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.

Non-steroidal anti-inflammatory drugs : Non-steroidal anti-inflammatory drugs are medications that impair the production of prostaglandins in the body. Prostaglandins are natural compounds that are responsible for producing fever, pain, and inflammation. They are called non-steroidal anti-inflammatory drugs because they reduce inflammation without the side effects of steroids. Steroids (Prednisone, Cortisone, Medrol, etc.) are potent medications that reduce inflammation, but steroids have predictable and potentially serious side effects, especially with long-term use. Non-steroidal anti-inflammatory drugs do not have these steroid side effects. They are called non-steroidal anti-inflammatory drugs because they reduce inflammation without the side effects of steroids. Steroids (Prednisone, Cortisone, Medrol, etc.) are potent medications that reduce inflammation, but steroids have predictable and potentially serious side effects, especially with long-term use. Non-steroidal anti-inflammatory drugs do not have these steroid side effects. In fact, many over-the-counter NSAIDs have the same active ingredients as prescription NSAIDs. The difference is in the amount of active ingredient contained in each tablet or capsule, and in the dosing requirements. Acetaminophen reduces pain and fever by acting on the brain. NSAIDs reduce pain and fever by reducing prostaglandin production and inflammation at the site of pain (ankle, knee, shoulder, etc.) Acetaminophen is generally considered easier on the stomach than NSAIDs. Aspirin, Aleve, Advil/Motrin are similar in reducing pain, fever and inflammation. But aspirin has more prolonged anti-platelet effect than the other NSAIDs. Different people respond differently to pain relievers. Therefore, choosing the right pain reliever can be somewhat of a trial and error process. I recommend that patients use the pain reliever that has worked for them in the past. This will increase the likelihood of effectiveness and decrease the risk of any side effects. Different people respond differently to pain relievers. Therefore, choosing the right pain reliever can be somewhat of a trial and error process. I recommend that patients use the pain reliever that has worked for them in the past. This will increase the likelihood of effectiveness and decrease the risk of any side effects.

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).

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