Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why physicians need to become more educated about alternative pain treatments

Cindy Perlin, LCSW
Conditions
November 1, 2024
Share
Tweet
Share

All indications are that pain care in the United States is in crisis. There is an epidemic of prescription opioid-fueled opioid addiction and overdoses (over a million dead and millions more addicted) as well as an epidemic of chronic pain. Estimates of the prevalence of pain indicate that from 21 percent (2021 National Health Interview Survey) to 56 percent (2021 Harris Poll) of Americans have chronic pain, and about 7 percent have high-impact pain (pain that limits daily activities on most days or every day). Forty percent of doctor visits are due to pain, and chronic pain is the leading cause of disability in the United States.

At the same time, a 2018 systematic review of pain medicine content in medical school curriculums in the United States found that the median number of hours dedicated to pain medicine was nine hours. This was an increase from a 2013 study that found that the average amount of time dedicated to pain education was less than two hours. Surveys of primary care physicians have found that most physicians do not feel competent in their ability to treat pain. Overzealous overreach and prosecution by the Drug Enforcement Agency (DEA) of even legitimate doctors treating legitimate pain patients with opioids has left many doctors fearful of treating pain patients with one of the few tools they have been told is effective. Pain patients frequently complain that they get little help from their physicians, who treat them like drug seekers and frequently abruptly taper or cut them off from opioids without regard to withdrawal issues and without offering other options. When pain patients lose their doctors due to relocation, physician retirement, or loss of licensure, they often cannot find other physicians willing to take them on.

The tools that conventional physicians have access to are primarily pharmaceutical or surgical and fall short for most patients due to poor effectiveness or side effects. Opioid addiction risks are high (10-12 percent of those prescribed), and that is not the only problem. More than 50 percent of patients prescribed opioids find the side effects intolerable or the drugs ineffective. Opioids also lower immune response, contribute to traffic accidents and fatalities, increase the incidence of falls in the elderly, can cause psychosis in vulnerable individuals, and can increase pain levels over time (hyperalgesia).

All other pharmaceuticals prescribed for pain have limitations in terms of ineffectiveness, serious side effects, or risks. Gabapentinoids, including gabapentin and Lyrica (pregabalin), provide pain relief in less than 25 percent of patients, according to patient surveys, while many report intolerable side effects, including fatigue, brain fog, anxiety, depression, mood swings, memory problems, suicidal thoughts, addiction, and more. Recent studies have found that gabapentinoids increase the risk of dementia. NSAIDs can cause life-threatening gastrointestinal bleeding, kidney damage, and an increased risk of heart attacks and strokes with chronic use. Immunosuppressant drugs increase the risk of infections and cancer. Antidepressants have not been shown to be effective for chronic pain, and side effects include drowsiness, dizziness, weight gain, heart rhythm problems, confusion, agitation, hallucinations, insomnia, increased eye pressure, and much more.

Surgical procedures are often misguided and cause harm. This is particularly true of back surgery, often based on a false premise that disc issues such as degenerated, bulging, or herniated disks are the cause of back pain. MRI studies going back as far as the 1990s found that most people, particularly as they grow older, have “disc disease” and often have no pain, leading researchers to conclude that findings of disc abnormalities may be coincidental and unrelated to the pain. Back surgery often makes things worse, resulting in failed back surgery syndrome, often treated with spinal cord stimulators that are often ineffective, poorly tolerated, and cause more harm.

Beyond the issues of ineffectiveness and serious side effects, the problem with conventional pain treatments is that they do not get to the real root of the problem, so patients do not get better. Common causes of chronic pain include nutritional deficiencies, muscle weakness, spasm, stiffness or imbalance, chronic inflammation, poor posture, toxic exposures, chronic stress, or unresolved trauma.

There is growing evidence that alternative pain treatments are effective in treating and often eliminating chronic pain by treating the underlying causes. These interventions include nutritional medicine (provided by functional and integrative MDs, nutritionists, and naturopaths), exercise, mind/body approaches (including meditation, psychotherapy, particularly trauma-informed, biofeedback, and neurofeedback), chiropractic, massage therapy, physical therapy, herbal medicine, cannabis, and more. There are also a variety of noninvasive devices that reduce pain and inflammation and accelerate healing, including red/infrared light therapy, pulsed electromagnetic frequency therapy (PEMF), frequency-specific microcurrent therapy, neuromuscular electrical stimulation (NMES), infrared heat therapy, hyperbaric oxygen therapy (HBOT), Calmare Scrambler Therapy, and more. These interventions tend to be very safe. The only “side effects” are improved overall health and well-being.

By becoming more educated about alternative pain treatments and making appropriate recommendations and referrals, physicians can vastly improve their pain patients’ quality of life as well as improve their own satisfaction with their work.

Cindy Perlin is a social worker.

Prev

How modern ads manipulate your health fears for profit [PODCAST]

October 31, 2024 Kevin 0
…
Next

Why this doctor stayed stuck in a job for years and how she finally broke free

November 1, 2024 Kevin 0
…

Tagged as: Pain Management

Post navigation

< Previous Post
How modern ads manipulate your health fears for profit [PODCAST]
Next Post >
Why this doctor stayed stuck in a job for years and how she finally broke free

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Cindy Perlin, LCSW

  • From suffering to healing: the role of trauma in chronic pain

    Cindy Perlin, LCSW
  • It’s time for a reckoning in pain medicine

    Cindy Perlin, LCSW
  • The feds say restrict opioid use. Now what?

    Cindy Perlin, LCSW

Related Posts

  • Beyond opioids: a new hope for chronic pain relief

    L. Joseph Parker, MD
  • Topoisomerase inhibitors and chronic pain

    L. Joseph Parker, MD
  • High-deductible health plans: a barrier to care for chronic conditions

    Shirin Hund, MD
  • Think twice before prescribing opioids as a first-line treatment for pain

    Gary Call, MD
  • Merging the wisdom of pain medicine and addiction medicine to optimize outcomes

    Julie Craig, MD
  • Euphoria-free pain relief: A gabapentin alternative you’ve been waiting for?

    L. Joseph Parker, MD

More in Conditions

  • Hope is the lifeline: a deeper look into transplant care

    Judith Eguzoikpe, MD, MPH
  • From hospital bed to harsh truths: a writer’s unexpected journey

    Raymond Abbott
  • Bird flu’s deadly return: Are we flying blind into the next pandemic?

    Tista S. Ghosh, MD, MPH
  • “The medical board doesn’t know I exist. That’s the point.”

    Jenny Shields, PhD
  • When moisturizers trigger airport bomb alarms

    Eva M. Shelton, MD and Janmesh Patel
  • Medicaid cuts are quietly fueling the diabetic kidney failure crisis

    Jane Zill, LICSW
  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • When errors of nature are treated as medical negligence

      Howard Smith, MD | Physician
    • Physician job change: Navigating your 457 plan and avoiding tax traps [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden chains holding doctors back

      Neil Baum, MD | Physician
    • Hope is the lifeline: a deeper look into transplant care

      Judith Eguzoikpe, MD, MPH | Conditions
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • From hospital bed to harsh truths: a writer’s unexpected journey

      Raymond Abbott | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • When errors of nature are treated as medical negligence

      Howard Smith, MD | Physician
    • Physician job change: Navigating your 457 plan and avoiding tax traps [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden chains holding doctors back

      Neil Baum, MD | Physician
    • Hope is the lifeline: a deeper look into transplant care

      Judith Eguzoikpe, MD, MPH | Conditions
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • From hospital bed to harsh truths: a writer’s unexpected journey

      Raymond Abbott | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why physicians need to become more educated about alternative pain treatments
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...