What are the medicines for chronic pain relief

Currently, commonly used drugs for chronic pain relief in clinical practice mainly include three categories: non-steroidal anti-inflammatory analgesics, opioid analgesics, and auxiliary analgesia (anticonvulsants, antidepressants). There is no panacea and must be selected according to the cause and degree of pain.

I have been in the pain department for almost 8 years. The most patients I see are mild to moderate chronic pain caused by osteoarthritis and chronic lumbar protrusion. I usually give priority to non-steroidal drugs such as celecoxib and ibuprofen, which can not only eliminate local aseptic inflammation but also relieve pain. However, this drug is not taken casually. "Painkillers" are particularly easy to irritate the gastric mucosa when taken on an empty stomach for a long time. Last week, I received an old patient with lumbar protrusion. He took ibuprofen when he felt pain. He took it for more than three months. This time, he was admitted to the hospital because of gastric bleeding. The pain did not go away and there were new problems. I sat in the clinic for a long time and regretted it.

If your pain is like pinpricks or electric discharges, and it hurts when you rub your skin with clothes, it is most likely neuropathic pain, such as post-herpetic pain and diabetic peripheral neuralgia. Ordinary ibuprofen is basically useless. Anticonvulsants such as gabapentin and pregabalin are commonly used at this time. It is equivalent to soothing the nerves that are overly excited and "discharging". There was a 72-year-old aunt who had post-herpes zoster pain. When she came here, she didn't even dare to wear underwear. She walked hunched over in a loose coat. After taking pregabalin for ten days, she came back for a follow-up visit. She could already say with a smile that she went to the square to dance the fan dance for half an hour the night before. There are also some old patients who have been in pain for three to five years. They generally have trouble sleeping and tense emotions, and the pain experience will be amplified. At this time, we often prescribe antidepressants such as duloxetine. Several times when patients get the medicine, they wonder, "I am not mentally ill, why are you prescribing this to me?" Don't get me wrong, this is to use it to regulate neurotransmitters, which can not only improve emotional sleep, but also directly reduce pain sensitivity. A two-pronged approach is much more effective.

Speaking of opioids, there is indeed a lot of controversy. Many people are afraid of becoming addicted when they hear about morphine and oxycodone. This concern is completely reasonable, so we will basically not take the initiative to prescribe them for ordinary chronic pain. Only moderate to severe cancer pain and refractory chronic pain where other drugs are completely ineffective will be considered. And if used strictly according to dosage specifications, the addiction rate is less than 1%, so there is no need to blindly reject them. On the contrary, many people cannot bear the pain and buy weak opioids such as Tramadol and take them indiscriminately. Without the guidance of a doctor, they take higher and higher doses, which makes them prone to dependence. There used to be a young man in his 20s who had chronic back pain and refused to seek formal treatment. He bought Tramadol online and took it for an extra year. When he finally quit, he was sweating and trembling, and suffered a serious crime.

Oh, by the way, there are also some topical medicines such as Voltaren ointment and lidocaine patch. If the pain is in a shallow location, such as knee pain or shoulder muscle strain pain, external medicines are preferred. Transdermal absorption only acts locally, and the side effects are much smaller than oral medicines. After all, chronic pain relief is only a symptomatic treatment. Finding the source of the pain is the key. Don't think about buying medicines on your own. It is better to seek a clear evaluation from the pain department of a regular hospital than anything else.