Nonpharmacological Pain Management
The concentration of controlling chronic pain is to allow each patient to have the best outcomes despite living with a serious illness. Healthcare providers are trained to meet the objective of reducing pain, stress and other debilitating symptoms of serious illnesses. As multiple barriers exist and prevent healthcare providers from being successful in managing pain in patients, the pain continues. The major approaches to pain management include pharmacological and non-pharmacological interventions. It is; however, unclear which approach gives the best results. This paper is focused on exploring pain management and alternative therapies such as non-pharmacological interventions.
Pain management is a challenging issue in delivery of healthcare. Despite significant achievements, the adverse impacts of unmanaged pain are considerably unresolved. Ineffective handling of pain can result in a marked decline in anticipated medical and physiological outcomes and the overall quality of life for a patient. When someone is diagnosed with a life-threating or serious illness, one of the first things that bring fear and stress in the patient life is pain. Indeed, this is the first question the patient commonly asks. It is important to evaluate the most appropriate method of handling pain that would attain optimal health outcomes with minimal side effects. It is crucial to know, what is the most appropriate pain management method in patients with long term or chronic pain? Are non-pharmacological interventions more effective than pharmacological interventions? There are different methods to manage pain but the common know is through medication where a class of drugs referred as opioids are commonly administered. These drugs have side effects that sometimes are short term or long term. However, medication is not the only available option for pain management in relation to patients suffering from long term pain. There are non-pharmacological approaches that are best and have no side effects on the patient’s life. My purpose is to talk about the difference between nonpharmacological and pharmacological approaches, show evidence of how dangerous opioids can be and provide evidence of how non-pharmacological and other alternative therapies can be successful when managing pain.
The Body of the Research Report:
The perception of pain by a patient is significant in determining the patient’s response to pain therapy. The term pain is described as a spiteful physical, sensory, and emotional feeling related to actual or possible damage to tissue (Resnick, Boltz, Galik & Holmes, 2019). Pain management can be defined as an interdisciplinary process of easing that experience and enhancing the quality of life of the individuals suffering from pain. Management of pain takes two forms: pharmacological and non-pharmacological. The former entails administration of drugs through the various routes, including oral, rectal, intramuscular, intravenous, and other non-traditional methods (Lehugeur et al., 2017). The drugs may be non-opioid or opioid analgesics depending on the type and intensity of the pain. Opioid analgesics work on opioid receptors, which are available in the nervous system. The painkillers are grouped according to their affinity and intrinsic activity. Their adverse impacts may include respiratory depression, declined intestinal motility, and nausea (Lehugeur, et al., 2017). Non-pharmacological methods entail the use of physiological technics such as hypnosis, distraction, and biofeedback to reduce patient anxiety and enhance his or her satisfaction. Furthermore, they may involve physical methods, including heat, cold, immobilization, and massage (Lehugeur et al., 2017). These interventions are easy to learn and can be conducted at home with no projected negative outcome.
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The American Pain Society estimated that the total cost of health care due to pain was around $635 billion a year (Krauss, 2019). In dealing with this widespread reason for hospital visits, opioids have often been the cornerstone in treating patients with severe and debilitating pain. While highly effective in the treatment and management of pain, it is now known to be an underlying epidemic in substance abuse and is the cause of many overdose deaths. It is believed that opioid use has the potential to even become a gateway to the use of heroin, which is a cheaper and more easily obtained alternative to prescription opioids (Smith, 2017). Understanding the pharmacokinetics of opioids is imperative in understanding the dangerous adverse effects that come with its use. The rapid onset of action produced by opioid analgesics is associated with a marked euphoria that has a great potential for abuse. I believe nurses have the predominant role in pain control by offering patients nonpharmacological interventions for pain relief. Steering patients away from opioids allows nurses to promote alternative methods of pain relief that are not associated with the dangers of abuse or addiction.
Addiction is a disease that develops and characterized by the psychosocial, genetic and environmental factors. Opiate addiction originates in people in many different ways. It can start with a need for pain management with the use of pain medication that escalates into addiction. Opiates encompass a wide variety of drugs from codeine and morphine to oxycodone, dilaudid, fentanyl and many others, all used by the medical world on a regular basis. Opiate addiction, however, it originates in an individual, is when the body becomes physically dependent on opiates to be able to function normally in everyday situations. The prolonged use of opiates is what brings on the problem of addiction. The American Medical Association (2013) states that some people even withdrawal from opiates after being given such drugs for pain while in the hospital without realizing what is happening to them. With the vast use of opioids medications as the main option of pain management, there is a rise in the overdose deaths, recent findings indicated that addictive medication like morphine or oxycodone does not have to be necessarily the first choice for a chronic illness. The research further suggested that opioids bear no additional advantage over the non-opioid or any quality or function with a patient who has chronic pain, instead, the findings demonstrated that these drugs have other side effects that may harm the life of the patient in the later day.
There are several different types of symptoms of addiction. There are mood symptoms including: depression, euphoria, mood swings, anxiety, hostility towards others, and agitation and irritability. The main intervention including; chrono therapeutic, behavioral activation and psychotherapies, and revealed that it is possible to include depression in patients in a complete structure intervention in an inpatient setting. These findings reported favorable results for interventions as opposed to controlled, however, methodological issues remain common (Wang et al., 2018). In this review, a diverse range of strategies treatment have been identified. This study also provided evidence, that treatment which are non-pharmacological for depression can be administered to enhance research and outcome done in inpatient settings. Research has it that opioids just acts on the nervous system to stop sending senses thereby reducing pain but not getting rid of the pain.
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There are some other nonpharmacological interventions involve treating and managing pain without the use of medications. These alternative therapies can help alleviate pain without the dangers associated with opioid use such as addiction and death. This method utilizes behavioral and physical approaches to alter thoughts and focus concentration in order to better manage and reduce the sensation of pain. Nonpharmacological therapies should be tailored individually to each patient and should focus on promoting comfort and altering one’s physiological responses to pain (Sheung-Tak et al., 2017). Examples of cognitive-behavioral interventions include the use of guided imagery, prayer, and biofeedback. Physical approaches include massage, cold and heat applications, and transcutaneous electrical nerve stimulation (TENS). By changing patients’ perceptions of pain, nurses can guide patients to alter their pain behavior and allow them to gain a greater sense of control. Physiological and behavioral changes associated with relaxation include the following: decreased pulse, blood pressure, and respirations; heightened awareness; decreased oxygen consumption; a sense of peace; and decreased muscle tension and metabolic rate (Sheung-Tak et al., 2017). Evidently, the benefits of using relaxation as an alternative for pain control can help promote comfort for patients. Nurses can utilize this information by encouraging patients to use interventions such as yoga and meditation for nonpharmacological pain therapies.
Other alternative therapy is the transcutaneous electrical nerve stimulation (TENS) which utilizes electrical currents that pass-through electrodes to produce therapeutic analgesia. The electrical impulses stimulate opioid and serotonin receptors found on sites along the spinal cord and brainstem, reducing the perception of pain. A double-blind study found that the use of TENS in females suffering from acute pain due to ovarian cysts, vaginal infection and vaginal trauma had reduced pain, a decreased heart rate, and lower incidences of nausea when treated with TENS (Mwanza et al., 2019). These nonpharmacological approaches may help patients take control over their pain and give them more control to improve quality of life.
I counterargument that even though opioids are strong pain medications, they can help if the patient has a severe short-term or acute pain such as pain after surgery or for a broken bone. Opioids are powerful drugs, but they are usually not the best way to treat long-term or chronic pain, such as arthritis, low back pain, or frequent headaches. If patients take opioids for a long time to manage chronic pain, they may be at risk of addiction.
Nurses play an extremely crucial role in health care; they spend ample time with patients and are responsible for assessing a patient’s needs and enabling his or her promotion of health. Nurses can be thought of as advocates for patients, as they are in a position to verbalize a patient’s needs and safety concerns. With the current opioid epidemic, it is imperative for nurses to promote the use of nonpharmacological interventions as much as possible. By decreasing a patient’s physiological and psychological need for opioid analgesics, nurses can decrease the incidences of abuse, addiction and death. Alternative therapies are cost effective, easy to apply, and non-invasive. Ultimately, these articles discuss the concept of pain management, investigating the most suitable option. Pain can be overbearing; therefore, patients need the help of healthcare providers as they cope with pain. It is practical that exploring the possible solutions to address the problem is significantly important. I do believe that both nonpharmacological and pharmacological approaches are important when treating pain but when medically managed, opioids are the most common medication prescribed which can lead to dependency. There are so many other nonpharmacological alternatives that can help the patient reduce chronic pain and will increase patient satisfaction and quality care.
- Chang, A. K., Bijur, P. E., Lupow, J. B., & John Gallagher, E. (2015). Comparative Analgesic Efficacy of Oxycodone for Short-Term Pain Management Following ED Discharge. Pain Medicine, 16(12), 2397–2404. https://doi-org.cosc.idm.oclc.org/10.1111/pme.12830
- Effective Medical Treatment of Opiate Addiction. (2013). JAMA: Journal of the American Medical Association, 280(22), 1936. https://doi-org
- Krauss, J. (2019). Helping Employees With Chronic Pain. Benefits Magazine, 56(5), 42. Retrieved from https://search-ebscohost-com.
- Lehugeur, D., Strapasson, M., & Fronza, E. (2017). Non-pharmacological management of pain relief in parts assisted by an obstetric nurse. Journal of Nursing UFPE on Line, 11 (12), 4929-4937. Doi: 10.5205 / 1981-8963-v11i12a22487p4929-4937-2017
- Mwanza, E., Gwisai, R. D., & Munemo, C. (2019). Knowledge on Nonpharmacological Methods of Pain Management among Nurses at Bindura Hospital, Zimbabwe. Pain Research & Treatment, 1–8. https://doi-org.cosc.idm.oclc.org/10.1155/2019/2703579
- Sheung-Tak Cheng, Ka Long Chan, Lam, R. W. L., Mok, M. H. T., Phoon Ping Chen, Yu Fat Chow, … Chow, Y. F. (2017). A multicomponent intervention for the management of chronic pain in older adults: study protocol for a randomized controlled trial. Trials, 18, 1. https://doi-org.cosc.idm.oclc.org/10.1186/s13063-017-2270-3
- Smith, D. E. (2017). Medicalizing the Opioid Epidemic in the U.S. in the Era of Health Care Reform. Journal of Psychoactive Drugs, 49(2), 95–101. https://doi-org.cosc.idm.oclc.org
- Wang, K., Burton, C. L., & Pachankis, J. E. (2018). Depression and Substance Use: Towards the Development of an Emotion Regulation Model of Stigma Coping. Substance Use & Misuse, 53(5), 859–866. https://doi-org.cosc.idm.oclc.org
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Pain management is a challenging issue in delivery of healthcare. Despite significant achievements, the adverse impacts of unmanaged pain are considerably unresolved. Ineffective handling of pain can result in a marked decline in anticipated medical and physiological outcomes and the overall quality of life for a patient.
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