Pain Medication Management
Pain Medication Management Phoenix AZ
Pain is an emotional experience of unpleasant sensations. Acute pain comes on suddenly, and is related to disease, injury to tissues, and inflammation. Chronic pain, however, persists for a longer time than acute pain, and it is often resistant to medical treatments. The goal of pain management is to enable individuals to work, improve function, and to participate in usual activities.
What conditions are treated with pain medication?
Common pain syndromes include:
- Chronic back pain
- Central pain syndrome
- Cancer pain
- Head and facial pain
- Myofascial pain
- Neuropathic pain
- Reflex sympathetic dystrophy (RSD)
- Spinal stenosis
- Temporomandibular joint disorder (TMJ)
How is pain measured?
No test can measure the intensity of pain, and no imaging device or instrument locates pain. The doctor relies on the patient’s own description of the duration, type, and location of pain, which are used to make a diagnosis. Testing is done to determine the cause of pain, such as electromyography (EMG), nerve conduction studies, magnetic resonance imaging (MRI) scans, computed tomography (CT), and x-rays.
What medications are used to treat pain?
Patients who have chronic conditions need help managing their pain. The pain management specialist uses various medications to achieve pain relief. Treatment options include:
- Acetaminophen – Generic Tylenol is acetaminophen. This medication is used to treat pain, and has certain anti-inflammatory effects. When used as prescribed, Tylenol is safe, but it is harmful to the liver if taken in excess. Any medication that ends in “cet” has a-cet-aminophen in it, so do not mix regular Tylenol with Darvocet, Lorcet, or Percocet.
- NSAIDs – Non-steroidal anti-inflammatory drugs (NSAIDs) are beneficial for various types of arthritis and pain related to inflammation (bursitis and tendonitis). These medications have limited effects for chronic pain, however, and should not be taken long-term.
- Corticosteroids – As a powerful anti-inflammatory agent, corticosteroids are used for short-term for many painful conditions. In addition, the pain management specialist may offer you an injection of a long-acting corticosteroid for conditions such as rheumatoid arthritis.
- Opioids – Also called narcotics, opioids are highly addictive but effective pain relievers. These substances are controlled by the Drug Enforcement Agency (DEA), and are only prescribed by a licensed healthcare provider. Examples of commonly prescribed opioids include oxycodone, hydrocodone, morphine, codeine, and fentanyl.
- Anticonvulsants – These medications are used to relieve neuropathic (nerve-related) pain. Because they alter the nerve function and block pain signals, they are quite effective for peripheral neuropathy, reflex sympathetic dystrophy, and other conditions. The most commonly used anticonvulsant for nerve pain is gabapentin (Neurontin). Other options include Lyrica and Tegretol.
- Antidepressants – Used in adjunct with other medications, antidepressants control chronic pain by changing the way pain is perceived in the brain. In addition, they decrease anxiety and aid with sleeping. Examples include tricyclic antidepressants (amitriptyline and nortriptyline), selective serotonin reuptake inhibitors (SSRIs) (Prozac, Celexa, Paxil), and serotonin norepinephrine reuptake inhibitors (SNRIs) (Effexor and Vibryd).
- Topical medicines – The lidoderm patch is often used to provide temporary relief to a painful body region. Other topical agents include creams and ointments, such as menthol and capsaicin.
What is a pain medicine treatment protocol?
At our pain management facility, we have guidelines for the treatment of pain. The features of this protocol are:
- Comprehensive medical history
- Detailed evaluation of the patient
- Written treatment plan
- Informed consent agreement
- Maintenance of records
- Periodic record review
- Random urine drug testing
- Controlled substance agreement