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September is Pain Awareness Month — an estimated 20.4 percent of U.S. adults suffer from chronic pain, according to a 2016 study by the Centers for Disease Control and Prevention.

It's also one of the top reasons adults seek medical care.

Many people naturally think of opioids when they think about management of chronic pain. The opioid epidemic has been making headlines for many years because of the negative side effects — addiction, abuse and overdose. While these side effects do happen, there are many lesser known side effects which can also affect health in a negative way. Up to 80 percent of patients taking opioids experience at least one side effect. Here is a listing of the lesser known side effects:

Brain: Patients can experience impaired concentration, confusion, sleep and memory problems.

Gut: Gastrointestinal problems such as constipation, nausea and vomiting are very common.

Immune system: The immune system can be compromised while on opioids. The body's ability to fight off infection weakens immediately upon taking opioids; even if patients don't experience the effects of a compromised immune system for months, they may become sick later.

Increased pain: Ironically, opiates can also increase patient's pain. This is a phenomenon that is not well understood, but after taking an opioid, some patients can quickly experience more pain than before they took the medication.

Mental health: Often patients with chronic pain also have depression, anxiety and negativity. This may intensify their feelings of pain. About 10 percent of patients actually develop depression while taking opioids.

Sex: People are often surprised to hear about how opioids can cause sexual problems. Opioids reduce sex hormone levels (e.g., testosterone, estrogen). Symptoms of decreased sex hormone levels include low libido, impotence, erectile dysfunction, lack of menstruation and infertility.

Other: Opioids may also cause dry mouth, excessive sweating, weight gain, loss of appetite and dry skin.

The CDC has published guidelines regarding when to initiate opioid therapy, as well as assessing benefits versus negative effects. In a few cases, the benefits of opioids outweigh the side effects.

Given this information, you can see why it is important to explore pain management options other than opioids. There are many other options that can help control pain. These include a variety of non-opioid medications, nutritional optimization and supplementations, botanicals, correcting hormonal imbalances, physical therapy, injections including nerve ablation, behavioral health strategies for pain coping, and implanted spinal cord stimulators. Pain management treatment should be individualized for each patient.

If you are suffering from chronic pain, you may benefit from a local pain management specialist's evaluation. Contact the SSM Health Spine & Pain Management Center at 573-681-3759 to make an appointment. The team of highly-trained doctors and specialists will work with you and your primary care physician to design a treatment plan to responsibly provide the best level of pain care for you.

Joanna Smith, PA-C, is a physician assistant at the SSM Health Spine & Pain Management Center. To make an appointment with Joanna or one of the other pain management providers, Dr. John Lucio or Dr. Nathan Kenyon, call 573-681-3759.

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