Avoid long-term use of narcotics for chronic nerve pain

Chronic pain has become an accepted complication of a career in high-velocity collision sports and combat sports. Unfortunately, the pain doesn't end with retirement and in fact can intensify with age. Novel approaches to treatment are needed to avoid chronic use of opiate medications.

The human nervous system is divided into the central nervous system and the peripheral nervous system. The central nervous system consists of the brain and spinal cord. The peripheral nervous system is made up of the nerves that extend from the spinal cord to the muscles, joints and skin.

Pain is transmitted via signals from peripheral receptors to the brain where they are interpreted. Peripheral nerve pain from contact sports is often the result of direct trauma or stretching of large nerve trunks.

Trauma to sensory nerves can result in sensory loss. Often, injured sensory nerves will typically transmit misinformation called paresthesias. These "perversions" of sensation are typically described as burning, crawling, tingling or pins and needles. They can escalate from being an annoyance to debilitating.

The key element in treating chronic pain is to avoid the use of narcotics or other habit-forming medications since they are not a long-term solution. Opiates and other narcotics are designed for short-term therapy only.

Non-pharmacologic treatments in the form of mindfulness meditation, regular aerobic exercise and yoga are accepted approaches. Acupuncture also has been reported to show significant benefit in reducing pain for some patients.

Non-narcotic medications are often successful in treating chronic pain. Antiepileptic drugs as well as antidepressants are designed to treat conditions that affect the brain by altering brain chemistry. These medications also are effective in treating chronic pain.

Non-narcotic treatment of chronic pain demands a multidimensional approach for the best chance of success.

Further research into innovative approaches for the long-term treatment of pain, including the role of cannabis, is necessary.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu