Some days it’s too painful for Teresa Roth’s 4-year-old son Thomas to put on his own shoes and socks.
Diagnosed at 18 months with Ehlers-Danlos Syndrome, the boy has chronic pain all over, particularly in his joints and his back. Paired with Chiari malformation, a brain structural defect, he also suffers the occasional “migraine times a million.”
“There’s a way to dull the pain a little bit, but they never go away,” said Roth of Gainesville.
After seeing the effects of methadone on her grandfather, Roth said she explores every option outside of regular opioid treatments for her son.
“After a while, he could never get enough. He got forgetful, he got more aggressive and rude. He wasn’t the man I grew up loving anymore,” she said.
Non-opioid treatments can include lidocaine cream for his neck, lidocaine patches for his back, anti-inflammatory drugs and various other tools.
Roth and her son travel to Augusta to see a Chiari expert.
“They don’t fight me on it ... but they see the other side,” Roth said of her conversations with doctors. “They see the flip side of the kids that they don’t have any options for because they’re on so many opioids daily.”
The push against opioids is intended to give Thomas options later in life when his condition progresses. Roth said she tries to avoid narcotics, except following surgery.
“They know I’ll try everything I can to avoid it, but I’m not going to let him hurt unnecessarily,” she said.
Since the added publicity of the opioid epidemic in the United States, Dr. Tennent Slack from the Northeast Georgia Physicians Group said he has seen more clients asking to stay away from opioids. Slack specializes in spinal care and pain medicine.
“Everybody should stay away from opioids if they can. On the other hand, it doesn’t mean that it can’t be helpful to some people,” Slack said, adding that is “very useful” for a subset of people.
After physical therapy or perhaps seeking a chiropractor, a patient may seek Slack for a targeted injection at the pain site or possibly surgery.
The Centers for Disease Control and Prevention issued a guideline for prescribing opioids for chronic pain in 2016. When considering the drugs for chronic pain outside of “active cancer, palliative and end-of-life care,” the CDC said “nonpharmacologic therapy and nonopioid pharmacologic therapy are preferred.”
“Clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient. If opioids are used, they should be combined with nonpharmacologic therapy and nonopioid pharmacologic therapy, as appropriate,” according to the CDC.
The recommendations also include prescriptions for immediate-release drugs at the lowest effective dosage.
Slack said he has also recommended acupuncture in certain instances, yet no one tool “has the market cornered on pain relief.”
“When you’re approaching a pain problem, you really should approach it from the standpoint from least invasive to most invasive,” he said.
Tamara Clarke of Flourish Acupuncture and Healing Arts said she was inspired to pursue Chinese medicine following her own experience with her mother, who suffered from a neurological condition. When she approached doctors about unconventional methods, the doctor said he didn’t condone the practices and would rather her mother have no hope than false hope.
“I was appalled at that answer, and I wanted to go into a field where I could be a voice of hope and ... options for people,” she said.
Acupuncture can increase blood circulation and endorphins, decrease inflammation and relax muscle spasms.
Clarke has been seeing some patients who can’t take opioid medications or don’t want to because of the side effects.
“We’re actually treating a lot of vets right now who, a lot of them, have been on medications for a long time, and a lot of them are having good success in decreasing their meds or getting off of them,” she said.
Clarke said it takes about 30 minutes for energy to flow through the 12 main meridians of the body. The meridians are considered invisible pathways for energy to flow, and these pathways are associated with an organ in the body.
Common symptoms of clients coming in are low back pain or neuropathy.
“Sometimes it’s not about getting rid of (pain). Sometimes it’s about increasing your quality of life by increasing mobility and lessening pain, getting them to sleep through the night,” Clarke said.
Slack said he encourages clients to bring together different tools and to keep an open mind about all methods.
“The people who have gotten into the biggest trouble with opioids are people who have relied heavily on the opioids to do all the work. That is not a winning strategy,” he said.