Acute pain tends to respond best to short-acting pain management medications, which makes sense if you assume that once an injury heals, the pain associated with that injury will go away. Chronic pain, however, may persist long after tissue injury has resolved and will require both long-acting and short-acting medications. Somatic pain tends to respond well to opioids (basically, medications derived from poppy or opium plants).
Opiods for Pain Management Medication, Pain Management
The former term for “opioids” is “narcotics,” and these potent classes of pain management medications are tightly controlled by the federal government because of their abuse potential. Opioids are very effective, however, at managing somatic pain, for instance, pain from a tooth ache or a pulled muscle. Ice, heat, and massage are also effective pain treatment strategies.
Opioids, as a class, are less predictably successful when treating neuropathic pain, for example, pain associated with herniated lumbar discs. Patients with pain related to these types of conditions will often indicate that opioid medications dull their brain but do not decrease the pain. Chronic neuropathic pain is more often treated with medications that are in the class of “anti-seizure” medications.
Pain Management Medications
The following are medications commonly used to assist with treating pain
• Opioids. As mentioned previously, opioids are highly effective in treating somatic pain but unpredictable in treating neuropathic pain. As a consequence, opioids are frequently used as the only medication for somatic pain, but as one of several medications for neuropathic pain. Opioids may be short- or long-acting and are frequently used together to address immediate pain and to allow for the treatment of breakthrough pain.
• Muscle relaxants. This class of medications slows the firing of muscle fibers and tends to cause the muscle to be less tense, which may help mitigate pain of somatic origin. Muscle relaxants also help you gain more complete range of motion or movement of the muscle group you need to use to rehabilitate the affected area.
• Anti-seizure medications. Anticonvulsants are pain management medications that stabilize nerve membranes and keep irritable nerves from firing (an event the body perceives as pain). This class of medications is used almost exclusively in neuropathic pain states. Because of its very specific and potentially serious side effects, this class of medication needs to be closely monitored when prescribed.
• Anti-inflammatories. This group of pain management medications includes the familiar, highly advertised items that can be purchased without prescriptions (“over the counter”) and can be found in most home medicine cabinets. Aspirin and ibuprofen are examples of anti-inflammatories and are very effective in the treatment of somatic pain states. There is no clinically-based evidence to support their continuous use in neuropathic pain states, although it’s common to prescribe them for nerve-based pain states.
Other Approaches to Pain Treatment, Beyond Pain Management Medication
Medications alone may be insufficient in the treatment of acute or chronic pain, somatic or neuropathic pain. Other physical approaches can and should be used to decrease pain and to enhance function. Examples include:
• Physical and occupational therapy. Supervised by skilled therapists, physical and occupational therapy as an approach to pain therapy can help restore function to a dysfunctional limb or part of the body. Through graded exercises intended to restore normal posture or normal range of motion of a limb, physical therapists can help your muscles work to enhance function and reduce pain. Part of this therapy might include pool exercises (including resistance exercises) or applying electrical stimuli to the skin to reduce pain, enhance blood flow to the muscle, and restore function.
• Manual approaches. Transcutaneous nerve stimulation (applied directly to the skin), massage, and acupuncture are all very effective in enhancing function and reducing pain for musculoskeletal injuries (somatic pain).
• Behavioral therapies. Pain-oriented psychologists may help you restore function and reduce pain by concentrating on the cognitive issues – such as stress, depression, and sleep deprivation – that increase pain. For example, your psychologist may introduce you to pain management techniques such as biofeedback , which can help you retrain your body so that your mind controls your reaction to your pain rather than having your pain control your mind. In addition, you know that often pain not only affects your whole body, it can also impact your entire family. A good psychologist trained in pain issues can help you deal effectively with both types of dysfunction.
• Interventional pain treatment. This approach to pain management is carried out by pain specialists and may include either injections or electronic implantable devices (for example, pain pumps with spinal catheter s or spinal cord stimulator s, which function as a pacemaker of the spinal cord or peripheral nerve). These approaches are very effective when other treatments have been ineffective or when the cause of the pain requires advanced treatment.
These are just some of the options for pain management medications and treatment.
