What are the chronic pain relief medications

Clinically used drugs for chronic pain relief currently mainly cover three categories: nonsteroidal anti-inflammatory drugs, opioid analgesics, and auxiliary analgesia. However, the specific selection is never based on the classification, and the plan must be customized based on the patient's pain type and basic physical condition.

To be honest, 80% of the chronic pain patients we encounter in our outpatient clinic have experienced taking medicine randomly on their own, either by randomly popping an ibuprofen when they feel pain, or by refusing to take medicine because they are afraid of being addicted and rolling in pain. Both extremes are very common. I received a 62-year-old patient with lumbar disc herniation last week. He has been suffering from pain for almost 8 years. He has been taking ibuprofen at home for 5 years. He dared not stop until he had stomach bleeding and was hospitalized. When he came, he was in pain so much that he could only curl up into a shrimp when sleeping. He broke into a cold sweat when turning over. After evaluation, The pain was due to inflammation combined with nerve root compression. I did not prescribe him any powerful oral analgesics, but only a low dose of pregabalin combined with topical flurbiprofen gel patch. After only two weeks, he reported that he could go downstairs and walk for half an hour on his own after a follow-up visit.

Many people are afraid of being "addicted" when they hear about analgesics. In fact, under the premise of standardized medication, the addiction rate of opioids for chronic non-cancer pain is less than one thousandth. Of course, this part of the clinical practice is also controversial. Some experts believe that even low-dose opioids may suffer from tolerance problems after long-term use, and the dosage will need to be increased to maintain the effect. Instead, it is better to use a combination plan to lower the dose of a single drug from the beginning, which can also reduce side effects. The current domestic and foreign guidelines are generally cautious about the use of opioids for chronic non-cancer pain. Generally, only moderate to severe pain that cannot be controlled by other drugs will be considered, and the dosage will be adjusted strictly with follow-up.

If you encounter neuropathic pain, such as post-herpetic pain, diabetic peripheral neuralgia, pain that feels like an electric shock or a pinprick, ordinary ibuprofen and acetaminophen are basically useless. You have to use drugs such as gabapentin and pregabalin that regulate nerve discharge. To use a popular metaphor, your home wires are short-circuited and sparks are emitted. If you do not adjust the sparks caused by light friction, you will definitely be treating the symptoms but not the root cause. There are also some chronic pains that cannot be diagnosed as organic problems, such as fibromyalgia, or patients who have long-term pain that makes them unable to sleep well and have a bad mood. A small dose of anti-depressant duloxetine or the like can be more effective than just taking analgesics. There was a girl in her 30s who worked in design. She suffered from fibromyalgia for 3 years, and everything in her body was cleared. After adding a small dose of duloxetine for half a month, she said that the pain that she woke up with every day was basically gone.

Don’t think that only oral medicines have side effects. The topical analgesic patches and analgesic creams that many people like to buy should not be made randomly. There was a young man who was working out and suffered from a strained rotator cuff for half a year. He put on the famous analgesic patch every day and changed it when it hurt. The skin around the shoulder where it was last applied was ulcerated, and he still said it plausibly. "External use cannot enter the stomach, so what side effects can it have?" In fact, long-term use of non-steroidal external preparations may cause local allergies, and absorption of a small amount of drugs will increase the burden on the liver and kidneys. Even if it is an over-the-counter analgesic, it is best to ask a doctor or pharmacist before using it, and do not take it blindly.