Welcome to matching the pill to the pain, part I, a brief review of medications used in the treatment of chronic pain. I'm Dr. Kent, your narrator from MyChronicPain.com. Chronic pain and suffering is what we're talking about. Chronic pain and suffering requires a holistic approach and there are many aspects of care. Medications are only one aspect. There are lots of opportunities to improve pain, suffering and function.
Now, if you're interested in a more comprehensive review of medications or more comprehensive review, you might consider joining one of our webinars like matching the program to the pain. This blog is brief and is not intended to replace the ideas of your healthcare team. It is offered as information to enhance your interaction with your pain medicine providers. Discuss what you learn with your team of providers, your therapist, your pharmacist, your nurse, your chiropractor, your physicians. Informed communication with experienced providers will help you explore all of the pain management opportunities for improved quality of life, better days. If you get the work done, you'll get relief.
So we're here to review the best pill for the pain. That means medicines. Medicines, what are they? Well, they are synthetic chemicals shown in clinical trials to work better than placebo or other medicines used for the same problem or disease. They work differently in different people. It takes trials of different medicines to find out the best regiment for you. An experienced clinician is needed. They certainly help quite a bit. Medicine is not a science.
It is a scientifically based clinical art requiring an experienced team of providers that will work together, communicate and reach the best outcomes for you. It requires communication from you. And I believe, keeping that in mind, that a good pain diary while you are changing your medicines will help communicate the change in therapies and how they are helping or hurting you. I advocate online diaries. If you are not very internet savvy, you might try something simple like mypaindiarywebsite.com or if you want more data collection and direct access to your doctor, you might try relief in sight. Ok. First, lets go over some of the basics of just using pain medicines. First, what are rescue medicines and maintentance medicines? A maintenance medication is a daily medicine used to suppress pain, suppress the disease process, preventing severe pain and improving disability.
It might suppress pain, or it might suppress the disease process, therefore, suppressing pain. Some examples: Gabapentin, Lyrica, they suppress nerve pain like in diseases like diabetes or shingles. You have immunomodulators like Enbrell, that treat Rheumatoid arthritis.
You also have chronic long acting narcotics. Now, these drugs may work all day, or a patch may work several days and they just suppress the pain that is experienced. Those are all examples of maintenance medications. Rescue medicines. Rescue medicines are short acting drugs that stop break through pain that your maintenance regiment just isn't handling or while you're changing your medication regiment.
It's pain that you need to be rescued from to help you keep functioning, debilitating pain. Non-steroidal anti-inflamatory drugs or short-acting narcotics are commonly used. Now, some general rules. Close monitoring is very important when you are changing medicines. You need to know what the side-effects are and what's helping and what's hurting. Pain diaries help a lot.
Go slow. Pay attention. Pay attention to those side effects, pay attention to if the therapy is working. Go one medicine at a time; That includes taking a pill away or adding a pill. If you don't what's working, if you've got multiple medicines going on at the same time being changed. Alright. Avoid too many medicines.
More medicines cause more side-effects. Subtract meds that aren't working. Ask your doctor when you add (subtract) a medicine, what can you replace it with? Get your pharmacist to help you. Remember, it's not just suppressing the pain, but it's also paying attention to the side effects. It's the best regiment for your function. The least side-effects with the best control you can get.
All right, we're going to go over adjunctive medicines real quick. They increase the treatment's efficacy or enhance it. It may be something like anti-depressants that are commonly used.
We use this term a lot, so that's why I want to go over it. Also lets go over symptomatic relief medicines. Symptomatic relief medicines are medicines that help the symptoms and triggers that make your pain cycle worse. For example: insomnia. Insomnia can really make the pain cycle bad.
By treating the symptom, this key trigger, you can reduce pain and suffering a great deal. You can improve mood, you can improve a lot of things. Melatonin or tryptophan are some other ones that are used, or maybe a tricyclic anti-depressant that'll help raise your pain threshold and help with your sleep and also help your type of pain. Alright, now, I've gone over a lot of things with you. In the next section, we're going to go over broad categories of medicines.
Medications are approved by the FDA for specific diseases, but we're going to go over broad categories: symptomatic relief medicines, opiates, non-steroidal anti-inflammatory drugs and acetaminophen, rheumatological drugs, anti-depressants, anti-seisure drugs, topicals and miscellaneous medications. Alright, that's it for part one. I hope it helped. I hope today is a better day for you. This is Dr. Kent signing off from MyChronicPain.com. Hope to see you at part two.
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