Opioids in Orthopedic Treatment
Opioids are a class of drugs originally derived naturally from the opium poppy plant. The chemicals in opioids can help relax the body and relieve pain. They are used in medical treatment in the form of well-known prescription drugs such as hydrocodone and morphine. While they aren’t inherently dangerous when prescribed and taken correctly, the natural dopamine “high” they can elicit can be extremely addicting.
It is estimated that approximately 84,000 people died in the United States in 2023 from overdoses involving opioids. This marks a decrease over previous years, but opioid abuse continues to be a public health crisis in the U.S. While prescription opioids are thought to be responsible for less than 30% of opioid-related overdoses, up to 20% of patients prescribed opioids after trauma or orthopedic surgery report long-term dependency.
A 2021 study estimated that 7.7% of all opioid prescriptions in the U.S. are prescribed by orthopedic surgeons. In the orthopedic space, patients are most often prescribed opioids for pain relief post-surgery, but in cases where the patient is prescribed opioids prior to surgery, the risk of prolonged opioid use becomes even more significant.
As awareness about the dangers of opioid dependency has increased, providers and patients alike are starting to seek alternative options for pain relief that minimizes or eliminates the use of opioids. Here at Prescribe FIT, we believe that a lifestyle health approach can be one of the keys to reducing the necessity of opioids in orthopedics.
An Alternative Approach to Pain Management
Most patients are driven to seek orthopedic treatment because they are in pain. However, many patients don’t know that MSK and joint pain can be impacted by a variety of factors related to their health. Opioids can provide quick, easy relief, but prescribing them doesn’t address the root cause of a person’s pain. And even after surgery, the lifestyle factors causing or exacerbating the pain will still be there.
Instead of prescribing opioids at the onset of treatment, we recommend a lifestyle health approach that seeks to mitigate pain at its core. Helping patients make small, sustainable adjustments in the following key areas can reduce their pain before surgery and improve their recovery experience after surgery:
Weight reduction
Obesity is one of the top risk factors for orthopedic pain. More weight means greater pressure placed on joints and muscles, often for a prolonged time. Many patients do not understand how their weight may be contributing to their pain. Through education and personalized health coaching, we can help patients grasp the need to reduce the burden on their body and then implement a plan to help them do so.
Nutrition
Nutrition relates to weight reduction, but it can play a role in pain reduction as well. We can educate patients about how to incorporate specific foods into their diet that help lower inflammatory markers, easing some pressure on their joints. We approach nutrition with a moderation approach. Instead of asking patients to cut foods out, we simply ask them to reduce the intake of some and increase their intake of others. We find that this helps patients achieve a more balanced diet that is sustainable in the long run.
Physical activity
Physical activity can have a big impact on MSK pain, but it feels counterintuitive for many patients who are already in pain. We can show patients how to introduce simple, low-impact activities such as walking into their daily life, helping them strengthen supporting muscles, reduce inflammation and increase overall mobility.
Lifestyle
Our goal is the same as the patients and providers we partner with: a pain-free life. That’s why we believe in root cause medicine and lifestyle health. We want to equip patients with the tools they need to achieve and then maintain a healthier body overall, as well as the education to understand how the choices they make affect their wellbeing.
Focusing on those key areas can make a significant difference in a patient’s pain, in addition to supporting more optimal surgical outcomes. Through those simple changes to diet, exercise and knowledge, 82% of our patients in severe pain typically report a reduction over 30 days. Imagine how it can positively influence their life long-term.
Proactive, Personalized Support for All Patients
Orthopedic surgery is a major, often life-changing event for patients who need it. But some patients with musculoskeletal pain or joint issues don’t need surgery. No matter if a surgical or non-surgical treatment plan is prescribed, lifestyle changes will help. However, many patients may struggle with compliance to generic lifestyle health or weight loss recommendations. Having proactive, personalized support throughout their orthopedic journey can make the experience much smoother for them.
Prescribe FIT helps keep patients and providers better connected through remote patient monitoring (RPM) technology and our dedicated Health Coaches, who are paired one-on-one with each patient. The combination of physician-monitored intervention and a supportive, knowledgeable support team at their fingertips helps patients work through, and stick with, the lifestyle changes they need to reduce pain.
Instead of leveraging opioids for pain reduction, consider a root-cause medicine program to start. Pain reduction through natural, evidence-based methods is highly possible for most orthopedic patients. While it may not be the immediate results opioid-based pain treatment would provide, it can improve your patients’ MSK and joint health for the rest of their lives. And, it can even support better surgical outcomes.
Ask us about our surgical optimization and lifestyle coaching programs today.
Published on February 11, 2024
