Pain management encompasses pharmacological, nonpharmacological, and other approaches to prevent, reduce, or stop pain sensations. Pain management can be trial and error. Pain can occur from various sources so a combination of medications may be needed.
Patients will be asked to fill out extensive questionnaires regarding pain levels, and general medical information about how they live with pain. Following the interview and physical exam, they will work with the patient to develop a treatment plan.
Some examples of the different types of medications used for pain management are:
Anti-inflammatories: Help reduce swelling and pain. Examples are Relafen, Mobic Celebrex, Ibuprofen, and Naproxen.
Analgesics: The most common pain relieving medications. Examples range from mild pain relieving agents such as Aspirin or Tylenol, to those used for moderate or severe pain such as Lortab, Percocet, and other opiates. (see below for more on opiates).
Muscle Relaxants: Help to reduce muscle spasms and tightness. Examples include Soma, Zanaflex, Flexeril, Baclofen, and Skelaxin.
Nerve Pain Medications: These help to reduce pain due to nerve damage and can be used to lower pain in general. Examples include Neurontin, Topamax, Keppra, and Lyrica.
Anti-Anxiety Medications: Help to reduce anxiety. Examples include Valium, Klonipin, Ativan, and Xanax.
Anti-Depressants: Help with depression as well as reduce pain in general. Examples include Lexapro, Wellbutrin, Paxil, Nortriptalyine, Elavil, and Prozac.
Opiates are frequently used to reduce moderate to severe pain. Medications such as Vicodin, Lortab, and Percocet are often used for acute or breakthrough pain and are generally prescribed for short periods of time. However, if a patient is taking an appropriate amount, the doctor may prescribe for longer periods. Many patients will take these medications long term.
If short acting medication is not adequate enough to decrease the pain, long-acting opiates may be prescribed. These opiates are slowly released into the system over a period of hours or days depending on the medication. Examples are Oxycontin, Duragesic (Fentanyl) patches, MS Contin, and Methadone. It is important to note that these medications can not be stopped abruptly. They need to be slowly tapered off to avoid side effects and withdrawal symptoms. It is essential that dosing instructions are followed carefully to avoid potential problems.