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What should you do if experiencing opioid-induced hyperalgesia?

Opioid-induced hyperalgesia (OIH) is a paradoxical response whereby a patient receiving opioids for the treatment of pain can actually become more sensitive to painful stimuli over time. The type of pain experienced might be the same as the underlying pain or might be different from the original underlying pain.

If you think you are experiencing OIH, first seek a pain evaluation, ideally from a multidisciplinary treatment team of providers. First-line treatments include non-opioid analgesics (non-steroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen; and acetaminophen) and adjunctive medications such as antidepressants and anticonvulsants. In addition, nonpharmacological therapies such as therapeutic exercise, physical therapy, cognitive-behavioral therapy (CBT), and complementary and alternative medicine (e.g., chiropractic therapy, massage therapy, acupuncture, mind-body therapies, relaxation strategies) may provide pain relief.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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