Pain Centre

22 August 2017

How to avoid addictive painkillers after surgery

Non-drug approaches such as acupuncture and electrotherapy were investigated to help curb addiction to medication for chronic pain.

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Do you have stubborn post-operative knee pain and have used drugs like oxycodone and codeine?

There are however drug-free interventions to manage pain, including acupuncture and electrotherapy, which may help reduce the need for prescription painkillers after knee replacement surgery, according to a new review.

According to a Health24 article, prescription opioids often used in the management of pain can quickly become habit-forming if not used correctly.

Opioids 'gateway to addiction'

"As prescription opioid use is under national scrutiny and because surgery has been identified as an avenue for addiction, it is important to recognise effective alternatives to standard pharmacological therapy, which remains the first option for treatment," the study team wrote.

There is increasing concern about opioid dependence among patients suffering from chronic pain. Examples of opioids include oxycodone (OxyContin and Percocet) and hydrocodone (Vicoprofen).

According to the South African Depression and Anxiety Group (SADAG), pain killers such as opioids are the most commonly abused prescription drugs.

There are about 16 million people in the US who abuse prescription medication, and it is believed that this research on drug-free pain relief can help curb the addiction problem.

Alternative treatments explored

The finding stems from an in-depth look at 39 already-completed studies. These studies included nearly 2 400 total knee replacement patients.

The studies looked at a number of different alternative treatments, including:

  • Acupuncture
  • Electrotherapy (the use of electrical energy to stimulate nerves and muscles)
  • Cryotherapy (involving the application of extreme cold to the surgical region)
  • Machine-based rehabilitation regimen known as continuous passive motion
  • Pre-surgery exercise regimens

Less reliance on opioids

The review team was led by Tina Hernandez-Boussard of Stanford University. The investigators found no evidence that either continuous passive motion or pre-operative exercise reduced pain after surgery or the need to take opioids. Cryotherapy also didn't appear to help curtail pain. It was marginally linked to a drop in opioid use.

Hernandez-Boussard and her colleagues outline their findings in the issue of JAMA Surgery.

Both acupuncture and electrotherapy were "moderately" linked to effective pain control and less reliance on opioids among knee surgery patients, the findings showed.

Image provided by iStock.