Updated February 01, 2015.

Important note: This article is meant to detail approaches for finding non opiate ways of treating chronic pain. In case of pain from advanced disease states and other end of life situations, it's important to consult hospice or palliative care to discuss pain management strategies.

If you're a caregiver of a loved one with chronic pain, you know that the struggle to find appropriate pain management can be an intense one.

While opiate painkillers may be needed or appropriate in some cases, some research supports the idea that opiate painkillers do not work well for chronic pain and may even cause a paradoxical increase in pain.

Opiates also come with their own set of problems; they often cause drowsiness, memory and cognitive problems and as well as nausea. They also almost always cause some degree of constipation. These problems are sometimes worse in seniors. Your loved one and your loved one's health care providers might be concerned about opiate use. If so, this can be an excellent time to introduce the discussion of other adjunctive methods of pain control. Your health care provider should be consulted with your concerns, but here are some strategies that you might suggest:

Physical therapy

Often the pain associated with osteoarthritis or with soft tissue back injuries can be addressed by strengthening the attending muscles. In addition, the stretching and massage available through physical therapy can address adhesions which is a major cause of long term post surgical pain.

In addition, a physical therapist can help address any gait difficulties that may be contributing to lower extremity pain. As a bonus, stronger lower extremities help prevent falls which are a common precipitating factor in elder decline.

Massage

Massage can help relieve muscle stiffness, loosen tightened joints and even sometimes reverse limited range of motion (contractures) that has developed over a period of inactivity. Massage also provides a general feeling of well being that can be helpful for maintaining a more positive mood, which research has indicated helps with pain.  

Acupuncture

Although acupuncture is used for many purposes, the most common purpose in the United States is to treat pain.  Although the mechanism of acupuncture is not fully understood, some Westerner practitioners believe that it increases your body's natural pain fighting endorphins.

Non-opiate medication choices

There are many different types of medication in addition to opiates that can help manage pain; often these are specific to the type of pain (eg nerve pain) or help with general inflammation. Consider your health provider about ideas for your loved one.

Treat underlying emotional difficulties

One of the major contributors to chronic pain is stress; there is almost no pain that stress cannot make worse. If your loved one is experiencing substantial stress, depression, or protracted grief, providing support and treating these conditions with appropriate medication or therapy might help decrease your loved one's experienced pain level. Finding the solutions to management of situations that cause the stress and/or depression may also be helpful. Sometimes boredom can increase the experience of pain for your loved one; in this case, increasing outside activities may be useful. 

Consult pain management specialists

Even mid size hospitals now often have pain management departments and these teams can provide excellent information about managing pain. If your loved one is interested they may even be able to join a support group for other people experiencing chronic pain.

Although it can be difficult to find nonpharmacological or nonopiate methods of addressing pain, it is possible that decreasing opiate use may well increase quality of life for your loved one.