Reducing Opioid Use in Spinal Patients: Dr. Larry Davidson on the Role of Non-Pharmacological Interventions

The rising concern over opioid dependency has prompted a major shift in how post-surgical pain is managed, particularly in spinal patients. Dr. Larry Davidson, a specialist in spine health, believes that limiting opioid use through integrative care strategies is not only possible but essential for safer, more sustainable recovery. As pain management improves, the spotlight has turned to non-pharmacological interventions that reduce reliance on opioids while still providing effective relief.

This shift encourages a more holistic approach, where physical therapy, personalized rehabilitation plans and patient education play pivotal roles in long-term recovery. Empowering patients with tools to manage pain naturally fosters greater independence and reduces the risk of long-term medication dependency.

Understanding the Risks of Opioid Dependency

Opioids, once considered the gold standard in postoperative pain relief, are now known to carry significant risks. Beyond their effectiveness in masking pain, opioids can lead to serious complications such as sedation, nausea, constipation, respiratory depression and, in prolonged cases, addiction. For spinal surgery patients, the consequences are especially troubling. Impaired mobility slows rehabilitation, and mental fog can hinder the recovery process.

As a result, both healthcare providers and patients are increasingly seeking alternative strategies that prioritize safety, function and long-term well-being. Non-pharmacological interventions have emerged as powerful tools in reshaping pain control while minimizing the need for opioids.

The Science Behind Non-Pharmacological Pain Management

Non-pharmacological approaches work by targeting various aspects of the pain experience: physiological, psychological and neurological. These methods address pain perception, reduce muscle tension, promote healing and improve overall well-being. While they may not eliminate the need for medication, they can significantly reduce opioid requirements by offering effective supplementary or alternative relief.

This diversified approach aligns with the concept of multimodal pain management, where multiple therapies are combined to address pain from different angles. By integrating these techniques early in the recovery process, patients often experience better outcomes and faster returns to function.

Physical Therapy and Movement-Based Techniques

Among the most effective non-drug methods is physical therapy, which plays a critical role in restoring mobility, improving circulation and preventing complications like muscle atrophy. Movement-based therapy can include:

• Stretching and strengthening exercises: Promote flexibility and rebuild strength in muscles surrounding the surgical area.

• Manual therapy: Hands-on manipulation helps reduce stiffness and restore normal joint function.

• Postural training: Teaches patients how to reduce strain on the spine through better body mechanics.

By encouraging gentle motion shortly after surgery, physical therapy not only reduces pain but also helps diminish the psychological fear of movement that can sometimes delay healing.

Cold and Heat Therapy

Ice and heat are time-tested remedies in musculoskeletal recovery. Cold therapy or cryotherapy is often used in the early postoperative phase to reduce swelling, numb the area and limit inflammatory responses. Later in the recovery process, heat therapy improves circulation, eases muscle spasms and enhances flexibility.

These simple, non-invasive treatments are often used as adjuncts to physical therapy and can be performed at home, making them accessible and effective for ongoing pain control.

Transcutaneous Electrical Nerve Stimulation (TENS)

TENS therapy involves using a small device that delivers mild electrical impulses to the skin near the pain site. These impulses are thought to disrupt the transmission of pain signals to the brain while stimulating the release of endorphins, the body’s natural painkillers.

Although results may vary, many spinal surgery patients report significant relief using TENS units, especially during activities that would otherwise trigger discomfort. TENS is portable, easy to use and carries minimal side effects, making it an ideal option for home-based care.

Cognitive Behavioral Therapy and Mind-Body Techniques

The psychological aspect of pain is increasingly recognized as an essential component of comprehensive care. Cognitive Behavioral Therapy (CBT) helps patients reframe negative thoughts about pain, stress and recovery. Through this method, individuals learn to develop healthier coping mechanisms and reduce the emotional distress that often accompanies physical discomfort.

In addition to CBT, practices such as guided meditation, deep breathing exercises, progressive muscle relaxation and mindfulness-based stress reduction are commonly incorporated into recovery plans. These techniques can lower stress hormones, regulate breathing and encourage relaxation, resulting in reduced perception of pain and improved sleep quality.

Dr. Larry Davidson remarks, “Spinal fusion procedures regularly involve the implantation of certain types of implants. A merger of AI and 3D printing could result in the production of an implant that uniquely serves the needs of a specific patient. Such preparation would be done before a planned procedure based on the imaging studies of the patient’s spine.” By integrating this level of customization with psychological support methods, care teams can better address both the physical and emotional dimensions of postoperative recovery.

Acupuncture and Complementary Therapies

Acupuncture, rooted in traditional Chinese medicine, is gaining acceptance as a legitimate complementary therapy for post-surgical pain. It involves the insertion of thin needles into specific points on the body to stimulate nerves and release natural pain-relieving chemicals.

Some patients also benefit from other forms of alternative care, such as massage therapy, chiropractic adjustments or aromatherapy. While not replacements for medical treatment, these interventions can support relaxation and decrease the overall pain burden when integrated appropriately under a clinician’s guidance.

Building a Supportive Clinical Environment

Reducing opioid use is not a task assigned to one individual; it is a team effort involving surgeons, nurses, pain specialists, physical therapists and mental health professionals. A collaborative care model ensures that non-drug interventions are coordinated, consistent and tailored to the individual needs of each patient.

Hospitals and surgical centers are also adopting Enhanced Recovery After Surgery (ERAS) protocols, which emphasize early mobilization, multimodal analgesia and patient-centered care. These pathways support reduced opioid exposure and better long-term outcomes.

A Shift Toward Sustainable Pain Relief

The movement away from opioid dependency in spinal care reflects a broader transformation in how postoperative pain is understood and managed. By incorporating evidence-based non-pharmacological interventions into standard recovery protocols, healthcare providers offer patients safer, more effective and more sustainable options for healing.

While medications may still be involved in the early phases of recovery, they are no longer the centerpiece. Instead, patients benefit from personalized, integrative care plans that support mobility, emotional well-being and confidence in the recovery process.

This shift also positions patients as active participants in their care. When equipped with tools, education and ongoing support, they are better able to navigate discomfort, reduce reliance on opioids and move forward toward full function with greater clarity and control.