Medications - Manage Your Chronic Pain!
There are several classes of medications that are available to treat your chronic pain.
Can Pain Medications Relieve Your Chronic Back & Neck Pain?
Medicines can often help control chronic pain. Many
different drugs, both prescription and nonprescription, are used to treat
chronic pain. All these medicines can cause side effects and should be taken
exactly as they are prescribed. In some cases, it may take several weeks before
medicines work to reduce pain. It is important to tell your
doctor ALL medicines you
are taking (including herbal and other complementary medicines) to avoid
dangerous drug interactions.
Before taking ANY new medications you should know
what the medication does, how often you supposed to take it, etc. Read here for more information:
A New Prescription! Now What?
Online Tools: Help Track & Understand Your Medications & Track Your Pain!
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Different families of Medications Used for Treating Chronic Pain Include:
Antidepressant Medications
- Much success has been achieved with these medications.
- These medications can not only help with the pain
symptoms, but also with many of the other depressive symptoms that are seen in
patients with chronic pain.
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Neuropathic Medications (Nerve Pain)
These
medications are not addictive, and when appropriately managed have few side
effects.
- Neuropathic pain is associated with injury to the nerve.
- Often this type of pain is associated with symptoms of
burning or increased sensitivity over the painful area
- Best treated by:
-
Antidepressants (e.g. Elavil, Paxil, Zoloft)
or
-
Anti-seizure medications (e.g. Dilantin,
Tegretol)
The antidepressant medications also have
beneficial effects of improved mood, decreased anxiety & improved sleep
cycle.
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Pain Medications
Pain medications are separated into several
categories:
-
OTC (Over the
Counter)
- Acetaminophen (Tylenol)
Tylenol is used to treat pain, but it does
not have the anti-inflammatory effects of the NSAIDs listed below.
- NSAIDs
(non steroidal anti-inflammatory drugs (NSAIDs):
The NSAIDs (e.g. Motrin, Aleve,
etc.) are best used in cases of acute pain, or flare-ups in patients with
chronic pain.
In general these should not be used
on a daily basis for the treatment of chronic pain as there are many side effects.
- COX-2 inhibitors (Celebrex)
- Newer anti-inflammatory medications designed to avoid
risk of ulcer formation, however, caution should still be used.
PRESCRIPTION Medications
Narcotics (short & long acting)
- When treating chronic pain, narcotic opioids should
be considered if pain cannot be otherwise controlled.
- Many pain management docs like the long acting medications
& understand their use and purpose. So if your doctor does NOT feel
comfortable prescribing (giving) you these medications, then you may want to
consider looking for a pain management doctor.
- Although these medications may be dangerous and
addicting
, however, they can also be extremely effective when used appropriately.
-
Short & long acting narcotics
are many times prescribed together.
-
Short Acting Opioids
(Narcotics):
Examples: Percocet, Vicodin, Ultram, etc.
Used for break through or "rescue
pain".
One common mistake when treating chronic pain
with opioid medications is only using the short acting types of medication (e.g.
Percocet, Morphine, Vicodin, etc.).
The short acting nature of
these medications encourages overuse and the development of
tolerance.
-
Long Acting Opioids
(Narcotics):
Examples:
Oxycontin, Fentanyl
These medications have fewer cognitive side-effects, and have
better control of chronic pain.
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Pain
Pumps
-
Pain pumps are designed to reduce pain by delivering pain medication to the space surrounding the spinal
cord.
- Because the medication is delivered directly to the receptors in the spinal cord, smaller doses of
medication are required to gain relief.
- The system consists of a pump and catheter, both of which are surgically placed under the skin. Click here for more
information on the
Medtronic
Pain Pump.
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Sleep Medications
Many chronic pain sufferers have troubles sleeping. If you have
troubles sleeping and are not yet taking a sleep medication this is definitely something to
ask about.
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Herbal Remedies:
There are numerous herbal remedies sold in the U.S. for
pain control. Of the top ten herbal remedies sold in the U.S., five are marketed
directly for pain relief. Many of these have side effects on their own and
can also interact with medications prescribed by your doctor. Make sure that you
tell your doctor about ALL of the medications you are taking!
- St. John’s Wort (Hypericum
perforatum)
Use:
Depression, Anxiety, headache, muscle and nerve pain
- Echinacea (Echinacea purpura)
Use: Respiratory infection, urinary infection,
wound healing, migraines
- Ginger (Zingiber Officinale)
Use: Nausea, GI upset, thermal burns, topical
analgesic
- Ginseng (Panax quinquefolius)
Use: Memory, depression,
headache, fatigue
Other herbal remedies used for pain also include
belladonna, capsaicin, camphor, chamomile, cloves, devil’s claw, cayenne, dong
quai, white willow and yohimbe.
References:
1. Katz,
WA "The Needs of a Patient in Pain" Amer. J. Med. 1998.
105(1B) Pages 2S-7S.
2. Marcus, DA
"Treatment of Nonmalignant Chronic Pain" Amer. Family
Physician. 2000. 61(5) Pages 1331-8.
3. WebMD Medical Pain Management Health Center
4. Medtronic Pain Control Pump
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