Chronic Pain Today

Acetaminophen, or APAP, is the drug behind the popular brand Tylenol. It is just as effective as NSAIDs are for pain relief, but they do not have the ability to bring down inflammation. They do have a few side effects, but is generally well tolerated in most individuals.

Examples of Acetaminophen Brands:
Tylenol
Feverall
Tempra
Aspirin Free Anacin

Dosages of Acetaminophen:
Most adults should be given the dose of a gram. This means two extra strength 500mg tablets, or three regular strength 325mg tablets. Pay special attention that you are not double dosing, as some of the popular cough and cold formulas add acetaminophen to their mix and this will still count toward your daily allowance of the drug.

Sometimes acetaminophen is added to opiods to provide better pain relief.

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.

Examples of Non-Prescription NSAID Brands:
Naproxen
Aleve
Advil
Exedrin
Motrin
Nuprin
Pamprin
Aspirin
Ecotrin
Bufferin

Examples of Prescription NSAID Brands:
Fenoprofen (Nalfon)
Oxaprozin (Daypro)
Etodolac (Lodine)
Sulindac (Clinoril)
Tolmetin (Tolectin)
Nabumetone (Relafen)

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.

Celebrex (celecoxib)

Mobic (meloxicam)

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.

OxyContin (oxycodone HCL CR)

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)

Wellbutrin (buproprion 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.

If you want a drug free way to cope with your chronic pain, holistic remedies are available. Considered “alternative medicine” these methods can bring relaxation and temporary pain relief.

Massage
Whether it helps by releasing toxins from the body, or that it just manipulates the muscles and helps release the body’s natural painkillers, massage is a deeply relaxing and helpful method of pain relief.

Acupuncture
Acupuncture was one of the very first Eastern treatments to be accepted into mainstream Western medicine. Doctors here believe that it works by releasing your body’s natural painkillers like endorphins.

Acupressure
Acupressure uses the pressure points of acupuncture, but instead of thin needle insertion it uses the manipulation of hands into these points. Fingers and the ball of the hand are used to press in or massage these points to release pain from the body.

Fibroids are tumors that grow in the uterus. They are known as fibroids, myomas, fibromyomas, or leiomyomas. One out of every four or five women over the age of 35 will get fibroids in her lifetime. Although they can be painful and bothersome, there is no additional risk of uterine cancer associated with having fibroids. Many women are asymptomatic, or don’t present symptoms with having fibroids, while others have a variety of symptoms. Common symptoms with having fibroids are heavy bleeding with their periods, bloating around the abdomen and trunk of the body, pelvic pain, bowel and urinary problems, and pain with sexual intercourse. You can live without treatment, although many are seen every year to reduce symptoms.

Typically the treatment for fibroids has been a hysterectomy. A hysterectomy is the total removal of the uterus. This brings on infertility, the cessation of menstruation, and could bring an earlier start to menopause. If the ovaries are left in tact, menopause could begin normally and without any additional side effects. The lack of menstruation will not mean that you are immune from typical menstruation problems like PMS.

There are less invasive methods of treating fibroids than surgical removal of the uterus. These methods are a myomectomy, a focused ultrasound, endometrial ablation, and uterine artery embolization.

Myomectomy
This treatment is up to 75% effective and is the removal of the fibroids in the uterus. The uterus is left in tact and isn’t removed. This is a great option for those that still want children as fertility is left untouched.

Focused Ultrasound
This treatment is the newest and the least invasive of the bunch. It is where ultrasound waves are used to increase the temperature of the uterus to destroy the fibroids. This procedure gives up to one year of reduced symptoms and pain.

Endometrial Ablation
This treatment is up to 90% effective and is where the uterine lining is removed. It will cause infertility. It doesn’t remove the actual fibroids in the uterus, just the lining. It will relieve the heavy periods associated with fibroids, but it won’t fix the pain and bloating that is associated with fibroids.

Uterine Artery Embolization
This procedure is up to 80% effective and is where they will inject particles no bigger than a grain of sand into the artery to the uterus. This will block the artery and kill off the blood supply to the fibroid. It does a good job of removing the symptoms of fibroids in many individuals.