We as humans always suffer from one type of pain or another. The pain can be mild and temporary, such as a headache, backache, earache etc. or it can be something quite severe and relentless, such as cancer pain or pain from fibromyalgia. To this end, the pharmaceutical market is flooded with all types of pain killers ranging from mild analgesics, such as paracetamol or NSAIDs to stronger painkillers, such as opioids. There also are some other interventional pain medicines, such as trigger point injections, Flector patches, steroid injections, lidocaine injections, intrathecal pain pumps etc. Doctors also use other type of medicines to relieve pain, such as Antidepressant Analgesics and Anti-Epileptic Analgesics. No wonder the patient and the general population is always confused which medicine is supposed to be taken and how and for what. Of course there are doctors for this purpose to guide us in taking medications; however, it is also important that we have some knowledge and awareness of the type of pain medication which we are taking and why.
In our OPIOIDS/RX section we have a wide array of information on different types of pain medicines, their types, modalities, mechanism, indications, contraindications, side effects, over-dosage etc. Given below is a brief look on some of the topics which we have covered. For a detailed read, please refer to the side menu where our OPIOIDS/RX section with many topics and sub topics is located.
Opioids are the best medications to relieve chronic, severe intractable pain. Prescription opioids include morphine; hydrocodone, oxycodone, and fentanyl. There is always a chance of addiction to opioids or street drug users to abuse prescription medications. For this reason, physicians have set opioid screening tests to differentiate between the legitimate uses of opioid for chronic pain and to discourage drug seekers. Some of the Opioid Screening Tools are:
- Screening tool for additional risk (STAR).
- Drug abuse screening test.
- Screener and Opioid assessment for patient with pain (SOAPP).
- Pain assessment and documentation tool (PADT).
- Opioid Risk Tool (ORT).
- Prescription opiate.
- CAGE questionnaire.
- Prescription Drug Use Questionnaire (PDUQ).
- Substance Use Questionnaire (40-42).
Other tests done to find if the patient has been using opioids include:
- Urine Drug Testing.
- Medication Cross Reaction in Immunoassay Study.
- Chromatography Urine Test.
There are many more topics which are covered under this section such as:
- FDA Approved Opioid for Diabetic Neuropathy Pain
- Forty-two Women Die Every Day from Drug Overdose-Report By CDC
- Opiate Withdrawal: Causes, Risk Factors, Signs, Symptoms, Treatment, Complications
- Opioid Treatment Programs: Establishing the Need, Benefits, Risks, Screening Tools
- Q and A: Effects of Opioids on Normal Breathing, Respiratory Center, Treatment
- Q and A: Should I Take Opioid Pain Medications? Pseudo-addiction, Anxiety Disorder
To read more about this gem of a medicine, which can be useful as well as harmful, depending on its use (and abuse), please read under our OPIOIDS/RX section on the side menu.
Antidepressants are medicines, which not only help in coping with depression, but also help with chronic pain by alleviating symptoms, such as fatigue, sleep changes, and gives the patient as improved quality of life. Some of the common types of antidepressants used for alleviating pain are:
- Tricyclic antidepressants.
- Prozac I.
Always follow your doctor’s directions regarding the time and method of taking antidepressants. Never, ever share your antidepressant medications with others. If the you or the patient suffers from side effects of antidepressants, such as swelling of face, lips, throat and breathlessness, or has had an overdose of antidepressants, then contact your physician or visit the nearest ER immediately.
To read more on antidepressant medications, please refer to the side menu under our OPIOIDS/RX section.
These medicines include Gabapentin/GABA agonist (Neurontin, Gabarone, Fanatrex). Gabapentin helps with the pain in fibromyalgia and also chronic neuropathic pain. Pregabalin, such as Lyrica, also helps in treating fibromyalgia. Follow your physician’s instructions regarding these medications and also read the directions on the leaflet of these medications before taking them.
If you experience any side effects with antiepileptic analgesics, such as hives; swelling of the face, lips, tongue, throat and difficulty in breathing or have overdosed on them, then contact your physician or rush to the nearest ER immediately.
To read more on ANTIEPILEPTIC ANALGESICS, please click under our OPIOIDS/RX section on the side menu.
This treatment modality comprises of:
- Intrathecal Pain Pump helps in attaining better pain relief and also in preventing opioid addiction and abuse. Intrathecal pain pump delivers limited dosage of opioids intrathecally via the pain pump.
- Lumbar Sympathetic Ganglion Block helps with pain by modulating and blocking the pain transmission at the level of sympathetic ganglion via injecting corticosteroids and local anesthetics.
Steroids are highly useful in treating pain. On the downside, they can cause innumerable side effects and withdrawal symptoms in a patient. Some of the symptoms of steroid withdrawal include: Acutely painful muscles and joints, muscle spasms, fatigue, weakness, weight loss, appetite loss, hypotension and hyperglycemia. Patient experiences these symptoms if the steroids are stopped abruptly.
To read more on how to cope up with steroid withdrawal symptoms, please read under our OPIOIDS/RX section on the side menu.
Epidural steroid injections have been used in treating sciatica and low back pain since ages. Some of the causes which result in radicular pain are:
- Disc herniation.
- Disk bulge.
- Degenerative disc disease.
- Lumbar spinal stenosis.
- Synovial cysts.
- Foraminal stenosis.
To know more on this topic, please refer to the side menu under our OPIOIDS/RX section.
Relentless chronic muscular pain is commonly caused by muscle spasm or inflammatory muscular disease. This can be relieved by giving local trigger point injections, especially if the pain is not responding to pain medications and physiotherapy. Complications from Trigger Point Injection include nerve injury, bleeding and infection.
Some of the Indications for Trigger Point Injections are:
- Muscles spasm or knots.
- Myofascial pain syndrome.
- Tension headache.
- Sports injuries.
Contraindications for Trigger Point Injections are:
- Widespread Muscle Spasm.
- Local infection.
- Bleeding disorder.
- Debilitated patients.
- Allergies to local anesthetic agents or corticosteroids.
- Acute muscle trauma.
For more information on TRIGGER POINT INJECTIONS including its mechanism, please read our Interventional Therapy topic under our OPIOIDS/RX section on the side menu.
- Flector Patch contains about 180 mg of diclofenac epolamine and is applied externally and locally anywhere on the body except eyes and genitals. Patients can experience allergic symptoms to flector patch, such as difficulty in breathing, hives and swelling of face, lips, tongue or throat.
- Lidocaine Injections are given locally as local anesthetics and anti-arrhythmics. They block the pain signals and create a numbing zone. Lidocaine can be injected close to the nerve or can be spread over the skin to block the nerve. Lidocaine is also used for treating cardiac arrhythmias by injecting it intravenously.