In my professional opinion, opioids have a limited role in the treatment of chronic pain. When the inflammatory response that causes acute and chronic pain is appropriately addressed in a timely fashion, prescribing opioids can usually be avoided.
I prefer to start with a more conservative approach which includes the use of anti-inflammatory medicine, whether over the counter or prescription, combined with therapy (physical/chiropractic) in the acute phase. I have found this can be effective in treating most causes of pain. When this fails, early interventional treatments can be very effective to treat the inflammatory response of the underlying cause of pain,thereby significantly reducing the need for opioid prescription.
Opioid misuse and abuse are a real crisis in the United States. This usually stems from excessive and inappropriate prescriptions to patients before proper diagnosis and treatment of the underlying cause of pain. I believe, as a pain medicine physician, that we must continue to prescribe opioids responsibly, doing so only when all other treatment options have been exhausted and failed using both conventional and innovative approaches.
-Dr. Aldon Williams