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Jamaica Scientific Research Institute
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Conventional Treatments for Pain


A sensation of pain depends on the area of the body that is injured and how the brain deals with signals from this area. Pain is often times resolved promptly with drugs such as analgesics and (occasionally) anxiolytics and once the underlying trauma or pathology has healed. Generally, the medications used in pain management aim to stop the transmission of nerve signals from the site of injury or to directly affect how the brain processes these signals.


 

Treatment options for Chronic Pain

  • Pharmacological interventions such as the use of non-prescription drugs like aspirin or ibuprofen or stronger medications such as morphine, codeine, or anesthesia. Other drugs, including muscle relaxers and some antidepressants may also be employed.
  • Alternative treatments including
    • Acupuncture
    • Relaxation
    • Biofeedback (treatment technique in which people are trained to improve their health by using signals from their own bodies)

 


  • Nerve blocks (the blocking of a group of nerves with local anesthetics) 
  • Electrical stimulation
  • Application of heat or cold to the affect area
  • Physical therapy and exercise
  • Surgery 
  • Psychotherapy (talk therapy) 
  • Cognitive behavioral therapy

Table below illustrates the Types of Medications used in the treatment of Pain. This list is not exhaustive.
Click here to view the chemical structures page.

 Drug Class
 ActionCommon Side Effects 
Non-opioid s

Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

including

ibuprofen, asprin, naproxen, celecoxib (COX-2 inhibitor)

Most NSAIDs act as non-selective inhibitors of the enzyme cyclooxygenase (COX), and so prevents the formation of prostaglandins and thromboxane.

These two compounds act (among other things) as messenger molecules in the process of inflammation.

Used in the treatment of acute or chronic conditions where pain and inflammation are present.

  • Myocardial infraction (except aspirin)
  • Irritation of gastro-intestinal tract
  • Salt and fluid retention 
  • Hypertension (high blood pressure)
  • Headache
  • Dizziness
Acetominophen / Paracetamol

Blocks COX-2 mostly in the central nervous system, but not much in the rest of the body.

  • Prolonged daily use increases the risk of upper gastrointestinal complications such as stomach bleeding.
  • May cause kidney or liver damage

Corticosteroids

such as

methylprednisolone and prednisone

Best used for acute pain or for periodic flare-ups of chronic inflammatory problems
  • Allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • Bloody or tarry stools
  • Changes in vision
  • Fever, sore throat
  • Wounds that will not heal
  • Increased thirst
  • Irregular heartbeat

Opioids / narcotics

(morphine, codeine, hydrocodone, oxycodone, oxymorphone, methadone)

 Binds to the opioid receptors of CNS and so block neurosignals from pain-source areas.

They provide a short, intermediate or long acting analgesic effect depending on whether the particular drug was formulated for extended release.
  • Sedation
  • Respiratory depression
  • Constipation
  • Strong sense of euphoria
  • Cough suppression
Anti-Depressants

  1. Tricyclic antidepressants (amitriptyline, imipramine)

  2. Selective serotonin re-uptake inhibitors (SSRIs) including fluoxetine and sertraline

  3. Mixed norepinephrine and serotonin inhibitors or SNRIs such as duloxetine, venlafaxine, milnacipran and bupropion

 Interferes with regulation of neurotransmitters and hence of certain neurosignals, including those that may be transmitting pain.

Used to treat chronic pain and are particularly helpful for fibromyalgia, headache, and neuropathic pains including diabetic neuropathy.

They are generally are less helpful for most acute musculoskeletal sports-type injuries.

  • Drowsiness
  • Constipation
  • Dry mouth
  • Urinary retention
  • Weight gain
  • Blurred vision
Anti-epileptics / Anti-convulsants

(carbamazepine, gabapentin, pregabalin)

Blocks certain nerve signals in the CNS.

Effective in various neuropathic pain conditions.

  • Drowsiness
  • Peripheral edema (lower extremity swelling)
  • Unsteady gait or poor balance
Other Analgesics

(Orphenadrine, cyclobenzaprine, mexiletine)


These are adjuvant medications. They either prolong the effects of analgesics or make them more effective.
Side effects will vary according to the drug used

For a full profile on a drug you may be taking, visit Drugs.com or Rxlist.com and simply enter the name.

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