Alternatives to Opioids

Alternatives to Opioids

In response to a growing opioid epidemic, the CDC released opioid prescription guidelines in March 2016. The guidelines recognize that prescription opioids are appropriate in certain cases, including cancer treatment, palliative care, and end-of-life care, and also in certain acute care situations, if properly dosed.

But for other pain management, the CDC recommends nonopioid approaches including physical therapy.

Meditation and Relaxation

Meditation and relaxation can be used in a variety of ways depending on the person. Relaxation is used to slow breathing, reduce heart rate and lower blood pressure, and produce a feeling of calm and stability. Various meditation techniques include guided imagery, deep breathing, biofeedback, progressive relaxation and more. Learn more

Cognitive Behavioral Therapy

Cognitive behavioral therapy is a form of psychotherapy that focuses on helping patients change their thinking patterns in order to change unhealthy behavior or moods. Sessions involve structured meetings with a trained mental health counselor or psychologist for a limited amount of time. Cognitive behavioral therapy often involves relaxation exercises, journal writing, and certain stress and pain relief methods. Learn more


Spinal traction is a form of decompression therapy that relieves pressure on the spine. It can be performed manually or mechanically.

Spinal traction is used to treat herniated discs, sciatica, degenerative disc disease, pinched nerves, and many other back conditions.


Chiropractic care typically involves manipulation or adjustment of the spine and other parts of the body by a chiropractor or osteopath. Chiropractors are healthcare professionals who are licensed by the state in which they practice. Learn more


According to the National Institute of Health, research suggests acupuncture can help manage certain pain conditions. Therefore, some states have acupuncture listed as an essential health benefit under insurance to treat pain. These states are Alaska, California, Maryland, New Mexico and Washington. Otherwise in other states individual providers decide whether to cover acupuncture.

Massage Therapy

According to the U.S. Department of Health and Human Services, massage therapy can come in many different forms. It typically involves the manipulation of soft tissue for health-related issues and can be used as a way to treat pain. Learn more


In transcutaneous electrical nerve stimulation (TENS) a special device transmits low-level electrical charges into the area of the body that is in pain.

A TENS system consists of a small, battery-powered machine connected by wires to a pair of electrodes. The two electrodes are connected to your skin near the source of pain or at a pressure point. A mild electrical current travels through your skin and along your nerve fibers which may cause a warm, tingling sensation. A typical TENS session lasts anywhere from 5 to 15 minutes.


According to the SAMHSA, yoga is both a mind and body practice that combines breathing techniques, physical postures, and meditation or relaxation. Many different styles of yoga exist, varying in focus and intensity of physical movement that can be tailored to fit each individuals needs. Learn more

Physical Therapy

Physical therapists treat pain through active movement. Opioids only mask the sensation of pain.

Physical therapy “side effects” include improved mobility, increased independence, decreased pain, and prevention of other health problems through functional movement and exercise. Occasionally muscle soreness may occur but this is normal and usually resolves in a few days. Opiod side effects can include depression, overdose, addiction, and withdrawal symptoms.

Physical therapy is effective for numerous conditions, and the CDC cited “high quality evidence” supporting exercise as part of physical therapist treatment for familiar conditions like low back pain, hip and knee osteoarthritis, and fibromyalgia. Opioid effectiveness for long-term pain management is inconclusive in many cases.