Issue 11.13
What comes to mind when you hear the word ‘pain medicine?’ Morphine, codeine, demerol? Or perhaps the common side effects of nausea, itching, and constipation is most prevalent. When it comes to pain medicines, they are not all created equal. In fact a lot of medicines used to treat pain weren’t originally created as pain relievers at all. During my fellowship training in pain management, I worked in a clinic which as a policy did not prescribe any controlled substances. We used only interventional techniques such as injections and nerve ablations, physical and behavioral therapy, and non-narcotic pain medicines such as anti-inflammatories, muscle relaxers, nerve membrane stabilizers, and anti-depressants. By combatting pain using multiple therapeutic techniques, quality of life can be restored and the side effects of opioid medications can be avoided – including addiction.
Anti-inflammatory medications are the most commonly used non-opioid pain relievers such as aspirin, ibuprofen, naproxen, and acetaminophen and should be a first line of defense against pain. Whether the anti-inflammatory is prescription or OTC (over the counter), there are certain risks common to nearly all medicines in this class, but if the benefits outweigh the risks, NSAIDs can be a valuable option in treating many types of pain. Check with your physician before starting an anti-inflammatory.
If it’s muscle tension, muscle spasms, and trigger points that you suffer from, a simple muscle relaxer may be of benefit. Most muscle relaxers are non-addicting with a few exceptions and share a common possible side effect of sedation, so if muscle cramps are keeping you awake at night, this may be a good option for you.
Neuropathic pain, often described as burning, tingling, or numbness, can be treated with membrane stabilizers. It may take a little time to work your way up to an appropriate dose, but the with fewer common side effects and low abuse potential, membrane stabilizers are a valuable resource in combatting nerve type pain.
I have to be careful when asking about depression. Although the relationship between pain and depression is an obvious reality, I don’t want patients to feel like I think their pain is “all in their head.” As it turns out, many anti-depressant medications have long been used for their pain-relieving qualities. Please note, some anti-depressants are better than others for treating pain, and there are side effects to watch for when starting an anti-depressant.
When it comes to treating pain with medicines, there are options other than those medicines within the opioid class.
If you would like to be evaluated, feel free to call our office, Desert Pain Specialists at 435-216-7000 for a consultation.