Advancements in pain management are giving new options to patients

Hardly a day goes by without the public being warned about the dangers of opioids. But still, according to the National Institute on Drug Abuse, more than 130 people die every day of opioid overdose and the problem is getting worse. A Houston Methodist pain specialist says new advancements in pain management are giving patients options.

There are alternatives besides opiate types of pain medications such as medications that target nerve pain, nerve blocks and physical therapy. If your physician isn't open to alternatives, then see a second, third, or even fourth doctor."

Sagar Chokshi, M.D., Houston Methodist pain medicine specialist

Chokshi says if a doctor only prescribes pain medication for chronic or severe pain, it's important for patients to ask three questions:

  • Are there any alternatives to pain medications?
  • Can we reduce the dosage of the pain medications by combining them with other treatment options?
  • What is the plan for weaning me off of the medications?

"It is possible to treat severe and chronic pain with little to no pain medications, so it's important to find a physician who understands your concerns about taking pain medications and can offer you alternatives," Chokshi said.

This is something Helen Espinosa learned firsthand. She woke up one morning with achy muscles in her low back and legs. Within a few days she developed shooting pain in her right leg and foot that was so severe that she could not get out of bed. After five days in a local hospital, she was prescribed heavy doses of a number of powerful opiate pain medications and sent home.

"I was in so much pain that I didn't ask what all the medications were for," Espinosa said. "I just wanted the pain to go away. The medications didn't make the pain go away and I ended up in a wheelchair because I couldn't walk."

Espinosa was on these medications for a month before she was referred to Chokshi. He gave her a spinal injection and another injection to target pain in a specific area of her leg. Most importantly, he made adjustments to her medications so she would not get addicted.

"Over a three month period, we got Helen walking again, with little to no pain, and got her completely off the heavy doses of addictive pain medications she had been prescribed," Chokshi said. "If she didn't change her medications when we did, it's quite possible she would have dealt with some of the side effects of opioids, such as dizziness, nausea, vomiting, and constipation, for the rest of her life."


  1. Larry Feldman Larry Feldman United States says:

    The vast majority of those deaths are, and have been for quite some time, mostly attributable to illicit fentanyl and other street drugs, or polypharmacy.  Calling spinal injections, something I had over twenty years ago, advanced therapy is like calling the Dodge Dart the epitome of a modern automobile.  As for the opiod-hysterical tone of the article:  BMJ Jan 2018 500,000 surgical patients given opiods post-op between 2006-2013: all of PT6% showed signs of misuse. Point 6%!!!  Nora Volkow, Director NIDA  March 2016 in NEJM article states that the majority of opiod naive patients turned addict are people with a predisposition, and that it is a minority among those to who it will happen.  Most patients with a legitimate prescription (per SAMHSA 80% of non-medical users have pills never prescribed for them) who became addicted had a prior history of some type substance abuse and or mental health issue, gamed their doctor, abused the directions thinking foolishly they could return to normal activity quicker or that they shouldn't feel any little twinges of pain, or got the script at a pill mill type operation.  Please stop with the ridiculous hysteria that only serves to harm responsible pain patients while doing nothing for the real problem, which has moved past prescription pills being the cheap readily available flavor of the day. It's now heroin, fentanyl, and the returns of coke and a p2p meth that's 1/4 the price it was 15 yrs back.

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