Pain Management

 In General

Pain Management

The intent of this article is to give some information to help in the safe healthy ways of managing pain. The US is having a real crisis in pain management. Approximately 90% of the world’s Hydrocodone is taken by US citizens. People addicted to prescription pain medicine is at a high. Back pain is one of the diagnoses commonly associated with prescription narcotic pain medicine.

The first comment I will make is pain is nothing but a message your body sends to the brain. It could mean something is broken, infected or in some way is causing you harm. It could also be letting you know something is not ideal, but no harm is being done. If you are unable to determine what that message is telling you, you may require a doctor to help you interpret it.

Irrespective of which version of pain you have we will briefly discuss some of the ways to manage it. There are several over the counter medicines available for pain. The first we will discuss is Tylenol/Acetaminophen. Drugs have branded/generic names and there is some debate regarding their being equivalent. Tylenol helps with pain and fever and is broken down by the liver. It has few side effects and is tolerated by most people with healthy livers. The next category is the NSAID Non-Steroidal Anti-inflammatory group. Medicines like Aspirin, Motrin, Naproxen, Mobic, Celebrex and about a dozen others make up this class. Some characteristics that vary in this class are the ability to help with pain, inflammation and fever and the tendency to have similar side-effects. Variably these medicines are generally broken down by the kidney. Kidney disease is more common than liver disease and prohibits use of these medicines. They can also irritate the stomach, slightly interfere with healing of bones and tendons and have some tendency to increase bleeding by their interference with normal platelet function. The last main category is the narcotic class which is overused these days and by optimally using the first two classes and by other techniques can be potentially decreased. Narcotics tend to cause peoples systems to require increased usage and doses by various mechanisms and is a source of dependency and withdrawal which also causes increased pain. Many Narcotics have Tylenol in them and that decreases the amount of Tylenol that can be taken at the same time. Hydrocodone 5/325 means 5mg of Hydrocodone and 325 mg of Tylenol.

Strategies to deal with pain are first to determine if it is necessary and healthy to pay attention to it or more adaptive to ignore it. Medicines can be taken in a parallel fashion. By that I mean you can take full doses of Tylenol, and NSAID and a Narcotic so long as you do not exceed the daily dose of the Tylenol component. For example you could take 12 Tylenols a day if you are only taking two of the Narcotic pain pills containing Tylenol and at the same time you are taking 800 mg of Motrin with each meal. If you forget the Maximal doses, that information is readily available on the internet.

There are other prescription medicines that help with pain like Neurontin/Gabapentin and Lyrica which helps with nerve pain, Steroids like Methylprednisolone and Antidepressants.

Other helpful things would be to use modalities like ice and sometimes heat and immobilization or putting the affected body part at rest. In general, the more healthy the mind and spirit and body and more fit you are, the better pain is tolerated and the less you have to begin with. I hope this information is helpful in strategies of managing pain.

Dr. T. Scott McGee