Pain is sometimes nature's way of telling you not to do something: don't stick your hand in an open fire, watch where you are walking, be careful with that knife. But exercise, especially physical therapy, can cause some short-term pain in return for stronger muscles, freer movement, better stamina.
The standard treatment for pain due to workout injury or general poor health is a combination of pharmaceuticals and physical therapy. For your injury, your physician will probably prescribe opioid analgesics or painkillers such as morphine, codeine, oxycodone, hydrocodone, and—less often—methadone, and fentanyl.
Reasons to Choose the Mind and Body over Medication
While pain can impede your recovery by discouraging physical activity, it is your body’s natural alarm system. The persistent sensation of pain should signal you to seek medical assistance as soon as possible. Chronic pain may indicate something more serious than a temporary sprain, such as fibromyalgia—a pain-processing disorder with no known cause or cure—or the degenerative joint disorder osteoarthritis.
Pharmaceuticals often offer effective treatment for short-term pain to carry you through recovery. Common painkillers include non-steroidal anti-inflammatories, opioids, local anesthetics, paracetamol, or antidepressants.
Numbing your pain completely, however, may not be wise. You might miss something your body is trying to tell you. There also is the chance that your body does not respond well to certain painkillers. Maybe you would just rather take a natural path to recovery.
If you elect to use a non-pharmacological approach to your pain instead of painkillers, here are some things you should know about your options.
Train Your Mind to Cope with Pain
When you decide to change from your sedentary lifestyle and begin a fitness program, it is common to experience some pain after a workout. “No pain, no gain” is often true. Getting into shape or increasing your physical performance may involve pain throughout your workout timeline.
One way to cope is to prepare yourself psychologically to accept that pain as unavoidable during exercise. Preparing for and anticipating pain will significantly lower the amount of stress it places on your body. The right attitude towards pain activates the full potential of your mind and enables you to focus your thoughts and concentration on better coping and management of pain.
The pain will also become more bearable when you can take your mind off it. With a strong will, you can easily distract yourself from the distress it causes. Eventually, as your physical fitness improves, your body restores itself without the experience causing too much discomfort.
Another alternative for pain management is physical therapy. It is not just for invalids who are recovering from a broken leg, radical surgery, or other physical injuries. Millions of Americans use physical therapy—instead of or in addition to medication—to cope with unexplained chronic pain every day.
What sets physical therapy apart from medication-based pain treatment options is its ability to restore the body more meaningfully. Pharmaceuticals offer quick but short-term pain relief. They become increasingly ineffective the longer they are used while the risk of addiction or dependence (and their side effects) increase.
Movement-based physical therapy may take longer and not completely eliminate pain, but also will restore strength, control weight, and improve blood pressure, quality of sleep, and emotional well-being.
“Physical therapy can't immediately make all your pain go away”, says the University of Utah Health’s Tamara Dangerfield. “It's not a quick fix, and it's not a cure. There's no cure for pain. Pain is part of your body's process.”
However, “Physical therapy can treat pain”, Dangerfield says, and that's not just movement or exercise. It also includes “electrical modalities"—ultrasound, electrical stimulation—and “dry needling” (similar to acupuncture).
Your first contact with physical therapy will undoubtedly involve much pain, but that doesn't mean physical therapy isn't helping or that you are somehow "failing". It will soon be manageable as you make progress.
Reasons Not to Choose Medication
Now that you know the options you have other than drugs, you may be wondering why you might want to shun pharmaceuticals.
- Medications become less and less effective as you continue using them. In the case of chronic pain, it will only be a matter of time before you will be needing more potent doses or higher amounts to achieve the same effect.
- There is a significant risk of dependence. Most opioid-based painkillers can quickly lead to addiction. That's why they were rarely prescribed for long-term or chronic pain in the past.
- Prescription opioids, the root cause of the opioid crisis, has been found susceptible to abuse and misuse.
- If you do become dependent on them, and your primary care physician (PCP) cuts off your supply, you might resort to black market drugs. (The opioid crisis in America has brought to light the extent of poor choices people make when dealing with pain.) Worse, you don't always know what you are getting or its potency. Drug dealers don't offer quality assurance or a FDA seal of approval. A slight miscalculation in dosage can lead to overdose and addiction.
Understanding Your Meds
There is a reason that some drugs are sold over the counter (OTC) and others are prescription-only: prescription drugs carry a higher risk of misuse. If a few OTC pain relief meds will get you back to exercising, that's fine. Opioids such as morphine and fentanyl are never sold OTC.
What is fentanyl? It is a synthetic opioid up to 100 times more potent than morphine and up to 50 times more potent than heroin. Nevertheless, fentanyl is a legally prescribed drug—usually prescribed for cancer patients or after major surgery—as well as probably the most deadly illegal drug in the opioid crisis.
To decrease the likelihood of diversion or misuse, legal fentanyl is often prescribed as a time-release transdermal patch (like a nicotine patch for quitting smoking). Illegal fentanyl, smuggled from China through the US mail or across the Mexican border, is often laced with or substituted for other drugs, including prescription opioids, benzodiazepine, cocaine, and heroin
Mixing drugs with other drugs or alcohol can have deadly interactions. That's why you should tell your PCP about all of the drugs or supplements you use. Without guidance from a physician and proper information about the painkiller you choose, you risk serious health consequences that include overdose and death.
Ultimately, the proper way to manage serious pain should be with the advice of a trained health professional. With foreknowledge of the alternatives, you can be an informed consumer and participant in your treatment. By understanding how both pharmaceuticals and non-pharmaceutical methods work best, you will be able to profit from pain management.