Robert Hindes, an expert in internal medicine and infectious diseases, discusses non-opioid treatment options for chronic pain. These include over-the-counter medications like ibuprofen and acetaminophen, which are generally not effective enough for long-term chronic pain. Non-drug therapies include electrical stimulation, nerve blocks, and injections of drugs that block or destroy pain fibers, such as capsaicin and resiniferatoxin. Spinal cord stimulation and cryoneurolysis (freezing nerves) can also help reduce chronic pain but tend to be more expensive. Stem cell research may lead to additional non-opioid options in the future.

1. What Non-Opioid Treatment
Options are Available for Chronic
Pain?
By: Robert Hindes MD

2. What Non-Opioid Treatment Options are Available
for Chronic Pain?
A graduate of Rutgers Medical School in New Jersey, Robert Hindes holds certifications in internal
medicine and infectious diseases. Robert Hindes was co-founder and chief medical officer of Trek
Therapeutics; in this role, he led the development of clinical strategy for the company, and
supervised all clinical activities, operations, and employees. Most recently, he was Vice President
of Clinical Research at Sorrento Therapeutics where he worked on injectable non-opioids for
treatment of chronic pain.

3. What Non-Opioid Treatment Options are Available
for Chronic Pain?
Over the counter medications such as ibuprofen, aspirin, and acetaminophen, are less prone to
overuse or abuse by chronic pain patients, but are generally not effective enough to provide a long-
term solution to chronic pain. Non-opioid pain treatments can also take the form of non-drug
therapies--such as the application of electrical signals and/or radio waves, and injections of new
types of drugs that selectively block or lyse pain fibers. These drugs include capsaicin and
resiniferatoxin (RTX) which can be administered in joints or directly around nerves. Other chronic
pain treatments include conventional nerve blocks. While some patients prefer to recover from
chronic pain by using medications, other patients prefer non-drug therapies—or the combination of
both options. Treatments such as injections and nerve blocks are particularly effective in facilitating
patients’ recovery in cases where the prolonged use of medication is not working.

4. What Non-Opioid Treatment Options are Available
for Chronic Pain?
Spinal cord stimulation and cryoneurolysis (freezing affected nerves) are other methods of non-
opioid pain reduction that can be effective, but that tend to carry a higher cost. Stem cell research
may also lead to the development of new non-opioid treatment options--however, it may take time
before these new options are viable.