Living 100

Before prescribing opioids for acute pain, carefully consider whether initiating opioid therapy is necessary.


A. Avoid prescribing for conditions where opioids are rarely indicated.

Here is a brief list of conditions that would rarely indicate opioids:

• Headache

• Self-limited Illness (i.e. sore throat)

• Uncomplicated Neck and Back Pain

• Uncomplicated Musculoskeletal Pain

B. Use alternative treatment modalities and non-opioid and non-pharmacological treatments for acute pain.

See below for complete lists of alternative treatments.


Patient Instructions:

• Activity modification

• Sitting/driving precautions (ergonomics)

• Avoid painful lifting and carrying

• Supportive shoes for standing and walking

• Lumbar sacral corset

Modalities:

• Regular Walking

• Physical Therapy

• Heat/Ice

• Acupuncture

• Yoga

• Pilates

• Massage

• Core Isometric Exercises

• Reflex Zone Therapy

• Aromatherapy

Topical Analgesics:

• Capsaicin

• Menthol

• Lidocaine Patch/Gels

• Topical Diclofenac

• Ketoprofen

• Salicylic Acid


Non-opioid Pharmacological:

• NSAIDs

• Tylenol

• Steroids

• Neuropathic Pain Agents

Risk of Abuse, Use with Caution:

• Muscle Relaxants

• Benzodiazepines

• Sleeping Pills

• Gabapentin

To determine eligibility and benefits, check with the patient's insurance provider; contact information should be listed on the back of the patient's insurance card. It is recommended that, when possible, physicians check payor websites to verify benefits in writing.