Chronic pain medicines - Information : Many medicines can help pain, including the ones listed in this handout. Each one may have side effects. Some side effects can be serious. It is important to listen to your family doctor carefully when he or she tells you how to use your pain medicine. If you have questions about side effects or about how much medicine to take, ask your doctor or your pharmacist. Acetaminophen (one brand name: Tylenol) helps many kinds of chronic pain. Remember, many over-the-counter and prescription pain medicines have acetaminophen in them. If you are not careful, you could take more acetaminophen than is good for you. Taking too much acetaminophen can cause liver damage. If you often have to take more than two acetaminophen pills a day, tell your doctor. Nonsteroidal Anti-inflammatory Medicines - Other medicines that help with pain are called nonsteroidal anti-inflammatory medicines. Examples include ibuprofen (two brand names: Motrin, Advil) and naproxen (two brand names: Aleve [over-the-counter], and Naprosyn [prescription]). You can take these medicines just when you need them, or you can take them every day. When you take these medicines regularly, they build up in your blood to fight the pain of inflammation (swelling) and give general pain relief. Many of these medicines are available in low-dose forms without a prescription. You need to tell your doctor if you are taking any of these medicines regularly. If your doctor wants you to take one of these medicines, always take it with food or a glass of milk, because the most common side effects are related to the stomach. If you already are taking other pain medicines, do not take these medicines without talking to your doctor first.

Chronic Pain : Chronic pain is a progressive disease state of the nervous system caused by the overloading of the body's natural pain control systems. The disease is accompanied by changes in the chemical and anatomical makeup of the spinal cord. Chronic pain is a malignancy. When it goes untreated it increases in intensity and spreads to areas of the body previously unaffected, damaging the sufferer's health and functioning. Doctors ignore your chronic pain for reasons that have nothing to do with the seriousness of your condition. Untreated chronic pain will damage your health and cause you to develop multiple health problems. Inactivity due to ongoing pain will lead to increased incidence of hypertension, heart disease, breathing disorders, cancer, and diabetes. If the disease is untreated in its most serious form, untreated chronic pain leads to suicide.

Non-steroidal anti-inflammatory drugs : Non-steroidal anti-inflammatory drugs are medications that impair the production of prostaglandins in the body. Prostaglandins are natural compounds that are responsible for producing fever, pain, and inflammation. They are called non-steroidal anti-inflammatory drugs because they reduce inflammation without the side effects of steroids. Steroids (Prednisone, Cortisone, Medrol, etc.) are potent medications that reduce inflammation, but steroids have predictable and potentially serious side effects, especially with long-term use. Non-steroidal anti-inflammatory drugs do not have these steroid side effects. They are called non-steroidal anti-inflammatory drugs because they reduce inflammation without the side effects of steroids. Steroids (Prednisone, Cortisone, Medrol, etc.) are potent medications that reduce inflammation, but steroids have predictable and potentially serious side effects, especially with long-term use. Non-steroidal anti-inflammatory drugs do not have these steroid side effects. In fact, many over-the-counter NSAIDs have the same active ingredients as prescription NSAIDs. The difference is in the amount of active ingredient contained in each tablet or capsule, and in the dosing requirements. Acetaminophen reduces pain and fever by acting on the brain. NSAIDs reduce pain and fever by reducing prostaglandin production and inflammation at the site of pain (ankle, knee, shoulder, etc.) Acetaminophen is generally considered easier on the stomach than NSAIDs. Aspirin, Aleve, Advil/Motrin are similar in reducing pain, fever and inflammation. But aspirin has more prolonged anti-platelet effect than the other NSAIDs. Different people respond differently to pain relievers. Therefore, choosing the right pain reliever can be somewhat of a trial and error process. I recommend that patients use the pain reliever that has worked for them in the past. This will increase the likelihood of effectiveness and decrease the risk of any side effects. Different people respond differently to pain relievers. Therefore, choosing the right pain reliever can be somewhat of a trial and error process. I recommend that patients use the pain reliever that has worked for them in the past. This will increase the likelihood of effectiveness and decrease the risk of any side effects.

How is pain treated : The goal of pain management is to improve function, enabling individuals to work, attend school, or participate in other day-to-day activities. Patients and their physicians have a number of options for the treatment of pain; some are more effective than others. Sometimes, relaxation and the use of imagery as a distraction provide relief. These methods can be powerful and effective, according to those who advocate their use. Whatever the treatment regime, it is important to remember that pain is treatable. The following treatments are among the most common. Acetaminophen is the basic ingredient found in Tylenol and its many generic equivalents. It is sold over the counter, in a prescription-strength preparation, and in combination with codeine. Analgesic refers to the class of drugs that includes most painkillers, such as aspirin, acetaminophen, and ibuprofen. The word analgesic is derived from ancient Greek and means to reduce or stop pain. Nonprescription or over-the-counter pain relievers are generally used for mild to moderate pain. Prescription pain relievers, sold through a pharmacy under the direction of a physician, are used for more moderate to severe pain. Anticonvulsants are used for the treatment of seizure disorders but are also sometimes prescribed for the treatment of pain. Carbamazepine in particular is used to treat a number of painful conditions, including trigeminal neuralgia. Another antiepileptic drug, gabapentin, is being studied for its pain-relieving properties, especially as a treatment for neuropathic pain. Antidepressants are sometimes used for the treatment of pain and, along with neuroleptics and lithium, belong to a category of drugs called psychotropic drugs. In addition, anti-anxiety drugs called benzodiazepines also act as muscle relaxants and are sometimes used as pain relievers. Physicians usually try to treat the condition with analgesics before prescribing these drugs. Antimigraine drugs include the triptans- sumatriptan (Imitrex), naratriptan (Amerge), and zolmitriptan (Zomig)-and are used specifically for migraine headaches. They can have serious side effects in some people and therefore, as with all prescription medicines, should be used only under a doctor's care. Biofeedback is used for the treatment of many common pain problems, most notably headache and back pain. Using a special electronic machine, the patient is trained to become aware of, to follow, and to gain control over certain bodily functions, including muscle tension, heart rate, and skin temperature. The individual can then learn to effect a change in his or her responses to pain, for example, by using relaxation techniques. Biofeedback is often used in combination with other treatment methods, generally without side effects. Similarly, the use of relaxation techniques in the treatment of pain can increase the patient's feeling of well-being. Capsaicin is a chemical found in chili peppers that is also a primary ingredient in pain-relieving creams. Chemonucleolysis is a treatment in which an enzyme, chymopapain, is injected directly into a herniated lumbar disc in an effort to dissolve material around the disc, thus reducing pressure and pain. The procedure's use is extremely limited, in part because some patients may have a life-threatening allergic reaction to chymopapain. Chiropractic refers to hand manipulation of the spine, usually for relief of back pain, and is a treatment option that continues to grow in popularity among many people who simply seek relief from back disorders. It has never been without controversy, however. Chiropractic's usefulness as a treatment for back pain is, for the most part, restricted to a select group of individuals with uncomplicated acute low back pain who may derive relief from the massage component of the therapy.