| Approach | Options |
| Try to find a more effective opioid | Opioid rotation |
| Try to open the "therapeutic window" | More aggressive side effect management |
| Try adding a systemic or spinal co-analgesic to reduce the opioid requirement | Add a systemic NSAID or an adjuvant analgesic, or trial of neuraxial (intrathecal, intraspinal) analgesia |
| Try adding a nonpharmacologic approach to reduce the opioid requirement | Consider neural blockade, a neurostimulatory approach, or a psychological or rehabilitative therapy |
