Safe Medication Management
Pain is a universal experience. However, when it becomes chronic, it can disrupt work, leisure activities, and relationships. At Access Pain Solutions Okmulgee, managing pain medication is a key component of our approach to pain treatment. If medication is included in your comprehensive treatment plan, we ensure it remains appropriate as your condition evolves. We provide Okmulgee patients with a range of pharmacological options and prioritize the careful management of your pain medication. Here’s what you need to know.
Pain is a universal experience. However, when it becomes chronic, it can disrupt work, leisure activities, and relationships. At Access Pain Solutions Okmulgee, managing pain medication is a key component of our approach to pain treatment. If medication is included in your comprehensive treatment plan, we ensure it remains appropriate as your condition evolves. We provide a range of pharmacological options and prioritize the careful management of your pain medication. Here’s what you need to know.
How Pain is Assessed to Prescribe Correct Medication
Although pain is a universal experience, its complexity and subjectivity make it difficult to treat. When a patient presents at our Okmulgee clinic with chronic pain, we have several pharmacologic treatments to consider. However, we first identify the type of pain the patient is experiencing before choosing a medication for pain management.
Chronic pain typically falls into two main categories:
- Nociceptive pain: Caused by inflammation or tissue injury.
- Neuropathic pain: Arises from injury or damage to the nerves themselves.
Nociceptive pain is generally managed with anti-inflammatory and analgesic medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) and opioids. In contrast, neuropathic pain requires treatments that target neurotransmitters and nerves, like antidepressants and anticonvulsant agents.
It’s important to recognize that these categories can overlap. For example, a severe fracture might cause both tissue damage and nerve injury, leading to both nociceptive and neuropathic pain.
As pain specialists serving Okmulgee, our role is to prescribe the appropriate pain medications in the right amounts to provide effective relief while minimizing side effects. We integrate medications with other complementary therapies to reduce overall dosage when possible, including adjusting medications, monitoring side effects, and managing potential drug interactions.
Medications for Nociceptive Pain
Nociceptive pain occurs due to tissue damage, where injury to a specific area prompts neurons to signal the brain, resulting in the sensation of pain.
There are two types of nociceptive pain:
- Somatic pain: Originating from the skin, muscles, bones, and joints.
- Visceral pain: Arising from the internal organs or the thoracic and abdominal cavities.
Nociceptive pain can be either sharp or dull and aching. It typically responds well to non-steroidal anti-inflammatory drugs (NSAIDs), with opioids used for more severe or persistent cases. Conditions involving inflammation, bone pain, and joint disease often show particular responsiveness to NSAIDs.
The following medications are commonly used to manage nociceptive pain for our Okmulgee patients.
Acetaminophen
Acetaminophen is a common over-the-counter medication used to relieve pain and reduce fever. It works by targeting the parts of the brain that process pain signals. Unlike non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen does not have anti-inflammatory properties. In cases of chronic pain without inflammation, Tylenol (a brand of acetaminophen) can be an appropriate treatment option.
When used correctly, Tylenol is a safe medication. However, excessive use can lead to serious liver or kidney damage. It is particularly important to use acetaminophen cautiously if you have liver disease, under a doctor’s supervision.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Many NSAIDs are available without a prescription, including:
- Aspirin
- Ibuprofen
- Ketoprofen
- Naproxen sodium
These medications alleviate pain by reducing the production of prostaglandins, hormone-like substances that cause pain and inflammation. NSAIDs are highly effective in reducing inflammation and are particularly useful for acute pain or flare-ups in chronic pain conditions.
However, NSAIDs are not recommended for daily use over long periods due to the risk of kidney damage and gastrointestinal issues, such as gastric ulcers. Newer COX2 inhibitors can help reduce the risk of GI complications, but caution is advised for individuals at risk of ulcers or GI bleeding.
COX2
Inhibitors
COX2 inhibitors are a newer class of NSAIDs that provide pain and inflammation relief while minimizing gastrointestinal toxicity and bleeding risks. They are as effective as other NSAIDs in managing inflammation, though not superior in pain relief.
While COX2 inhibitors are generally more expensive than over-the-counter NSAIDs, they may be cost-effective in cases where GI bleeding is a concern, as they reduce the need for additional medications to counteract NSAID side effects.
Opioids
In treating chronic pain, narcotic opioids should be considered only when other pain management options are ineffective. Although opioids carry risks of addiction and dangerous side effects, they can be effective when used correctly.
Opioids are chemical substances with actions similar to morphine. The term “opioid” is derived from opium, an extract from the poppy plant, and these agents have been used for centuries to relieve pain. Opioids work by binding to receptors in the central nervous system and the gastrointestinal tract.
All opioids produce similar clinical effects but vary in potency, onset speed, and duration of action. They are available in both short- and long-acting formulations. Some are used continuously, while others are used intermittently for breakthrough pain.
A common mistake in chronic pain treatment is relying on short-acting opioids, which, while effective for acute pain, can lead to sedation, euphoric side effects, and encourage overuse and tolerance development. Long-acting opioids tend to cause fewer cognitive side effects and provide better chronic pain control.
There are no sufficient long-term studies proving the effectiveness of opioids in treating chronic non-malignant pain, and they are not officially approved for this purpose. They can cause significant side effects, including gastrointestinal upset, nausea, sleep disturbances, constipation, and addiction. Studies indicate that 5-15% of chronic pain patients on narcotic pain medications develop dependence.
Atypical Opioids
There is considerable debate regarding the use of opioids for chronic non-cancer pain. Some physicians believe opioids play an important role in treating all types of chronic pain, including non-cancer pain. Others warn against widespread use due to issues like tolerance, which can reduce the effectiveness over time.
At Access Pain Solutions Okmulgee, we believe opioids or any treatment should be used when the benefits outweigh the risks and side effects. This approach is appropriate when:
- The patient shows significant improvement in functioning.
- Pain is reduced or eliminated.
- The patient develops a more positive outlook.
- Side effects are minimal or manageable.
The long-term use of opioids for chronic, non-cancer pain is challenging due to potential negative effects such as tolerance, misuse, hyperalgesia (increased sensitivity to pain), hormonal imbalances (e.g., decreased testosterone, libido, and irregular menstruation), depression, and immune suppression.
Medications for Neuropathic Pain
Neuropathic pain arises from nerve damage and often presents with symptoms such as:
- Burning sensations
- Increased sensitivity
- Shooting pains
Patients typically describe neuropathic pain as severe, sharp, lightning-like, stabbing, burning, numbness, tingling, or weakness.
The treatment for neuropathic pain differs significantly from that of other pain types. Medications for nociceptive pain, like NSAIDs and opioids, are generally less effective for neuropathic pain. Instead, neuropathic pain is best managed with membrane-stabilizing medications, including:
- Anticonvulsants
- Tricyclic antidepressants
- Certain antidepressant medications
These drugs work by modulating neurotransmitters in the brain, with antidepressants also offering added benefits such as improved mood, reduced anxiety, and better sleep. These medications are non-addictive and have minimal side effects when used correctly.
Anticonvulsants
Anticonvulsant medications are categorized into first- and second-generation agents. Second-generation anticonvulsants are generally better tolerated and cause fewer side effects.
- Carbamazepine, a first-generation agent, is effective for conditions like trigeminal neuralgia and can offer some relief for post-herpetic neuralgia and diabetic neuropathy. Its primary side effect is sedation, and patients using it should undergo regular blood and liver function tests due to the risk of blood disorders and liver abnormalities, which usually resolve after discontinuing treatment.
- Gabapentin, a second-generation anticonvulsant, is considered the gold standard for painful diabetic neuropathy and post-herpetic neuralgia. It is well-tolerated, even at high doses, and may also reduce anxiety. Unlike carbamazepine, gabapentin has minimal drug interactions, although nausea or dizziness can occur at higher doses or with rapid dose escalation.
Pregabalin, a more potent successor to gabapentin, is also effective for diabetic neuropathy and post-herpetic neuralgia and can be taken less frequently. It is the only FDA-approved medication for fibromyalgia pain.
Antidepressants
Chronic pain often leads to emotional distress that can hinder pain relief. Antidepressants help by adjusting neurotransmitter levels, enhancing signals for well-being and relaxation, thus improving pain control for chronic pain conditions that resist typical treatments. They also benefit mood, sleep, and anxiety levels.
Tricyclic antidepressants are commonly used for chronic pain, particularly effective for burning or searing pain due to nerve damage, such as in diabetes, shingles, or stroke. They are also useful for fibromyalgia and as a preventative for migraines. These medications do not cause dependence or addiction and are safe for long-term use, though they can cause side effects like drowsiness, dry mouth, constipation, weight gain, urination difficulty, and blood pressure changes. They are generally started at low doses, gradually increasing to minimize side effects.
SSRIs and SNRIs
- SSRIs may help alleviate chronic pain, often by easing depressive symptoms.
- SNRIs are generally more effective than SSRIs for controlling pain, particularly neuropathic pain, and tend to be better tolerated than tricyclics, making them a preferable option for chronic neuropathic pain management.
Take the First Step
to Freedom From Pain
Don’t let pain hold you back any longer. Take the first step toward lasting relief by contacting Access Pain Solutions Okmulgee. Complete the form below to request a callback, and our compassionate team will be in touch to discuss your needs and schedule your appointment.