are struggling with addiction. However, the doctors still distributed more than 1

91 million opioid prescriptions.

"Many older adults may need to take opioids unnecessarily," says David Ring, a professor of surgery and psychiatry at Dell Medical School, University of Texas, Austin, and a spokesperson for the American Academy of Orthopedic Surgeons.

However, for many types of pain, opioids are no more effective than nonopioide medications. And nonopioids such as acetaminophen (Tylenol and generics) pose risks. "That's why we often prefer to use non-drug therapies as a first-line option," says Ring.

Here's what you can do to safely treat four common types of pain.

Back pain

Back pain affects almost half of all healthy, active people over the age of 60 years. Most of the time, it can be successfully treated and treated with non-drug therapies: The American College of Physicians recommends therapies such as heating pads, massage, acupuncture, tai chi and yoga as a first-line treatment.

If we've kicked your back and are in terrible pain, try over-the-counter ibuprofen (Advil and Generic) or naproxen (Aleve and Generic) for a week or two, says Roger Chou, a professor of medicine at the United States Oregon Health and Science University in Portland.

This may be a better choice than acetaminophen, which has not been found to be effective by ACP.

Recent research has also shown that people who stay active – with gentle activities such as running and stretching – recover faster and have less discomfort than those who stay in bed.

If the pain persists for more than a week or two, consult your doctor, who may prescribe physiotherapy, or, in some cases, a limited history of spinal manipulation with a licensed chiropractor

For chronic low back pain that is not In response to these measures or to prescription strength nonsteroidal anti-inflammatory drugs (NSAIDs), ACP recommends the prescription pain pill Tramadol (Ultram and Generic) or the antidepressant Duloxetine (Cymbalta and Generic). But both have a small effect. You still need to use methods that are not medically treated.

Postoperative Pain

If you are undergoing surgery, you should schedule a pain management plan before surgery: ask your surgical team if regional anesthesia is possible (rather than general), including peripheral nerve block.

Both can help to reduce the need for opioids after surgery, says Stavros G. Memtsoudis, director of intensive care services at the Department of Anaesthesiology at the Special Surgery Hospital in New York City.

Although opioids may be a useful component of a postoperative pain plan in the short term, they are not panacea.

Research published in the journal Anesthesiology last May reported more than 1.5 million surgical interventions At least two other analgesics, such as acetaminophen and an NSAID, were shown to work better together with an opioid.

In general, you should take opioids only when needed to relieve breakthrough pain a no longer than three weeks after a procedure.

People coming out of surgery should also have "realistic expectations – they can not expect them to go home from the hospital and feel completely free of pain," says Memtsoudis. "But they should be able to read without being distracted by pain."


About 17 percent of adults over 65 have reported headaches more than twice a month. For people who are prone to migraine, first-line treatment is usually a class of drugs called triptans that reduce inflammation and narrow blood vessels.

However, these patients must be prescribed with caution to anyone who already suffers from heart disease, high blood pressure or other medical conditions other risk factors.

It has not been shown that opioids improve migraine symptoms and may make triptans less effective, says Alan M. Rapoport, a clinical professor of neurology at the David Geffen School of Medicine at UCLA in Los Angeles.

If you have the dull pain of a tension-type headache – the most common type – once or twice a month. You can treat it with an over-the-counter analgesic such as ibuprofen or acetaminophen. Exercise or relaxation can also help.

However, if you get them more frequently – about every week – you should consult your doctor.

With frequent headaches of any kind, research has shown that complementary therapies such as acupuncture are used B. Massage and biofeedback can be effective in some cases.

Others benefit from a daily preventive, such as a tricyclic antidepressant or the blood pressure drug propranolol (Inderal and Generic).

Joint Pain

Of people 65 and older, more than 55 percent of men and almost 70 percent of women may have arthritis. The most common form is osteoarthritis, where the articular cartilage breaks down, causing pain, swelling and movement disorders.

Research has shown, however, that opioids should generally not be used to treat OA; the potential damages outweigh the benefits.

Instead, wrap an ice pack in a towel and apply to the affected area for up to 20 minutes – a cold can relieve acute joint pain.

If a The joint feels stiff but not painful. Apply a heating pad for 15 to 20 minutes. Then try a low activity, such as walking, which can relieve pain as well as an over-the-counter NSAID such as ibuprofen or naproxen.

Naproxen seems to be the most effective oral painkiller for joint pain. Do not use it for more than a week without consulting your doctor. Yoga, tai chi and swimming can also help.

If these steps do not help, you should try a recent NSAID. However, think twice about the use of diclofenac (Voltaren and Generic), which is associated with an increased risk of heart attack and stroke.

You can also help prevent OA relapses by trying to stay healthy. Studies have shown that in overweight or obesity, weight loss can reduce pain and inflammation.

Copyright 2018, Consumer Reports Inc.

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