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Analgesics OTC : Many pain medications are available over-the-counter (without a prescription, or OTC) in the U.S. for short-term relief of joint pain, muscle aches, headache, menstrual cramps, and fever. These OTC analgesics are generally well tolerated and safe when used properly. But side effects do occur and in some instances can be serious. Today, we will ask Dr. William Shiel how to use these analgesics properly in order to minimize risks and side effects. We will also ask him to compare traditional pain relievers with the newer pain relievers, the selective COX-2 inhibitors. There are two major classes of pain relievers available in this country without prescription; they are acetaminophen (Tylenol) and Nonsteroidal antiinflammatory drugs (NSAIDs).
Chronic pain medicines - Information : Many medicines can help pain, including the ones listed in this handout. Each one may have side effects. Some side effects can be serious. It is important to listen to your family doctor carefully when he or she tells you how to use your pain medicine. If you have questions about side effects or about how much medicine to take, ask your doctor or your pharmacist. Acetaminophen (one brand name: Tylenol) helps many kinds of chronic pain. Remember, many over-the-counter and prescription pain medicines have acetaminophen in them. If you are not careful, you could take more acetaminophen than is good for you. Taking too much acetaminophen can cause liver damage. If you often have to take more than two acetaminophen pills a day, tell your doctor. Nonsteroidal Anti-inflammatory Medicines - Other medicines that help with pain are called nonsteroidal anti-inflammatory medicines. Examples include ibuprofen (two brand names: Motrin, Advil) and naproxen (two brand names: Aleve [over-the-counter], and Naprosyn [prescription]). You can take these medicines just when you need them, or you can take them every day. When you take these medicines regularly, they build up in your blood to fight the pain of inflammation (swelling) and give general pain relief. Many of these medicines are available in low-dose forms without a prescription. You need to tell your doctor if you are taking any of these medicines regularly. If your doctor wants you to take one of these medicines, always take it with food or a glass of milk, because the most common side effects are related to the stomach. If you already are taking other pain medicines, do not take these medicines without talking to your doctor first.
Chronic pain treatment : One of the most serious problems in modern medicine is the undertreatment of patients in chronic pain. More than 30 million patients suffer from chronic pain, and seven million of them cannot relieve their pain without opioids (narcotics), but only few doctors in the country are willing to prescribe them, according to the National Chronic Pain Outreach Association. Today's massive denial of pain medication is a consequence of the social, regulatory and law enforcement climate created by the War on Drugs. Doctors can suffer loss of license or even incarceration, when the inevitable mistake of providing medicine to a dishonest patient who may be misusing or diverting medication occurs. The climate has led to a situation in which most physicians are incorrectly trained in pain management and under- or non-treatment of pain is the norm. Doctors who treat pain correctly typically must exceed the usual prescribed dosages, and in so doing draw the scrutiny of state medical boards and the U.S. Drug Enforcement Administration (DEA). The DEA demands that doctors and pharmacies regularly provide them with records of every prescription for controlled substances that is written or filled. The fate of pain patients in the "police state of medicine" is grim. Day after day of constant torment drives many to depression or even suicide. Many patients receive enough medicine to provide relief for four hours out of the day, and have to decide which 20 hours of the day they will spend in extreme pain. Frightened doctors sometimes "fire" patients, cutting them off from pain meds suddenly, thereby putting them at risk for shock or withdrawal. And those patients receiving adequate prescriptions live in fear that their doctors could be put out of business by the government or frightened into cutting them off. Former addicts as well as former prisoners are in the worst situation of all, being automatically suspect -- but pain patients from these backgrounds need and deserve proper treatment nonetheless.
Treatment of Pain : Pain can occur for many reasons, and strike in a variety of locations. Back pain, disc pain, facet and nerve root pain, chronic headache pains and migraines are just a few of the problems that we can diagnose and treat: Acute and Chronic Back Pain Pelvic Pain Post-surgical Failed Back Syndrome Diabetic Neuropathy Disc Pain, Facet and Nerve Root Pain Atypical Facial Pain Complex Regional Pain Syndromes; RSD Herpetic and Post-Herpetic Neuralgia Chronic Headache Pain; Migraines Other painful conditions resulting from disease and injury
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