Chronic pain, defined as pain lasting over three months, is a growing problem for many Americans. Personally, I do not know anyone that suffers from chronic pain, but when I worked in a dental office, many of our patients suffered from chronic pain, and were on long term opioid prescriptions because of it. This was very surprising to me. Opioids are usually prescribed to treat acute pain. They work by binding to opioid receptors in the nervous system and other parts of the body, minimizing the number of pain signals sent to the brain, resulting in reduced feelings of pain (“What Are Opioids?” 2016.). However, research has proven that opioids aren’t the most effective way to treat chronic pain (“Cautious, Evidence-Bases Opioid Prescribing,” n.d.). Furthermore, with daily use, opioid dependence or tolerance can develop in a matter of days of weeks (“Cautious, Evidence-Bases Opioid Prescribing,” n.d). Many sufferers of chronic pain also try to self-medicate, turning to unhealthy food, tobacco, or illicit drug use (Myers, 2012). While these methods often provide short-term relief, they can often lead to more harmful effects and even enhance the pain (Myers, 2012). There are other, healthier options for pain management. These options can include low impact exercise, such as yoga or tai chi, which release endorphins that help combat the pain (Myers, 2012). Other studies have found mediation or deep breathing techniques effective in chronic pain management (Myers, 2012). Also, with help from a professional, acupuncture or physical therapy, can also help (“Non-Opioid Options for Managing Chronic Pain,” 2016).
Another potential option for chronic pain management is related to genetics and gene therapy, specifically the NOP-coding gene (“Nociceptin: Nature’s Balm for the Stressed Brain,” n.d.). NOP is a receptor for the opioid neurotransmitter, nociceptin (“Nociceptin: Nature’s Balm for the Stressed Brain,” n.d.). Researchers have found that nociceptin acts in the amygdala and counters the anxiety producing effects when the brain is placed under acute stress. NOP agonists, compounds that activate the NOP receptors, are being researched as an opioid alternative to treat chronic pain (“Nociceptin: Nature’s Balm for the Stressed Brain,” n.d.). This is very intriguing, considering the harsh side effects and addictive qualities of opioids.
Of course, when considering the treatment of chronic pain, it is important to understand the perception of pain itself. Surprisingly, research has shown that psychological factors can influence the perception of pain. For example, paying higher attention to the pain increases the intensity of the pain. This explains distraction techniques in chronic pain treatment. (Linton & Shaw, 2011). How one thinks about pain also influences the pain itself. If one thinks negatively about pain, the intensity of the pain increases. Anxiety and fear have also been found to increase pain disability (Linton & Shaw, 2011). Overall, it is obvious that a wholistic approach is necessary in chronic pain management.
References
Cautious, Evidence-Based Opioid Prescribing. (n.d.). Retrieved from https://agencymeddirectors.wa.gov/Files/PrescGuide.pdf
Linton, & Shaw. (2011, May 1). Impact of Psychological Factors in the Experience of Pain. Retrieved from https://academic.oup.com/ptj/article/91/5/700/2735743
Myers, B. (2012, June 9). The Best and Worst Ways to Cope with Pain. Retrieved from https://www.everydayhealth.com/pain-management/the-best-and-worst-ways-to-cope-with-pain.aspx
Nociceptin: Nature's Balm for the Stressed Brain. (n.d.). Retrieved from https://www.scripps.edu/news-and-events/press-room/2014/20140108roberto.html
Non-Opioid Options for Managing Chronic Pain. (2016, September). Retrieved from https://www.health.harvard.edu/staying-healthy/non-opioid-options-for-managing-chronic-pain
What are Opioids? (n.d.) Retrieved from https://www.asahq.org/whensecondscount/pain-management/opioid-treatment/what-are-opioids/