Opioids fail in long-term pain relief

Q: I’ve been taking opioid pain medication for five months to relieve the chronic pain of arthritis in my spine. It helped at first, but now the pain is worse an di am loath to increase my dose. How do I ease the pain and get off these scary drugs? — Janette F., Nashville, Tennessee

A: This is a complicated issue. We cannot comment on what is the best therapy for your arthritis, not knowing its extent or if surgery is a smart option. But new insights into pain management may help you rethink your approach.

Pain researchers from the University of Washington School of Medicine recently laid out their insights on why opioids are not a good remedy for pain.

Ultimately, they say, taking opioids usurps and suppresses the body’s natural emotional and physical pain relief processes. Then it becomes difficult for the body to ease chronic pain or for you to feel rewards and enjoy interaction with others.

Instead, you want to ease

DRS. OZ AND ROIZEN off the opioids and encourage your natural pain-relief systems to improve your mood and quell your physical discomfort. Ask your doctor about physical therapy, meditation, acupuncture, alternative medications and the potential for getting benefit from radiofrequency ablation or surgery.

Q: My doctor says I have frozen shoulder. All I know is that it hurts and my range of motion is restricted. What are the best ways to manage this and will it ever go away? — John J., New York

A: Frozen shoulder, aka adhesive capsulitis, is pretty common, but we don’t really know why thick bands of tissue, called adhesions, develop in the capsule that surrounds your shoulder joint, causing pain and limiting motion.

The American Academy of Orthopaedic Surgeons says frozen shoulder has three stages: freezing, frozen and thawing.

■ Freezing is when it begins to seize up and can last from six weeks to nine months.

■ Frozen means you have lost motion, and that can last up to six months.

■ Thawing is the slow return to normal functioning and can take two to three years.

It happens most often to folks 40 to 60 — more often women — and diabetes increases the risk of developing it.

A new metareview of 65 studies, with 4,097 participants, published in JAMA Open Network, says that the best treatment is corticosteroid injections given with a prescribed exercise program or receiving electrotherapy or passive mobilizations.