Beyond Pain Management: Effective Techniques for Lasting Relief (Part 5 - Medications & Medical Procedures)
CONTENTS
Introduction: The Role of Medication in Pain Recovery
Pain As A Messenger
Making Sense of Your Options: Types of Pain Medications
A Case Study: How Opioids Can Cloud Recovery
Consulting with Your Healthcare Team
Informed Decisions: Balancing Risks and Benefits
Pain Procedures: When Are They Right?
A Holistic Plan: Combining Medications and Therapies
Further Reading and Resources
Final Thoughts: Taking Control of Pain Management
According to the NICE guidelines on chronic pain, medications and medical procedures can have a role in this, but they are not front-line treatments for chronic primary pain. Instead, they should be viewed as tools to support recovery, not overshadow it, and they facilitate other therapies that work on multiple levels—physical, emotional, and mental.
But let’s be honest: most pain relief procedures or strong painkillers only provide partial relief and rarely eliminate pain completely. That’s why understanding how each treatment works—and being aware of both their potential and limitations—can help you use them effectively and safely.
Painkillers, for instance, can make it easier to move without the constant bracing and guarding that severe pain often causes. The right dosage is crucial.
Pain itself is a messenger, alerting us to potential dysfunctions in movement, posture, or even emotional stress. Blocking this signal can, paradoxically, lead to dysfunctional movement patterns because you don’t have the protective feedback of pain.
These are the questions that I’m interested in exploring with coachees. What kind of relief can you realistically expect? Will it help reduce pain enough to enable more gentle movement, or is there a real risk that this will lead to dysfunctional movement patterns?
But relying on them alone, without addressing underlying movement issues, can sometimes lead to a setback rather than a step forward. That’s where a more holistic approach comes in, using pain medications strategically alongside therapies that tackle the root causes of pain—such as improving posture, engaging in mindful movement practices, and incorporating complementary therapies like acupuncture.
There’s a wide range of pain relief medications available, from over-the-counter painkillers like ibuprofen and paracetamol to prescription-only options for more complex conditions. When it comes to back pain or arthritis, NSAIDs (like ibuprofen) are often recommended as the best anti-inflammatory medicine for reducing swelling and discomfort, while paracetamol can be a safer choice for everyday pain relief.
If you need something stronger, strong painkillers such as opioids (e.g., morphine) may be used short-term and should only be used long-term as a last resort due to their addictive potential and the risk of opioid-induced hyperalgesia (OIH), where prolonged use can increase sensitivity to pain¹.
For long-term pain management, it’s crucial to consider the safest pain medication options. While antidepressants and anticonvulsants may sound unusual, they can be the best pain relief for nerve-related conditions like sciatica or fibromyalgia. Low-dose antidepressants like amitriptyline work by altering the way your nerves communicate pain, making them a valuable alternative to traditional pain meds for chronic conditions. See the further resources section below for the references for this.
When deciding which medication suits you, it's important to weigh up not just the strongest painkillers but also the safest pain medications that offer relief without high risks. Always consult your doctor to tailor a plan that balances effectiveness with safety for long-term use.
Let me give you an example. A good friend of mine, Sarah, was on strong opioids for years after a severe back injury. She’d gotten used to them and built tolerance- the difficult truth for her was that they didn’t affect her pain significantly.
Eventually, she agreed with her doctor to try tapering off, though she was sceptical at first—thinking “If these don’t work that well, what else could?” But over time, she noticed something unexpected. With less brain fog, her energy came back, and she started moving better during her exercise.
It was tough, but by swapping the strongest painkillers for a mix of safer options like paracetamol and mindful movement practices, she found herself feeling clearer and more in control. Now, she’s discovered that the key to pain management isn’t in the strength of the meds but in finding a balanced plan that works for her.
Pain management is a team effort. When you sit down with your doctor or pain specialist, it’s important to have a clear picture of what’s going on with your pain.
Track your pain levels for a week or two beforehand, and pay attention to what makes it better or worse. Consider logging whether your pain flares up a day or two after certain activities—it’s not always immediately obvious what’s causing a spike in symptoms. This information will help you communicate clearly, giving your healthcare team the best chance to recommend the most appropriate meds and procedures.
It’s easy to reach for a pill when the pain’s bad, but long-term use of any pain medication comes with risks.
Opioids, in particular, should only be used as a last resort due to their addictive potential. But even common meds like NSAIDs can cause problems if used for extended periods, leading to issues like stomach ulcers or kidney damage. So how do you decide? One approach is to apply the BRAD model: Benefits, Risks, Alternatives, and Doing Nothing.
Benefits: What kind of relief can you realistically expect? Will it help reduce muscle pain enough to allow for gentle exercise or stretching?
Risks: Could it lead to dependency, gastrointestinal issues, or long-term side effects?
Alternatives: Are there safer pain medications to consider, like paracetamol for mild pain, or even non-drug options like physiotherapy?
Doing Nothing: Sometimes, managing pain without meds—through mindfulness, pacing, or other lifestyle changes—is a better strategy.
When medication alone isn’t enough, certain medical procedures might be worth considering. Some of the most common include:
Corticosteroid Injections: These are used to reduce inflammation and pain in joints and muscles, often in cases of arthritis. They work quickly and can offer temporary relief, but repeated use isn’t recommended as it may weaken surrounding tissues.
Nerve Blocks and Trigger Point Injections: These can target pain in a specific area, like the back or neck, and provide temporary relief by interrupting pain signals. For many, they offer a window of time to engage in rehabilitation exercises or movement therapies.
Spinal Cord Stimulation and Ablation: If you’re dealing with severe, intractable pain, especially after failed surgeries, these options might be recommended. But they’re complex, and like strong painkillers, should only be considered after other avenues have been explored.
It’s easy to focus on which meds or procedures offer the strongest pain relief, but pain management isn’t just about dampening pain signals. Think of these tools as stepping stones toward a bigger goal: moving better, building strength, and reclaiming your day-to-day activities. Whether it’s the best anti-inflammatory medication for back pain or an injection to ease a flare-up, use these interventions to open the door to more active therapies like physiotherapy or mindful movement.
If you’re looking to dive deeper into evidence-based pain management strategies, check out these resources:
NICE Guidelines for up-to-date recommendations on various pain medications and procedures.
Cochrane Reviews for rigorous analyses of which pain management approaches are backed by strong evidence.
You can also explore apps like Manage My Pain or PainScale for tracking your medication use and outcomes, helping you better communicate your pain patterns to your healthcare team.
There’s no single “best” pain medication or perfect procedure—it’s about finding the right combination for you. Medications and medical procedures can be powerful allies, but they should be just one part of a broader pain management plan. Keep talking to your healthcare team, stay curious about your options, and remember that progress is about finding what works for you—not just chasing after the strongest painkillers or the quickest fix.
With the right support and strategies, you can find a path that’s not only about managing pain but truly living again.
Help on Your Pain Recovery Journey
If you need help evaluating all the different pain relief options out there, including medications, and a holistic treatment plan tailored to your individual needs then please get in touch to discuss how I can help you on your recovery journey.
REFERENCES
- 'Why painkillers sometimes make the pain worse' | (Science) | <https://www.science.org/content/article/why-painkillers-sometimes-make-pain-worse> | accessed: 9th October 2024.ncbi.nlm.nih.gov/pmc/articles/PMC5472077/">
