Managing Chronic Pain Without the Use of Opiates
Are you dealing with chronic pain and seeking out ways to manage it without opiates and other pain meds? A recent study came out confirming that Opiod medication is not useful for chronic back or joint pain. In my years as a Licensed Marriage & Family Therapist, I have encountered many clients dealing with chronic pain issues. Some of these clients have gone the pain-meds route and are actively treating their chronic pain and are comfortable with this treatment, and don’t have any plans to change this treatment. Some individuals suffering from chronic pain are treating it with opiates, and would like to stop and find alternative means of pain management.
Another group of individuals may be just beginning their journey into the treatment of chronic pain, have not yet explored the opiates route, and are not interested in exploring that route. These clients want to learn ways to manage their chronic pain with alternative methods such as meditation, yoga, acupuncture, nutrition, and therapy (yes: anxiety, stress, grief, and trauma can cause us to tense up our muscles and this can create chronic pain.) If you fall into this group, then this article is for you!
I have been dealing with —and actively managing—chronic pain issues since I was 22 years old. I have been diagnosed with various autoimmune disorders uch as Fibromyalgia and Undifferentiated Rheumatoid Arthritis to give a name to the unexplained pain I was experiencing. I felt strongly that I did not want to go the route of medications, anti-inflammatories, and opiates as I didn’t see where that road could end. Once you start, how do you stop? I wanted to understand my chronic pain issues as much as I possibly could, and find solutions that were sustainable and increased my health and wellness rather than making me dependent on a habit-forming medication that causes negative side effects such as fatigue, memory less, decreased energy, and increased tolerance over time . I wanted to know what caused my pain and what holistic, somatic, spiritual, ayurvedic, nutritional, and physical therapy interventions were out there.
Over a decade after I was first diagnosed, I now consider my journey in managing chronic pain to be a big experimental adventure. I love to learn all about different ways of taking care of myself, try them out and see what works for me and what doesn’t.
If you are motivated to seek out alternative methods of managing chronic pain, there is a whole world of options out there for you to try. I know it because I myself did it! Here are some recommendations if you are starting out on this path. This is not a comprehensive list and cannot be used as medical advise as I am not a doctor. So please read with that in mind.
1. Take a serious look at your substance use.
Firstly, if you smoke cigarettes, I promise you that is contributing to your chronic pain. Smoking cigarettes creates inflammation in the body and inflammation is what causes pain. So, if you smoke, I promise you will not be able to resolve your chronic pain issues as long as you do. Check out this book for a helpful method of quitting smoking. There’s a lot of support out there for quitting smoking and if you need any help you can reach out to me and we can set-up a time to chat.
Another inflammatory? Alcohol. We live in a drinker’s world where alcohol is lauded as the celebratory, social elixir. But if you are downing a bottle of wine every night and complaining of chronic pain in the body, know that cutting back on wine and replacing it with water, la croix, or tea is going to go a long way in clearing up the inflammation in your body. If this turns out to be harder for you than you thought, check out this book and this resource to see some amazing and groundbreaking methods for helping people create a new relationship with alcohol. I can’t say enough about how important it is to take a look at our relationship with alcohol and other drugs and get really honest with yourself about how it does or does not serve you.
2. Yoga
Practicing yoga may have been the single greatest intervention that I learned in my journey in managing chronic pain. I started practicing regularly at this studio about a decade ago and after five years of practice became so sold on it that I took the 2,000 Hour Teacher Training and became a Registered Yoga Teacher. While I do not currently teach yoga as part of my therapy practice, it greatly informs my therapeutic approach and I highly recommend yoga to all my clients, and especially those dealing with chronic pain. Yoga can help you tune into areas of the body where you might be unintentionally gripping, straining, or holding tension, which could be contributing to overall tension and pain in the body.
Common spots that we hold tension include: gripping in the jaws, straining in the eyes or eyebrows, tensing of the neck and shoulders, and clenching around the hips and hip flexors. Understanding how to check in with those parts of the body and release the unnecessary gripping goes a long way in decreasing overall systemic pain. Check out this yoga practitioner for online streaming videos and amazing resources, and check out this online streaming service for affordable at-home yoga with amazing teachers.
3. Acupuncture
Acupuncture has also played a huge role in managing my chronic pain at various points along my journey. Acupuncture is amazing because not only does it balance out your Qi or life force energy, but every acupuncturist I’ve been to is also super knowledgeable about inflammation in the body and anti-inflammatory diet and nutrition. Acupuncturists are usually not just acupuncturists but also trained in Ayurvedic medicine, and they will recommend holistic interventions such as diet advice and herbal supplements that will truly rock your world. I had no idea that plants were so powerful before I started acupuncture. Acupuncture also once brought back my period when I lost it for a year while I was in college, and helped me address digestive issues and bloating. Message me for referrals for great acupuncturists in LA!
4. Nutrition is everything.
There is often a food allergy or intolerance that is underlying chronic pain—especially if you notice it accompanied by bloating and other digestive issues. This nutritionist offers free material and support in managing nutrition to decrease inflammation in the body. Elimination diets like this can also be helpful in determining if you have a food intolerance or sensitivity. The basis behind an elimination diet is that basically you remove all possible culprits (so sugar, alcohol, gluten, diary, etc) for 2-4 weeks and then add one back in at a time and see how your body reacts to each one as you re-introduce it.
There is a lot of evidence pointing to our guts being our “second brain”, and that making sure we feed ourselves whole, nutritious foods, that replenish our gut bacteria to a healthy state can go a long way in treating depression and anxiety, which are both linked to chronic pain.
5. Exercise, Exercise, Exercise
The single most important intervention that has improved my chronic pain is moving my body. Oftentimes when we are pain, we think its best to lay down or skip that gym workout. Or we just don’t feel like getting up when your neck feels like it weighs 45 lbs. But find some way to move your body, whether that is a 20 minute walk in the morning and afternoon, or gentle stretching in a restorative yoga class, or light jogging on the treadmill. We do not get to not move our bodies, and expect our bodies to keep working well.
We do not get to not move our bodies, and expect our bodies to keep working well.
Along with the physical importance of keeping our muscles and joints lubricated and strong, exercise is so important for releasing endorphins in the body, which decreases depression, improves mood and sleep, and helps relax the body which decreases inflammation and therefore, pain!
6. Meditation & Breathwork
Meditation is incredibly powerful in dealing with chronic pain. Programs such as Mindfulness Based Stress Reduction, developed by Jon Kabat-Zinn, were created to treat individuals dealing with chronic and fatal illness in an inpatient setting and there is significant evidence substantiating the effectiveness of MBSR—especially Body Scan Meditations— in decreased pain and suffering in these patients. Basic mindfulness can help you become aware of negative thinking patterns that cause tension in our thoughts and our body, and teaches us to let go of thoughts, and envision them passing by like clouds in the sky. This meditation teacher is amazing and has helped me create a home meditation practice. Check out this meditation studio in LA for additional support in learning meditation skills.
7. Breathwork
Breathwork is a simple and effective way to reduce chronic pain, anxiety, and generally relax the parasympathetic nervous system. The parasympathetic nervous system is responsible for the “rest and digest” functions of the body (as opposed to the “fight or flight”, sympathetic nervous system) and when we are able to activate the parasympathetic nervous system, we release hormones and neurotransmitters in our bodies that help us to relax. When we relax, we don’t clench or grip as much. Try a simple 4-4 breath: inhale slowly through the nose for a count of 4, and exhale slowly through the nose for a count of 4. Do this 2-3 mins and see how you feel after.
8. Psychotherapy
Psychotherapy can be an important and powerful adjunctive treatment for chronic pain. In addition to helping us identify the negative thinking patterns we engage in that create anxiety or despair, and then creating more balanced and positive thinking patterns, it can help us become aware of the relationship between thoughts, emotions, and body sensations. We also might tell ourselves very negative stories about the pain we are feeling in our bodies, such as: “This pain will never go away", or “This pain will get in the way of my life”, and these thoughts will lead us to feel extremely anxious or doomed about the future.
We also might tell ourselves very negative stories about the pain we are feeling in our bodies, such as: “This pain will never go away", or “This pain will get in the way of my life”, and these thoughts will lead us to feel extremely anxious or doomed about the future.
This is super unhelpful because stress and anxiety cause us to clench or grip unnecessarily in the body, which can also contribute of chronic pain! Therapy can help address and reduce anxiety that might be contributing to your pain issues.
Chronic pain has also been linked to depression, and a lack of seratonin/dopamine in our brains & gut. Treating the underlying issue of depression with the use of psychotherapy can help chronic pain by getting your brain chemistry back on track.
Treating the underlying issue of depression with the use of psychotherapy can help chronic pain by getting your brain chemistry back on track.
9. EMDR
Trauma is another cause of pain in the body and EMDR or Eye Movement Desensitization Reprocessing is shown to be extremely effective in the treatment of trauma. When we experience trauma, the body remembers it vividly, and can close down or shut off in order to protect itself. We might even shut down our hearts if we have been hurt or frightened deeply, which can create tightness in the thoracic (upper spine) and tightness around the ribcage, which, for example, can be a cause of neck and shoulder pain. EMDR therapy to address traumatic experiences can help us to open up parts of our body and mind that shut down during the traumatic event (to keep us safe), and bring all the parts of the brain online so that we can reprocess the traumatic event in a way that takes the extreme emotional charge out of the memory. We can then access memories of traumatic events from a much calmer place, that does not disorganize or terrify us as much.
10. Spirituality/Shamanism/Reiki
The practice of Reiki balances out the chakra systems which are related to our feeling rooted, grounded and safe in the world. Reiki assumes that if the chakra systems are not balanced, this can be the root of depression, anxiety, pain, and feeling ungrounded or unaligned in general. Working specifically on the root chakra can really help with feelings of safety and belonging in the world, which can affect chronic pain throughout the body. When we do not feel safe, from a deep core level, the rest of the chakra system will become unbalanced. This Reiki/Shaman practitioner has helped me learn so much about myself and what my body needs to feel rooted and grounded.
Many people turn to Spirituality for a sense of comfort and safety in the world. This spiritual leader does a lot of helpful work around Spirituality and making it non-religious and accessible for most anyone.
11. Physical Therapy
Physical therapy teaches ways to move the body and areas that need to be strengthened so that we are not overusing or overcompensating with certain parts of of bodies. I have personally benefitted from PT multiple times, for treatment of knee pain as well as neck pain. I came out of PT with a set of exercises designed especially for me— that kept me safe and made me feel empowered to get back into the gym after a long time of being afraid of getting injured, or aggravating the pain. I went here for PT in early 2019 and loved it.
12. Psychoactive Medication Intervention
A source of chronic pain can be a lack of seratonin and dopamine, which is also linked to depression. So if you are trying to avoid opiates or other pain killers, you might consider trying an SSRI (Selective Seratonin Re-uptake Inhibitor) that is specifically indicated for depression-related chronic pain. Visit your Rheumatologist or make an appointment with a Psychiatrist for a medication evaluation to learn more on this topic.
This is by no means a comprehensive list but these recommendations are a great start for anyone looking to manage chronic pain without the use of opiates. I am happy to share my knowledge on a free 15 minute phone consultation , or book a session with me to learn more!
For continued reading and resources on any of the above topics, and other helpful resources about healthy relationships, please see the Resources and the Blog page on my website.
