Pain management.  Two simple words… yet so much meaning behind them.  What really is pain management? What is the true difference between chronic pain and acute pain and how they are managed?  Will chronic pain every go away?  Will I ever have my life back the way I used to know it? All these questions are just a few of the hundreds if not thousands of questions that swirl through the heads of people considering pain management treatment.  Some of these questions can be answered through a quick Google search, while others have no answer.  The truth is that chronic pain is different for everyone.  100 million Americans suffer from chronic pain and each and every one will perceive their pain differently, will manage their pain differently, and will have a different outcome.  While the medical management of chronic pain is highly scientific, the true art lies in  crafting individualized, multi-modal approaches for each and every person.

In this blog series, we will look at the full spectrum of chronic pain treatment from medical management to interventional procedures, to cutting-edge therapies like spinal cord stimulation and stem cell therapy.

PART 1: Medical Management

Pain is one’s physical response, but the measurement of pain is very specific to one’s perception of pain. The brain’s perception of pain is greatly affected by one’s emotions. What this means is that one who is depressed, anxious or fearful may experience pain much differently, often more severely, than one who has pain but who has no emotional issue. This is the reason each person feels and reacts differently to pain which makes the treatment of pain very challenging.  As experts in the pain field, the treatment of pain requires a multi-modal approach which will be discussed during this blog series.

The first one in this series will involve the discussion of medication as one aspect in the treatment of pain. For many people in chronic pain, pain medication is important in providing necessary pain relief; however, it is not the only tool that can be used to treat pain and should be used in a multi-modal approach. The following is a list and use of certain categories of medications used in the management of chronic pain.

  • Acetaminophen- Known as Tylenol is purchased over-the-counter and used to help relieve pain. This medication is also used in combination with some opioids such as Lortab and Percocet. This is an important fact when using opioid medication in combination with over-the-counter acetaminophen to prevent exceeding the recommend daily dosage of acetaminophen.
  • NSAIDS – Also known as nonsteroidal anti-inflammatory drugs, NSAIDS are able to help relieve pain and inflammation. Some of these medications are purchased over-the-counter and include things such as Aleve, Advil, and Ibuprofen. However, some medications in this category are prescribed by your healthcare provider such as Celebrex, Mobic, Duexis, and Vimovo.
  • Antidepressants – Amitriptyline and Cymbalta, are antidepressant medications used to treat symptoms of neuropathic pain. This medication works by alleviating nerve pain.
  • Opioids – These types of medications must be prescribed by your doctor and include Lortab, Percocet, Morphine, Oxycontin, among others. They work by blocking pain signals. This type of medication is usually prescribed in two forms- Short-acting opioids and Long-acting opioids. Short-acting opioids work faster to reduce pain but the pain relief usually lasts only 4 to 8 hours. Long-acting opioids are gradually released to reduce chronic pain but the pain relief usually lasts 12 to 36 hours depending on the prescribed medication.
  • Anti-seizure medication – Anti-seizure medications reduce the pain in the spine caused by any extensive damage to the nerves. These medications include Lyrica, Neurontin, Horizant and Gralise.
  • Muscle relaxers – Muscle relaxers will help alleviate some types of pain by relaxing the muscles.
  • Local anesthetics- These medications include lidocaine and mexilitine which are usually in a topical cream that helps numb the region to which it is applied to reduce pain.

Please stay tuned as our next series (Part 2) will cover the interventional side of pain management.  This includes minimally invasive therapies such as epidural steroid injections and radiofrequency ablations.

Author: Holly Robertson, FNP

Holly Robertson received her BSN from the University of Tennessee in Memphis in 1994 and her MSN from Mississippi University for Women with Honors in 1997. She is a member of The American Nurses Association, Mississippi Nurses Association and The Association of Women’s Health, Obstetrics and Neonatal Nurses.    Holly joined MidSouth Pain Treatment Center in 2012 and has been dedicated to treating chronic pain ever since.  MidSouth Pain Treatment Center, founded by Dr. Michale E. Steuer, has been treating patients in the Mid-South since 1999.  MidSouth Pain Treatment center has 5 convenient locations in Tennessee and Mississippi. Tennessee: Germantown, Jackson, and Cordova.  Mississippi: Southaven and Oxford.

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