Medication and Chronic Pain

Medication and Chronic Pain

Introduction

Chronic pain is defined as a type of pain that persists for more than three months and goes beyond the expected time of healing. Such pain often fails to respond to conventional pain medication and occurs due to various reasons including external injuries, unsuccessful surgeries and the like.

Medication for Chronic Pain

Medication is the first line of treatment adopted for chronic pain. In this section we have discussed the three main categories of drugs used for the purpose.

A) Neuropathic Medications

Neuropathic pain is associated with the injuries that affect the nerve. This type of pain is normally accompanied by symptoms of burning or increased sensitivity in the painful area. Medicines which treat such conditions to the best include antidepressants (including Elavil, Paxil, Zoloft) and antiepileptics (such as Dilantin and Tegretol).

B) Psychiatric Medications

Antidepressant medicines have been by far the most successful in treating chronic pain. Apart from helping with the pain symptoms, these medicines also help with many of the depressive symptoms which are commonly seen in individuals suffering from chronic pain.

C) Pain Medications

1) Acetaminophen

Available under brand names such as Tylenol, acetaminophen is a known remedy for many types of chronic pain. It is important for the patient to remember that acetaminophen is present in many of the over-the-counter medicines as well. If taken in excess, acetaminophen can actually cause liver damage. Hence, it is important that this drug be taken only on prescription.

2) Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of drugs with analgesic, antipyretic and anti-inflammatory properties. These drugs are used for reducing pain, fever and inflammation. The three main categories of NSAIDs include salicylates, traditional NSAIDs and COX2 selective inhibitors. Commonly used NSAIDs include:

  • Aspirin
  • Ibuprofen (Motrin, Advil, Motrin IB)
  • Naproxen (Naprosyn, Aleve)
  • Nabumetone (Relafen)

These medicines are comparatively safer to use and can be self-administered, if required. However, there are a series of side effects associated with the use of NSAIDs, including heartburn, nausea, diarrhea, dizziness, skin rashes, stomach cramps and the like. Side effects like blood vomits and bloody stools are serious in nature and should be reported to the healthcare provider immediately.

3) Narcotics

Narcotics are also quite popularly prescribed as a medication for relief from chronic pain. It is important for the patients to know that these narcotics can also be strongly addictive. However, experts strongly insist that there is a difference between physical dependence and psychological addiction. It is the latter which is considered potentially dangerous. Psychological addiction occurs when the body becomes so habitual to it that the there is a strong desire to use the drug, whether there is pain or not.

Transdermal patches

A transdermal patch is a modern technique of pain management designed to treat chronic pain and other conditions. Also known as a skin patch, a transdermal patch is a medicated adhesive patch, which is placed on the skin to deliver regular doses of medication into the bloodstream through the skin. In the recent years, transdermal patches have proven to be one of the most effective pain management techniques for the treatment of chronic pain. The main conditions in which transdermal patches are commonly used include:

  • Motion sickness, with the use of scopolamine
  • Cessation of smoking
  • Menopause, with the use of estrogen
  • Osteoporosis
  • Angina, with the use of Nitroglycerin patches
  • Peripheral pain associated to shingles (herpes zoster), with the use of lidocaine patches

Drug Abuse – Key Aspects

One of the most crucial aspects associated with the use of medication for chronic pain is drug abuse. Research shows that chronic pain most commonly responds to non-opioid drug treatments. It is advisable to use such non-opioid pain-relievers that do not have an addiction potential. These include aspirin, acetaminophen, ibuprofen, naproxen and other NSAIDs.

List of common medications

In this section, we’ve listed some of the most common medications prescribed for chronic pain.

OxyContin Neurontin Ambien Darvocet-N Celexa Dilaudid Effexor Flexeril Lexapro Tylenol with Codeine Dymbalta Ultracet Keppra Mobic Zoloft Paxil Valium Skelaxin Percocet Prozac Ativan Ultram Celebrex Relafen Xanax Seroquel Fioricet Tegretol