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Q&A: How can I manage my back and neck pain without opioid medications?

If medication is necessary to treat your back and neck pain, consider the more than 200 non-opiate drug options available.

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    by Paige McLaughlin, For the Inquirer
    Published 

Q: How can I manage my back and neck pain without opioid medications?

A: During their lifetimes, more than 60 percent of adults will experience back pain and more than 20 percent will experience neck pain that interferes with daily activities. Some back and neck pain sufferers may believe that they have no hope for relief other than opioid medication that is increasingly subject to prescribing limits due to the opioid addiction epidemic.  Fortunately, there are other options to effectively manage or treat back and neck pain, from lifestyle changes to alternative therapies to more traditional medical approaches.

The key to overcoming chronic pain is to recognize it early and begin treatment. Many people attempt to power through, thinking the pain will subside. But what may have started as acute pain from an injury can easily evolve into persistent chronic pain, requiring advanced therapies and treatments.

Because everyone experiences pain differently, you should work with your doctor to create a customized treatment plan. Strained muscles or ligaments, excess weight, poor posture, stress, genetics, and the wear and tear of daily activities can all contribute to back or neck pain. If you are experiencing this kind of pain, first consider some of the following approaches:

  1. Physical therapy: Over time, regular physical therapy can help strengthen muscles, improve function, and reduce risk of future pain or injury. Aquatic physical therapy can ease pain by improving, among other things, body mechanics, posture and flexibility.

  2. Nerve stimulation therapy: Acupuncture and transcutaneous electrical nerve stimulation (TENS) can help relieve chronic pain. TENS uses a small, battery-powered machine to block or "scramble" electrical pain signals at the source.

  3. Strength and flexibility exercises: Yoga and tai chi can be highly effective, noninvasive options for pain management. These activities emphasize slow and soft movements — perfect for chronic pain sufferers — to increase mobility and function.

  4. Lifestyle modifications: Rethink your daily routine. Exercise regularly and incorporate gentle, natural stretching into your day, especially if you work in an office. Eat foods with antiinflammatory properties that can reduce stiffness in your back and neck, such as leafy greens, cherries, blackberries, whole grains and fish. Lastly, address the psychological or stress-related factors potentially contributing to your pain. Practice meditation or other mindfulness activities regularly.

If medication is necessary to treat your back and neck pain, consider the more than 200 nonopioid drug options available. Anti-convulsant and anti-depressant medications can work to block the electrical pain receptors in your brain. Your doctor may also recommend more advanced treatments, such as anti-inflammatory injections, epidural injections, and electrical spinal cord stimulation, which can help reduce or block back pain at its source. Severe back or neck pain sometimes can be treated with surgery; however, there are many treatment options that can be tried before surgery needs to be considered.

Talk to your doctor to identify the causes of your pain and work together to create a treatment plan.

Paige McLaughlin, MD, is a pain management specialist at Mercy Fitzgerald Hospital and Mercy Philadelphia Hospital.