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Safe and Effective Medication Management at All Star Pain Management
Pain is the most common reason why people seek medical care. Acute and chronic pain can lead to lost time at work. In addition, pain leads to interference with usual daily activities, greatly affecting a person’s quality of life. The most common conservative form of pain management is medication use.
**All Star Pain Management offers medication treatment on a case by case instance. Each patient is different and has a unique presentation. Each patient receiving opiates will need to abide by an opioid agreement.
What is the difference between acute and chronic pain?
Acute pain is usually associated with identifiable trauma or injury, and a person responds to treatment with pain resolution within 3 months. Chronic pain, however, persists for longer than 3 months. This pain is often difficult to treat, and the cause is not always clear.
Chronic pain can be continuous, episodic, or a combination of both. As reported by patients, chronic pain can lead to financial distress, disturbed sleep, social withdrawal, depression, weight changes, emotional stress, and increased irritability.
How common is chronic pain?
In a recent survey of a large group of people of varying ages, the rate of chronic low back pain was 29%. In this survey, 17% reported severe headache or migraine, 15% reported neck pain, and 5% had facial or jaw pain. Analgesics the most commonly continued or newly prescribed medications, prescribed and used at a rate of 11.4%.
Acetaminophen (paracetamol or Tylenol) is a well-tolerated medicine, with few drug-drug interactions. It can be used safely during pregnancy and is not linked to increased blood pressure. Because of is low cost and safety profile, acetaminophen is considered a reasonable first-line drug option.
Aspirin relieves mild to moderate acute pain, when given in a dose of 500-1,200 mg. Patients with a history of asthma or urticaria should not take aspirin due to high risk for allergic reaction. In addition, aspirin should not be used in patients who have ulcers or stomach problems.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDS work by inhibiting COX-1 and COX-2, producing an anti-inflammatory effect. Most NSAIDs are effective and inexpensive, and they are available over-the-counter. Examples include naproxen, ibuprofen, and ketoprofen.
NSAIDs work better for pain relief than aspirin and acetaminophen, and are often used along with a muscle relaxant for lumbar strain. Topical indomethacin works for mild, localized pain, and topical diclofenac offers good pain relief for sprains and strains.
COX-2 Selective NSAIDs
Celecoxib (Celebrex) is the only COX-2 selective NSAID still available in America. This medicine is approved for dental pain, bone pain, headache, dysmenorrhea, osteoarthritis, ankylosing spondylitis, and rheumatoid arthritis. Celebrex cost a bit more than traditional NSAIDs, but it is associated with longer pain relief and fewer side effects.
For patients with severe, chronic pain or intractable, acute pain, opioids are used. These drugs often are formulated in combination with an NSAID or acetaminophen. In 2010, hydrocodone/acetaminophen was the most commonly prescribed medication in the U.S. Because of the risk of liver injury, patients should not take combination opioids long-term.
Full Opioid Agonists
Morphine and codeine are full opioid agonists that can be used when opioids combined with NSAIDs or acetaminophen do not control severe pain. These drugs are quite effective due to high affinity for opioid receptors.
Tapentadol (Nucynta) is a schedule II controlled substance that is used only for severe acute pain. This drug is a muopioid receptor agonist and norepinephrine reuptake inhibitor. A weaker version is tramadol (Ultram), which is effective for chronic and acute pain.