September is Pain Awareness Month

September is Pain Awareness Month

Created on: Monday, September 11, 2017
Author: Sports and Orthopaedic Specialists

While many of our patients report to the clinic with the goal of decreasing pain, the pathway to this goal does not always include the use of narcotic pain medications. As opioid abuse in the United States has become rampant, it has is more important than ever to recognize the risks associated with pain management. According to the U.S. Department of Health and Human Services, the rate of overdose deaths involving opioids (including prescription pain relievers and heroin) has quadrupled since 1999.

 
Professional associations such as the American Academy of Orthopaedic Surgeons have recently increased efforts to emphasize the need for caution on both physician/provider team and patient side of prescribing pain medications. The section below is an excerpt from the AAOS Prescription Safety page: 

Tips to Safely Manage Pain

Given the dangers of prescription opioids, how can patients safely and effectively manage pain?
  • First, expect some pain. Pain is part of the normal healing process after surgery or an injury and will improve day-by-day. The first few days after a surgery or injury are typically the worst.
  • Many injuries and conditions do not require prescription medication for pain relief.
    • Splints, regular use of ice or heat on and off the affected site, and non-opioid pain medications (such as acetaminophen or ibuprofen) are often enough to manage the pain and discomfort of many common injuries such as lacerations and fractures.
    • Don't discount the powerful effects of a positive coping strategy, peace of mind and relaxation on your comfort and recovery. Studies have shown that patients who are prepared to experience pain after an injury or surgery are more likely to feel less pain, and have a more positive feeling that their recovery is on track. The support of family and friends, as well as entertainment and laughter, can all help during times of discomfort.
  • Discuss a pain relief plan with your doctor and stick to it.
    • Your doctor can specify an appropriate plan to minimize pain, which may include a combination of opioids and over-the-counter pain medications. Because pain medications may have adverse effects when combined with even over-the-counter medicines, it is important to tell your doctor about all medications you are taking.
    • Your doctor also can tell you how much is too much pain, and how to know (in the rare instances) when a problem or infection has occurred.
  • If prescribed opioids, try to take as little as possible and stop taking them as soon as possible.
    • One way to do this is by adding over-the-counter pain medications, such as acetaminophen (e.g. Tylenol) and ibuprofen (e.g. Advil) to opioid treatment. Before doing this, however, you should always check with your doctor. Many opioid pills already contain acetaminophen and, in large doses, acetaminophen can cause serious side effects. In addition, people who are taking blood thinners should not take ibuprofen or any other nonsteroidal anti-inflammatory medications, such as naproxen (e.g. Aleve) or aspirin.
    • If there is no acetaminophen in the opioid pills, you can add acetaminophen—either two extra strength pills every six hours around the clock or two regular strength tablets every four hours around the clock for two days.
    • Alternate the acetaminophen with ibuprofen so that you're taking one or the other every three hours, and never take more than four grams (4000 milligrams) of acetaminophen daily.
    • If you have had a nerve block (an anesthetic injection) that has worn off, you can take the stronger pain reliever every three hours for the next three doses.
  • Only take opioids as prescribed.
    • Never take more than instructed, take someone else's medicine, or give your medication to someone else.
    • Never combine opioids with alcohol or anxiety medication.
    • Never use opioids to treat anxiety or to sleep, out of fear of pain, or to feel good.
  • Always store and dispose of opioids safely.
    • Pain relievers are a leading cause of serious poisoning of children and pets when medications are left unsecured.
    • Hide or lock up opioid medications to avoid access by family, friends or houseguests.
    • Keep prescription medications in their original packaging so it is clear for whom the medications were prescribed and the directions for appropriate use.
    • Place unused opioids in a disposal unit in a pharmacy or police station. To find a disposal site near you, visit the U.S. Drug Enforcement Administration's Controlled Substance Public Disposal Locations.
  • Remember: Only one doctor should prescribe opioids. As medical record systems and state databases are implemented and improved, fewer patients will be able to secure pain prescriptions from multiple providers.
 
This information is only a guideline and should not take the place of recommendations from your physician. Please click here if you wish to learn more about the AAOS Public Service Campaign. You can find additional information regarding pain management on the Allina Health website, including a podcast with Dr. Matthew Monsein.
 
References: 
American Academy of Orthopaedic Surgeons OrthoInfo.  Prescription Safety. http://orthoinfo.org/topic.cfm?topic=A00771. January 2017.
 

 



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