In the United States there is a very large debate going on about narcotic medications and chronic pain management. As a modern medical society, we expect to go to the doctor/hospital and take a pill to instantly relieve our pain. After all, narcotics are the mainstay treatment for acute pain relief. This has created a problem for people who develop chronic pain. Those individuals who develop chronic pain still have the same perception and expectations that a pill will take away their pain. Unfortunately this has led to a massive amount of over-prescribed narcotics.
An issue often overstepped about narcotics is tolerance and abuse. Opiates such as hydrocodone, oxycodone, and hydromorphone all have addictive qualities and tolerance side effects. Just like alcoholics, the first time someone takes a drink, it takes less alcohol to have a buzzed effect. However in a 20 year chronic alcohol abuser, it takes much more alcohol to achieve this effect. 
This is an example of tolerance and the same principle is applied to narcotics. Now apply this to a 50 year old who is expected to live to 80 years old being treated for chronic pain with narcotics. That means 30 years of pain medications. This scenario often ends with patients being unhappy, wanting a higher and higher dose to control their pain. Chronic narcotic use can also cause additional health problems.
One current trend is the movement towards nonopiod pain management. Using medications that do not cause tolerance or addiction should always be preferable. New chronic pain management movements include a nonopiod multimodal approach. Things that may be included in this approach; physical therapy, nonopiod medications, injections, ice/heat etc. At Prairie Spine & Pain Institute, we believe and implement this approach. Our goal is to return the patient to the highest level of function while reducing pain as much as possible. Avoiding narcotics and side effects/complications of narcotics in a long term setting is the best approach for patients with chronic pain.
About The Author: Derek N. Morrow, PA-C is a physician assistant with Prairie Spine and Pain Institute. Derek works in the clinic setting as a health care provider seeing patients. He is also utilized in the operating room as a first assist in surgery. In the clinic setting, his key function is to diagnose new patients and conduct their initial treatment. He works directly with patients to establish customized treatment programs and to monitor their progress. He also conducts history and physical evaluations for many patients. He performs many office procedures including trigger point injections, large joint injections, and bursa injections, all with the help of ultrasound guidance. He is radiologically trained, and uses his knowledge of X-ray, Ultrasound, MRI, CT, and EMG-Nerve Conduction Studies to establish a diagnosis and determine the appropriate treatment. Derek is surgically trained and plays a vital role in the procedures we perform at Prairie Spine and Pain Institute.
