Pain is the activation of electrical activity in neurons which have sensory endings with a higher threshold for reaction. This means that while surface receptors may register pain from heat or touch, deep nerves that sense pain will not register this occurrence throughout the body. While any type of pain, acute or chronic, can become the source of massive discomfort, it should also be remembered that pain reactions are a defense mechanism.
By being able to sense pain as an indicator that an action can be harmful to health, people are also able the effectively survive by avoiding that specific pain. Even acute pains that are deeper within the body are also a part of this defense mechanism, since it signals that something is physically wrong and should be attended to.
Although the industry of pain control and pharmaceuticals can offer significant relief to many individuals, it is also important to realize that many doctors recognize pain as the fifth vital sign, since this can also indicate possible imbalances in the body.
While most people have experienced acute pain in their lifetime, the sensations do subside as the body heals. With chronic pain, the condition is not only on going, but can also become progressively worse, especially dependent on the underlying cause. For this reason, chronic pain is classified into two main types:
- Chronic non-malignant – this type of pain may have a diagnosed or an undiagnosed cause, such as a non life threatening illness, including some types of joint pain, fibromyalgia, and auto-immune disorders. This type of pain will last for longer that three months and may not respond well to many treatments.
- Chronic malignant – this is ongoing pain which is directly related to a progressive and worsening illness that may also be life threatening. Illnesses that can cause this type of pain include most cancers and many neuropathic conditions.
Effective Drugs for Chronic Pain
How well popular drugs for chronic pain can actually work is often reliant on the underlying causes of the sensation. The further classifies the sources of pain into groupings that may respond more favorably to certain medications.
Somatic pain is generally used to describe discomfort that arises throughout the frame work of the body. This can include joint pain, as well as pain in the bones, muscles, and ligaments. The manner in which these types of pain are described can include adjectives such as throbbing, stabbing, and highly localized. The causative site tends to be fairly well defined, and is often linked to structural conditions. Popular and effective drugs for this type of pain include:
- Nerve blockers
Visceral pain is specific to the organ systems, and is usually felt due to inflammation or disease in the kidneys, intestines, and liver. This type of pain will also be accompanied by other symptoms that are related to the underlying cause, and although the organs that are affected may be identified, the pain itself is slightly less defined. Visceral pain tends to present as
- Internal aches
- Sharp and gnawing pains
- The sensation of being squeezed from within
- Pain associated with sweating, cramping, and nausea
Effective drugs for visceral pain include the same ones as are applicable for somatic pain, although anti-emetics may also be used to reduce nausea and cramping.
Neuropathic pain can be one of the harder chronic pains to diagnose, as the location of the sensation is not always the location of the actual physical damage. Generally, neuropathic pain refers to the destruction of sensory nerves, but it can also refer to the overstimulation of nerve response. The feelings that are associated with this type of pain include:
- Numbness and tingling
- Pins and needles
- Stabbing or prickling
Treatment for neuropathic pain can be limited, but may include narcotics as well as anti-depressants, anticonvulsants, and GABA or derivatives to improve nerve health.
Sympathetically Mediated Pain
One of the most prevalent and mysterious chronic pain conditions is sympathetically mediated pain. This is generally though to arise from hyperactivity in the sympathetic nervous system, which leads to an overwhelmed response to any form of stimulus.
The result is that even something as simple as a light touch from a loved one or the feeling of clothing against the skin can set off a reaction. It is primarily characterized as having pain which occurs when there is no overt reason that it should be experienced. For this type of pain, nerve blockers are primarily used, although some anticonvulsants and even biological may be used to address the underlying issue.
Risks and Side Effects of Long Term Medication Use
Although medications for the management of chronic pain can provide relief, their long-term use can result in unpleasant side effects. NSAIDs can be responsible for everything from stomach ulcers and gastro-intestinal distress to anemia and bleeding, while narcotics can impair function and also lead to dependence. Nerve blockers and anti-depressants can also lead to health risks, with side effects that include:
- Sleep and mood changes
- Depression of cognitive function
- Dry mouth
- Nausea and loss of appetite
- Injury that occurs from being unable to adequately register pain
While many popular drugs for pain relief can be effective and beneficial, individuals with chronic pain conditions should also be aware that the condition is ongoing and that treatment can mean a lifetime of different medications and side effects.
Other Treatments for Pain Relief
Other treatments for pain relief can provide a better solution for chronic pain sufferers. Applicability can vary based on the cause of the condition and on any other underlying health issues, but some alternatives for pain relief include:
- Epidural shots – these are often highly effective for people who tolerate steroids well. Injections are given several times a year for lasting relief, although there is a limit to how frequently shots can be administered.
- TENS – this is electrically stimulation of the nerve endings and is often used to treat somatic pain. It is non invasive and non-pharmaceutical, but may not be appropriate for some neuropathies or in cases where there is a seizure disorder.