Jun 06 2008
Chronic Pain Drug Therapies
There are several forms of drug therapies on the market for chronic pain. You and your doctor need to come up with the best treatment plan designed with you in mind.
NSAIDS
NSAIDs, or nonsteriodal anti-inflammatory drugs, are very common. The most common of these is the drug ibuprofen. Most are sold without a prescription but some are still regulated and need a prescription to obtain. These are short acting and typically take more to notice an affect. They can cause bleeding after long term use, so care should be taken. They are good for pain relief and for relieving inflammation. Remember for NSAIDs, higher doses do not equal more pain relief. You should call a doctor if you notice blood in the stool, stomach pain, or black stools, as this is a sign of a problem.
Opiods
Opiods, or narcotics, offer some of the best pain relief on the market. There is no maximum dose, but higher levels can affect things like breathing. These drugs are supervised to adjust the dose to make sure that the degrees of side effects are lessened and there isn’t any addiction occurring. The main side effects of these seem to be sedation, nausea, and some constipation. The purpose of these will allow the patient to live a more normal life with more function. However, you shouldn’t drive taking opiods, as you can be legally charged with driving under the influence while taking opiods.
Antidepressants
Antidepressants in general are well absorbed in the majority of people, and most doctors use them in chronic pain management. They are prescribed at a lower dosage than if they were for mental health use, but patients on them get better sleep, eased depression, and mild pain relief.
Elavil/Endep (amitriptyline HCL)
Corticosteriods
Corticosteroids, also known as glucocorticoids or just steroids, are synthetic replicas of a hormone that is produced in the body naturally, such as adrenaline or cortisol. By putting in more than normal amounts of hormones will reduce inflammation. They are often prescribed for cancer pain because of their ability to decrease nausea, increase appetite, and elevate mood. They come in injections and in pill form.
Topical Analgesics: Capsaicin
Capsaicin is used in body rubs and creams to stimulate heat on the skin for muscle pain relief. Capsaicin is the ingredient in peppers that makes them hot. It uses a rating system called Scoville Units to rate the degree of intensity in the pepper. For example, a habanero pepper has the highest scoville units of a pepper at 300,000, therefore it has the most capsaicin.
Nerve Block Injections
A nerve block injection is where there is an injection of an anesthetic to relieve pain directly into a nerve. This will relieve the pain temporarily, but not long term. Generally nerve blocks are used to block pain receptors long enough for the patient to be able to have some range of motion to have physical therapy. Frequent nerve blocks are needed as the pain will come back when the anesthetic wears off, usually in a few days.
Trigger Point Injections
A trigger point injection is where there is an injection of an anesthetic to relieve pain directly into a trigger point on the body. These tender areas are generally associated with chronic pain like fibromyalgia. While they do not relieve pain in everyone, many can see their pain relieved from trigger point injections.
