What are the medicines for chronic pain relief

Currently, commonly used drugs for chronic pain relief in clinical practice mainly include non-steroidal anti-inflammatory drugs, neuromodulatory drugs, muscle relaxants, and opioid analgesics. The specific choice depends entirely on the cause of the pain. The greater the pain relief, the better.

I have been in the pain department for almost 5 years, and I have seen too many people take ibuprofen when they feel pain. In the end, the pain in their stomachs has not stopped after eating. Last month, there was a 62-year-old aunt who had been suffering from radiating pain in her right lower limb due to lumbar disc herniation for 3 years. She took ibuprofen at home. She always has medicine to take. Recently, she was in so much pain that she couldn't get out of bed. She already had a superficial ulcer after a gastroscopy. We stopped her oral painkillers and replaced her with gabapentin and topical flurbiprofen gel patch. In just one week, the pain was reduced by more than half, and she was able to go downstairs to buy groceries.

Let’s talk about common sense that many people don’t know: chronic pain and acute pain are completely different. Acute pain is like a burst water pipe. Just grab a big basin to connect it (take strong painkillers to suppress it). Chronic pain is a slow leakage of water pipes in the wall. It’s useless just to wipe the floor. You have to find the leak. If you have mild to moderate chronic pain from musculoskeletal sources such as lumbar muscle strain or knee arthritis, you can actually give priority to using topical non-steroidal anti-inflammatory drugs, such as Voltaren ointment and loxoprofen sodium patch. Transdermal absorption directly acts on the painful area. The amount entering the blood circulation is only a few tenths of that taken orally, and it has almost no irritation to the gastrointestinal tract. Many people find it troublesome to take oral medications, which is completely unnecessary.

But if your pain feels like pinpricks or electric discharges, and the pain jumps out when you touch the skin, such as post-herpetic pain, diabetic peripheral neuralgia, or radiating pain from lumbar disc herniation pressing on the nerve belt, then taking ordinary analgesics is basically a waste of money. You need to use drugs that specifically regulate abnormal nerve discharges, such as pregabalin and gabapentin, sometimes with small doses. A lot of duloxetine - the first reaction of many patients when they get the drug is "I'm not depressed, doctor, you prescribed it wrong." In fact, this drug has been used in pain guidelines for many years. After chronic pain for a long time, the pain signal pathway of the brain will become extremely sensitive. Use it in small doses to help reduce overactive pain signals. It is not used to treat depression at all. Don't stop blindly.

There are also many young people who suffer from chronic neck, shoulder and back pain caused by sitting and standing for long periods of time. Their muscles feel as hard as slate. This kind of pain is mostly caused by long-term muscle spasm. Anti-inflammation alone is useless. Take some muscle relaxants such as eperisone hydrochloride to stretch the muscles. Once the tight muscles are relaxed, the pain will naturally be relieved. A while ago, there was a young man who works in the Internet. He had neck pain for almost half a year. Even if he took 2 ibuprofen a day, it didn't work. He also suffered from acid reflux. He changed it to a topical patch and added a muscle relaxant. He came for a follow-up visit in a week and said it was much better.

Only for severe chronic pain, such as late-stage cancer pain and severe bone and joint degeneration that makes it impossible to sleep and walk normally, will opioid analgesics such as tramadol and oxycodone be used. These are strictly controlled prescription drugs. They must be prescribed by a doctor after assessing the pain level and body tolerance. You must not buy them blindly on your own. Addiction risks and side effects must be monitored by dedicated personnel.

Many people are now discussing the use of cannabinoid drugs to treat chronic pain. At present, a few countries in Europe and the United States have indeed been approved for some indications, but there are no related drugs legally marketed in China, and there is still controversy among academic circles about the cognitive damage risks of long-term use of such drugs. There is really no need to take risks and buy non-compliant products. By the way, there is another question that everyone often asks: Can ordinary over-the-counter painkillers be taken for a long time? There is no completely unified conclusion in the academic community. Some studies believe that the risks of low-dose intermittent use are controllable, but there are also long-term follow-up data that show that if used continuously for more than 3 months, the risk of gastrointestinal bleeding and cardiovascular adverse events will increase by 2-3 times. It is prudent to not take it by yourself for more than 1 week. If it doesn't work, go to a doctor to adjust the medicine quickly. Don't force yourself to take medicine, and don't take medicine blindly.