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Understanding Opioid-Induced Hyperalgesia: Insights from Dr. Edward Rubin, MD


If you or someone you know has been prescribed opioids for chronic pain, you may have come across a somewhat paradoxical condition known as opioid-induced hyperalgesia (OIH). As a pain management specialist, I, Dr. Edward Rubin, MD, believe it’s crucial to shed light on this condition to enhance patient care and understanding.

Opioid-induced hyperalgesia is a phenomenon where prolonged opioid use paradoxically leads to an increased sensitivity to pain. While opioids are effective in managing pain initially, over time, they can alter the way our nervous system processes pain, making a person more sensitive to pain stimuli.


The signs of OIH can be subtle and often mistaken for a worsening of the original pain condition. If you find that your usual opioid dosage becomes less effective over time, or if you experience pain in other areas of your body, it might be an indicator of OIH. It’s essential to discuss these symptoms with your healthcare provider for appropriate management.

The management of OIH involves a multifaceted approach. One strategy could be tapering down the opioid dosage under medical supervision. Alternative pain management techniques, such as physical therapy, acupuncture, and non-opioid medications, may also be explored. Mind-body practices like meditation and yoga have shown promise in managing chronic pain and improving overall well-being.

Prevention is equally important. If you are being prescribed opioids, it is crucial to use the lowest effective dose for the shortest possible duration. Regular check-ins with your healthcare provider can help in monitoring and adjusting your treatment plan as needed.

Remember, OIH is a complex condition, and its management requires a personalized approach. As a pain management expert, I emphasize the importance of patient education and a collaborative approach in dealing with chronic pain.

For more information or to schedule a consultation, feel free to contact my office.


By Dr. Edward Rubin


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