Opioids aren’t some magic pill. Most patients only see a 20 to 30 percent reduction in pain, which can leave those with chronic pain desperate for relief and at-risk for addiction. “They don’t really accomplish the goals,” says Dr. Richard Rosenquist, chairman of the pain management department at the Cleveland Clinic’s Anesthesiology Institute. “And they carry adverse effects.” So medical professionals are shifting to alternative methods such as injections, acupuncture, mindfulness and yoga to treat chronic pain. Doctors explain some less-familiar alternatives.
Patients with neck, back or joint pain can get an average of nine months of pain relief from this procedure that uses heat or cold to destroy the nerves. “You prevent the conduction of the current or the signal from the affected joint,” says Dr. Salim Hayek, chief of the division of pain medicine at University Hospitals. In cryoablation, a surgical probe uses nitrous oxide to freeze affected nerves. In radio frequency ablation, a needle delivers radio frequency waves that heat up surrounding tissues and disrupt the nerve’s ability to send pain signals. Doctors often pair these options with physical therapy to assist in relief.
This nonsurgical approach uses topical creams, gels and patches for muscle, nerve or joint pain. Arthritis patients, for example, may find relief with an anti-inflammatory gel similar to Motrin, such as prescription Voltaren. Prescription lidocaine patches can be used to help numb superficial conditions. Some have even found a surprising remedy in capsaicin, an over-the-counter and prescription-strength cream that uses hot pepper extract to destroy the smaller nerves in the skin. “The theory about hot pepper is that you think you’re getting a sensation other than pain,” says Dr. Charles Emerman, chairman of emergency medicine at MetroHealth Medical Center.
These methods treat a variety of conditions by targeting the brain or nervous system with electrical stimulation or drugs to relieve pain. To address neuropathic back and leg pain, for example, electrodes and a neurostimulator unit are surgically implanted in the patient, who can direct the currents with an external remote. “We’re using electrical energy to help modify pain signals before they get to the brain,” says Dr. Richard Rosenquist of the Cleveland Clinic. Patients with muscular or nerve pain who don’t want surgery can use a popular TENS unit in which electrodes soothe the painful area through buzzy, electrical stimulation.