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If you are in pain, it’s likely that your pain changes you and your daily life. Whether you experience the occasional headache or migraine you suffer from serious conditions like Rheumatoid Arthritis (RA), managing your pain effectively is an important part of good self-care. Unfortunately, pain management medication is a complex and difficult topic – what works for every patient isn’t necessarily the same.
Some patients experience pain on a chronic, unrelenting basis. This chronic pain can exacerbate itself, becoming highly debilitating and leading to a significant reduction in quality of life. These patients often find themselves sacrificing a significant amount of their freedom, independence, and lifestyle just to prevent further pain. Eventually, some patients even become housebound.
No matter what your condition, there are effective ways to manage your pain at whatever level you experience it. Suffering alone in silence doesn’t have to be your only option. Pain management medication ranging from OTC narcotics to stronger post-surgical opiates all have a role to play in preserving function and providing relief.
First Things First
Before exploring your options for pain management medication, it’s important to visit your doctor. In doing so, you can learn about the source of your pain and gain insight about the best approach for its management. What works for back pain, for example, won’t necessarily be as effective for someone experiencing chronic pancreatitis. Because there are so many different types of treatments available today, this step helps to narrow down the options that are best to manage your particular pain.
What is the Official Definition of Pain?
What exactly is “pain?”
The answer to this question is exactly what makes treating pain so complicated: the definition of pain often differs patient to patient. Pain tolerances and individual biochemistry can also predict whether not a patient defines an experience as painful or just uncomfortable. Even physicians often have their own definitions of pain.
While doctors might vary on what criteria they personally use to assess the pain of their patients, the International Association for the Study of Pain developed a consensus statement that offers an excellent baseline starting point. Essentially, the description notes that pain is an emotional and sensory experience that’s unpleasant. This description is important in that it acknowledges pain as not just something that you feel, but something you experience. The IASP also recognizes that pain can affect the patient’s holistic well-being, including both physical and mental health.
Why is Your Pain Different Than Others?
There is a general consensus that pain is both a sensory and emotional experience, but that doesn’t mean that everyone experiences pain the same way or to the same degree. Pain measurement is determined by what a particular person brings to the experience.
If you are anxious or depressed, your perception of pain could be much greater than someone who is not suffering from these conditions. Similarly, if you have a fear of pain, this can make any pain you do experience worse than if you weren’t fearful. Feeling negative emotions like fear, anxiety, and sadness can amplify perceptions, making pain more severe.
Because pain has an emotional and mental aspect, doctors often prefer to address both aspects of the patient at once. This is wise; research shows that pain patients experience mental health illnesses at a much higher rate. This is logical – being in chronic pain certainly isn’t a fun experience for anyone!
Managing Pain in a Holistic Manner
Pain management medication works best when it is part of a holistic treatment for pain. Treating the source of the pain, adjusting lifestyle or diet, and even utilizing hands-on therapies like massage and chiropractic may all help your pain while addressing the whole person.
While opioids are the frontline choice for treating extreme pain (such as after surgery or end-of-life care), they aren’t necessarily the best choice for treating chronic pain. Most opiates have a relatively short life-span and build tolerance quickly. This makes chronic use problematic as doses must be escalated regularly. However, each patient is unique, and some conditions may call for aggressive pain management medication with opiates despite national recommendations.
Other potential pain management medication includes:
- Acetaminophen – (Tylenol) This drug works by blocking prostaglandins in the body which heighten pain reception. It is available over the counter, but must be taken carefully to avoid liver damage.
- Steroids – (Prednisone; Dexamethasone) – these drugs suppress the immune system locally or systemically. This may reduce pain and the inflammation that often accompanies it.
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) – these drugs work by blocking prostaglandins and reducing inflammation. This class of pain relievers includes Aspirin, Naproxen and Ibuprofen. While effective, NSAIDs can cause gastrointestinal bleeding if taken in high doses.
- Selective Serotonin Reuptake Inhibitors (SSRIs/SNRIs) – these drugs change brain chemicals to alter mood and/or pain interpretation. They can help alleviate pain as well as help you sleep.
- Anti-Seizure Drugs (Depakote, Neurontin; Lyrica) – these drugs change chemicals and electrical signals in the brain. While typically used to prevent seizures, research does show that they can reduce the intensity of pain signals – especially nerve pain.
Compound Medications and Your Pain
Many people find it difficult to manage their pain, even with medications. Patient drug viability varies dramatically – some patients may become very nauseous from opiates or may be virtually unable to take NSAIDs due to stomach conditions. They might be allergic to a component that is typically found in pain management medication. These experiences can be seriously frustrating and limiting, but there are still options.
A compounding pharmacy can strip down pain management medication to their base ingredients and reformulate a better solution that works. This includes changing dosage format, ingredient lists, or even flavors to make medication easier to take. For example, a compounding pharmacy may take an NSAID medication and make it into a topical salve to avoid damaging the stomach.
Compounding pharmacies create prescriptions right on the spot to the patient’s needs. That means that, should a commercial dose fail to be effective for you, they can micro-adjust the dose to get it just right. You receive all of the benefits of your pain management medication without risking higher-dose-than-necessary side effects. This is especially important for sensitive populations like children and the elderly.
Compounding offers patients access to combination medications that aren’t normally produced for sale by manufacturers because there’s simply not enough of a demand for them to do so. With your doctor’s guidance, the compounding pharmacist can create a customized medication. This medication is designed specifically to treat your pain and make it manageable. Just speak with your pharmacist if you want to know more!
Other Pain Management Medication Methods
Pain management medication often works best if it’s used in conjunction with other techniques that you can use on your own. Taking the time to meditate, employing specific relaxation techniques (such as deep breathing or guided visualization) can significantly reduce emotional reaction, which in turn reduces pain. The beauty of these approaches is that you can use them anywhere at any time.
Using cold and heat therapy (or a combination of the two), massage, or physical manipulation of the area also reduces pain. You can perform basic massage and manipulation right at home just by stretching or rubbing your muscles. Alternatively, you can seek the assistance of a physiotherapist instead.
Biofeedback provides you with the training that allows you to control your heart rate, muscle tension, temperature and other aspects of your body. By strengthening the connection between body and mind, you may find it easier to deal with your pain.
Some patients find transcutaneous electrical nerve stimulation (TENS) therapy effective. In this therapy, light electrical signals travel through the muscles; the signals aren’t high enough to be painful, but trick the muscles into relaxing. TENS treatment can also interrupt nerves to make them feel numbed, rather than transmitting pain.
Mental Health Approaches
As mentioned previously, some patients benefit most from addressing the emotional influences of pain. One of the best ways to do this is by attending dialectical behavioral therapy (DBT) or cognitive behavioral therapy (CBT) with a registered therapist. During sessions your therapist will teach you about your pain. They will also empower you to better understand its role in your life.
If your doctor believes you may be suffering from depression or anxiety, treating those conditions with therapy and/or medication may have a secondary side effect on your pain. By reducing stress and emotional upheaval, you will be better equipped to handle your pain when it comes.
What is probably the most important piece of advice to remember when it comes to pain is to not wait to address it. As soon as you notice your pain is affecting your life in a negative way, seek help. The longer you suffer from pain, the more likely it is to become chronic and require long-term treatment. Rather than letting your pain chip away at your ability to function and enjoy the life you envision, reach out to your pharmacist or physician and take advantage of the resources available.