Medication is not the only answer: pain expert

Pills containing codeine are no longer available over-the-counter.
Pills containing codeine are no longer available over-the-counter.

Exercise and lifestyle changes are among the “meaningful pain relief” available in lieu of codeine-based products according to pain expert Professor Philip Siddall.

On February 1, new laws from the Therapeutic Goods Administration restricts the sale of painkillers such as Panadeine, Nurofen Plus, Mersyndol and pharmacy generic brand pain relief products, as well as some cold and flu medicines.

The ban, which will require people to get a prescription to access the painkillers, is part of an effort to curb codeine addiction, abuse, and overdoses.

Codeine is a form of opioid that converts to morphine inside the body. It has long been used for mild pain relief and to treat coughing.

Research has found that more than 500,000 Australians have some form of codeine addiction.

Professor Philip Siddall.

Professor Philip Siddall.

Dr Siddall, director of the HammondCare Greenwich Hospital Pain Clinic, said reliance on codeine is not a healthy option in the long term.

“Risks with normal use include constipation, and impairment including drowsiness and loss of concentration is common as people increase their dosage. There is also the very real risk of addiction – in fact, more Australians die from prescription drug overdose than illicit drug use,” he said.

“Exercise and lifestyle changes, relaxation, meditation, distraction and pacing are among the tools available for meaningful pain relief.”

Dr Siddall practices a holistic approach to pain relief, guided by a team including a physiotherapist, clinical psychologist and pain medicine specialist with participants attended six weekly group sessions, each three hours long.

The HammondCare clinic, which also operates Fairfield’s Braeside Hospital, was recognised as the top pain service in Australia and New Zealand for opioid use reduction in 2016, with two-thirds of patients reducing their daily morphine equivalent use by more than 50 per cent.

He said there there is no single answer when it comes to treating lower back and neck pain  – the most common complaints among sufferers of chronic non-cancer pain.

“...it’s generally a combination of all the solutions that we like to refer to as a toolbox of skills,” Dr Siddall said.

“The first step is a very comprehensive assessment. We’ll stand back as a multi-disciplinary team and look at all the factors associated with their pain in totality.

“For many people, the issue is a sense of hopelessness. They feel as though the pain has taken over and is driving their life. The pain is like a bogeyman that won’t let them go to the shops or play with their grandchildren.

“Once people have a greater sense of control, they don’t feel as threatened. The pain is still there but they are in control again because there’s something they can do about it.”