Pain Management Strategies

Pain Management Strategies

Each person recovers from procedures in their own way, and two people having the same procedure might have completely different experiences of pain. Pain after procedures is normal and is a body’s sign that it is healing. Patients should balance activity with rest. Pain is an uncomfortable but natural part of recovery. While everyone feels pain differently, typically procedural pain is the worst during the first 2-3 days and then begins to get better. Opioids are not the first-line therapy for pain management.

The goal of pain management is to do activities of daily living like:

  • Eat
  • Sleep
  • Breathe deeply
  • Walk

OPEN’s Opioid Prescribing Recommendations are procedure-specific and developed through data analysis, literature review and expert consensus. The recommendations are updated as new evidence is published to keep providers current with best practices in opioid prescribing.

  • Acute Pain: Licensed prescribers may prescribe an opioid drug to treat acute pain in seven-day increments only, and no more than once in each seven-day period. An opioid may only be prescribed for pain that is associated with invasive procedures, trauma, or disease
  • Surgery Pain: Acetaminophen and NSAIDs should be used together as first-line medications for postoperative pain in surgical patients, unless patients have contraindications or high risk of adverse effects. Use of prescription opioids ONLY to manage severe breakthrough pain that is not relieved by acetaminophen and NSAIDs. For additional information and resources visit Surgery Pain Management – Michigan OPEN (michigan-open.org)
  • Dentistry Pain: Dental extraction pain can be managed without opioids. Acetaminophen and ibuprofen are good treatment options with less risk for adverse effects. The American Dental Association recommends NSAIDS as a first line therapy. For additional information visit Dentistry Pain Management – Michigan OPEN (michigan-open.org)
  • Pediatric Pain: First line pain management for pediatric patients is acetaminophen and ibuprofen together around the clock, dosed by weight. Following the instructions on the bottle may result in under dosing. Prescriptions for acetaminophen and ibuprofen may be sent to the patient's pharmacy. For additional details and dosing information, visit Pediatric Pain Management – Michigan OPEN (michigan-open.org)
  • Obstetrics Pain: First-line pain management should include non-opioid and non-pharmacologic strategies. Acetaminophen and NSAIDs should be used together as first-line medications for postpartum pain unless contraindicated. For additional information and resources visit Obstetrics Pain Management – Michigan OPEN (michigan-open.org)
  • Chronic Pain: Opioids are not the first-line therapy for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. Providers should consider alternative treatments, including nonpharmacological therapies and non-opioid medications before prescribing opioids for chronic pain. Evidence suggests that alternative non-opioid treatments can provide safer, effective relief to patients suffering from chronic pain.

Focus on functional goals and improvement, actively engaging patients in their pain management.

Providers who prescribe controlled substances and opioids are the front line of fighting unnecessary use and misuse of opioids. Together, we can end the epidemic.