Yes, at least in West this is true that treatment of chronic pain with opioids has led not only to an epidemic of opioid addition in treatment but also an addiction to opioids and a considerable amount of deaths due to overdose.
Patients and Doctors perspectives combined:-
Patients are not given knowledge of pain and are depending on Doctor (literally it means to teach) to know what they are suffering from.
Already they are suffering from pain due to some disease/ condition and due to Google search of symptoms, and results showing various complications, increase their fear factor, which takes a deep-seated memory regarding pain and associated agonies in the brain which are difficult to erase.
It’s about Cittavritti- read ahead
Among 5 Vritti’s, Smriti i.e. Memory is strongest.
The memory of Maldynia (Bad pain) cannot be erased except with Eudynia (Good pain), which has to be temporary, equivalent/ more severe pain which simulates the Bad pain within the body and replace it in the brain.
So to get relief from pain, patients should be told –
“NO PAIN NO GAIN”
Also, patients should be told regarding Newton’s third law of motion
” To every action, there is an equal and opposite reaction”
So any treatment, for example, Dry needling, is painful and I explain the patient, the pain if simulates the original pain within the body, the patients get equal pain relief.
Also, another aspect is the brain sends signals to the area of treatment for the repair and regeneration process.
Along with it use of Cognitive Behavioral Therapy(Dry Needling plus CBT = Needle Induced Yoga) helps to relieve pain not only at the physical level but also at Mental, Intellectual and Spiritual levels.
We follow 10 point protocol at Pune Pain Clinic & Yoga Centre.
I would advise patients to go for
1. Thorough examination
2. Investigations ( CBC, BSL random, vitamins D3 and B12, serum calcium and magnesium, USG, Xray AP, Lateral, MRI as required.
3. Confirmation of Diagnosis and counselling regarding treatment.
4. Treatment options explanation.
5. Interventional pain management with local anaesthetic and steroid if patients agree in spite of the complications which can happen.
6. Needle Induced Yoga (Dry Needling plus CBT bases on Patanjali Ashtang Yoga) treatment for muscles.
7.Stamped NMS treatment, for affected nerves.
8.Along with the correction of the deficiency of vitamins D3/B12 and minerals (calcium and magnesium).
9. Treatment won’t stop here, the patient will be taught graded exercises and
10.Stress management by Traditional Yoga techniques to get pain-free state at physical, mental, intellectual and spiritual levels.
Dr 
