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Thursday, 1 July 2021

Chronic Pain Management: Opioid Drugs or Manual Therapy?

Chronic pain is becoming more and more common in Australia, with approximately 3.4 million Australians currently living with chronic pain according to Pain Australia.


Out of the 3.4 million Australians living with chronic pain, a majority (56%) have cited that their chronic pain restricts the types of daily activities they can undertake. At the rate chronic conditions are developing, it is estimated that the number of Australians living with chronic pain will increase to 5.23 million by 2050.

Types of Chronic Pain Care

In order to treat the growing number of individuals living with chronic pain and related conditions, increasing research is being conducted on the effectiveness of traditional drug medications versus complementary and alternative medicines and pain management strategies.


According to Pain Australia, referrals to pain specialists occur in less than 15% of pain-related general practitioner (GP) medical visits currently. Instead, medications such as aspirin, acetaminophen, ibuprofen and opioids are recommended or prescribed in close to 70% of GP consultations. Despite the advice by general practitioners, Pain Australia’s research shows that best pain management practice does not support long term use of medication for chronic pain management. 


As a result, multidisciplinary, non-pharmaceutical and manual therapies are starting to gain popularity as an alternative to traditional pain management medications.

Opioid Drugs for Pain Relief

According to an infographic released by the Barral Institute, opioid drugs work to manage pain by binding to opioid receptors in the spinal cord, brain and other areas of the body. Opioid drugs reduce pain messages being sent to the brain and subsequently reduce feelings of pain. Due to their function, opioid drugs are used to mask pain rather than to resolve the underlying causes of pain.


Additionally, opioid drugs also have many potential negative side effects on individuals (especially if taken long term or in large quantities), including:

  • Addiction
  • Abdominal pain
  • Reduced heart rate
  • Indigestion
  • Hallucinations and visual disturbances
  • Nausea
  • Impairment of motor skills

Manual Therapies for Pain Relief

Unlike opioid drugs which provide pain relief by masking pain receptors in the body, manual therapies work to identify patterns of dysfunction in the body to target the root cause of pain.


There are many types of manual and natural therapies recommended by the NSW Agency for Clinical Innvation’s Pain Management Network, including:

  • Manipulative body-based methods (massage, acupuncture, chiropractic care and osteopathy)
  • Cognitive behavioural therapy (CBT) which helps to address patterns of thinking and behaviour in individuals living with chronic pain
  • Mind-body interventions (counselling, meditation, creative therapies such as art and music therapy)
  • Physical therapy as self-management strategies for chronic pain, working to strengthen an individual’s muscles and correct postures
  • Biologically based therapies (taking nutritional supplements and vitamins)


When it comes to chronic pain management, Australians are able to choose between using traditional western medications such as opioid drugs, and self-managing with manual therapies. Before committing to either treatments, individuals are advised to confirm with their health practitioner the safety of both methods to their health.

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