Pain Management in Johnson City, TN: Care, Evaluation and Clinical Judgment

Overview

Non-Opioid Pain Management

Pain management focuses on reducing or controlling discomfort in the body. While prescription medications—such as opioids—can provide relief, some patients may develop dependence or experience challenges when using these medications long-term.

A Supportive Approach to Pain

Non-opioid pain management emphasizes strategies that aim to manage discomfort with a low risk of drug dependence. These approaches may include:

• Medications or supplements with a low risk of dependence, prescribed under medical supervision
• Integrative therapies such as physical therapy, acupuncture, or massage
• Lifestyle adjustments, including nutrition, exercise, and stress management
• Mind-body techniques to support overall well-being

The goal is to help patients manage pain while maintaining quality of life and minimizing the risk of medication dependence.

How can this risk be reduced? Paying attention to it early is part of careful, responsible pain care.

One way to lower the risk of addiction while managing pain is to choose approaches that have a low risk of dependence. This type of approach is what we call non-opioid pain management.

Non-Opioid Pain Management Methods

Non-opioid pain management focuses on strategies that aim to reduce or control discomfort with a low risk of dependence on prescription drugs. These methods may use approaches or medications with a low risk of addiction, always under the guidance of a qualified healthcare provider.

Some patients choose a combination of supportive therapies that address pain while promoting overall wellness. Below are some approaches that people use to help manage pain without relying on addictive medications. Individual experiences vary.

Prolozone Pain Therapy

What is Prolozone Therapy?

Prolozone is a form of musculoskeletal and joint pain treatment technique. It uses oxygen, in the form of ozone, with the aim of supporting the repair of damaged tissues, ligaments, joints, and tendons. Research on prolozone is limited, and results vary from person to person.

How does Prolozone Therapy work?

Before we look at the technique used in prolozone, it is important to remember that many pains we experience in our daily life originate from injuries.

These injuries may or may not be physical. Rather than focusing only on the sensation of pain, this approach aims to address the injury itself and support the body's natural repair processes.

For a damaged part of the body to repair, it needs critical elements that the blood provides: vitamins, minerals, and oxygen. In the view of Dr. Dalal Akoury, MD, MPH, oxygen is the most important of the three.

Prolozone involves three steps:

1. First, an injection of a homeopathic anti-inflammatory medication is given, with the aim of reducing inflammation and swelling and supporting circulation.
2. Second, the area is treated with vitamins that play a role in tissue repair.
3. Finally, the area is infiltrated with oxygen in the form of ozone.

The aim of the treatment is to give the tissues what they need to support the body's natural repair processes and circulation to the area. Individual experiences vary.

Which conditions do people seek Prolozone for?

The following are some of the conditions for which people seek prolozone therapy:

• Torn tendons
• Neuromas
• Heel spurs
• Sports injury
• Sciatica
• TMJ syndrome
• Degenerated or herniated discs, and other conditions

This list describes why people ask about prolozone; it is not a claim that prolozone treats these conditions. Whether it may be appropriate for you is decided after an evaluation with Dr. Akoury.

Can this treatment be addictive?

Prolozone is not considered addictive. It does not rely on prescription pain medications, which in some cases can lead to addiction. Unlike painkillers, which mainly reduce the sensation of pain, prolozone aims to support repair of the injured area. Like any injection, it can have side effects such as temporary soreness or swelling; Dr. Akoury will discuss the risks with you.

Neural Therapy

This is another non-opioid approach to pain that involves the autonomic nervous system. The autonomic system is a fundamental control system in our bodies. This system is responsible for controlling important body functions such as blood circulation, body temperature, breathing, heart rate, etc.

How does it work?

Neural therapy uses injections of procaine, a local anesthetic, with the aim of calming stressed and injured nerves and supporting normal nerve signaling to the tissues and body organs that they supply. Research on neural therapy is limited, and responses vary.

NAD+ Treatment

NAD+ refers to Nicotinamide Adenine Dinucleotide, a coenzyme that continuously cycles between NAD+ and NADH forms in the body. Many of the body's metabolic enzymes, including those involved in cellular energy and tissue repair, depend on coenzymes such as NAD+ to do their work. NAD plays an important role in the production of ATP, which is the energy molecule in the body, and is involved in over 100 metabolic functions in our human chemistry.

Is NAD+ therapy safe?

NAD+ is a naturally occurring coenzyme involved in cellular energy. When given under medical supervision, NAD+ therapy is generally well tolerated, although some people experience side effects such as nausea, flushing, or discomfort during an infusion. NAD+ is being studied for its role in the body's antioxidant defenses, and the related molecule NADPH is used by immune cells called phagocytes to help destroy pathogens. Some people report improved mental clarity and alertness; individual experiences vary.

Pain Neutralization Technique (PNT)

This is one of the pain relief therapies some patients choose. It is a non-pharmacological, non-invasive technique for pain neutralization.

How does it work?

This technique uses gentle manipulation of tissue with the aim of altering the nerve-based reflexes that are thought to perpetuate trigger points and muscle pain. It is a very gentle method since it doesn’t use pressure like some of the other methods for treating trigger points; instead, it uses finger massage of the points.

Magnesium and Pain

Magnesium is one of the nutrients studied for pain relief, and it is not addictive. Magnesium plays a role in muscle relaxation, and this is one reason it is studied in relation to pain.

A key principle in the proposed mechanism of magnesium is its role in limiting excessive stimulation of NMDA receptors, which are involved in pain signaling. One of the advantages of magnesium is that it is readily available, since it can be found in supplement form at most health food stores. Talk to your physician before starting a supplement, especially if you have kidney problems or take other medications.

Who This May Be Appropriate For

This service may be appropriate for:

• Adults living with ongoing musculoskeletal, joint, or nerve-related pain who want a physician-led evaluation
• People who want to learn about non-opioid, integrative options to discuss alongside their current care
• Those who would like to know whether approaches such as Prolozone, neural therapy, or PNT may be appropriate for them
• People who want education on nutrition, magnesium, and lifestyle strategies that may support comfort and overall wellness
• Adults who want to keep their primary care physician or pain specialist involved in their care

A consultation with Dr. Akoury helps decide whether this service is a good fit for you. It is not a substitute for emergency care or for care from your primary care physician or pain specialist.

What to Expect at AWAREmed

Your first step is a consultation with Dr. Akoury. She reviews your medical history, lifestyle factors and relevant test results. Based on this review, she discusses whether any of the options described on this page may be appropriate for you and how they could fit alongside the care you receive from your primary care physician or pain specialist.

Learn more about Dr. Akoury's background and integrative approach.

Request Your Appointment Today

To request your appointment, please call (423) 430-6170 or contact us online.

See also: Regenerative Medicine and Chronic Inflammation, or book a consultation.

Related reading: PRP therapy: how platelet-rich plasma is used, including for joint pain

Frequently Asked Questions