Pain Management, Research Paper Example

Abstract

The paper examines the management of chronic pain. The term chronic pain is defined. The various methods of treating chronic pain are discussed. The main medications that are used in managing the condition are discussed in the paper. These include drugs like narvcotics, antidepressants, Opioids and non steroid and non inflammatory among other are examined. Alternative means of maintaining pain are also examined.

Introduction

Pain is unpleasant emotional and sensory experience that is associated with potential and actual damage. It is also a sensory experience that is described in terms of actual and potential damage. There are two main types of pain. These are acute pain, and chronic pain. Acute pain mostly results from inflammation, disease and tissue injury. This pain comes suddenly for example, after a surgery or traumatic experience. It is usually accompanied by emotional distress and anxiety. This pain is self limiting. It can be diagnosed and treated. In some instances it can become chronic pain.

Chronic pain is soreness that endures for a long time. It is resistant to most known medical treatments (Bogduk & Merskey, 1994).It often causes severe troubles for patients. It is usually made worse by psychological and environmental factors. Pain management is a central part in dealing with pain that is chronic. There are different medications that are used to treat chronic pain. They are prescribed according to the cause of the pain, and also according to the severity of the pain (Bogduk & Merskey, 1994). The paper is going to look at some of those forms of medicating chronic pain.

Pain Medication Delivery Systems

It is useful to note that chronic pain drugs are used to treat long lasting, unending pain. One of the medications that are employed in managing unceasing pain is morphine. In the medical fraternity, it is known as the gold standard in alleviating chronic pain. This is the reason that makes it be the drug against which all other narcotics are compared.Fentanyl is another effective drug in the treatment of chronic pain. It is quite beneficial because it has less histamine than morphine. This means that it has fewer side effects (Bogduk & Merskey, 1994).The side effects of both Fentanyl and morphine are listed below. These two drugs used to fight chronic pain have adverse effects on the body. As the paper has recorded above, morphine has more side effects than Fentanyl. The adverse reactions include watery eyes, allergy related traumas, itching skin and sneezing among others. The more severe side effects include respiratory problems, headaches, dizziness, confusion and cramping and evacuation issues (Melzack & Wall, 1996).These two drugs are released through the transdermal patch. The advantage of these two drugs is that they are comparatively inexpensive when measured against other drugs. They also relieve chronic pain effectively. Another advantage of these drugs is that they are short acting. This means that they get out of the body quickly. To revisit the disadvantages, these drugs give the patient euphoria. Because they are short acting, they tend to be addictive.

Opioids

Opioids medications are other drugs that used to treat chronic pain. They provide a long, short, or intermediate analgesia. The analgesia depends on the formulation properties. Opioid drugs are administered by injection, orally, through both oral and naval mucosa, inravenously, transdermally rectally, intrathecally or epidurally (Melzack & Wall, 1996). These medications are usually prescribed together with shorter acting drugs in case of breakthrough exacerbations. One advantage of these drugs is that they are strong analgesics (Melzack & Wall, 1996). Most Opioids medications are administered orally Skin patches and suppositories are also used. One disadvantage of Opioids is that they provide only partial analgesia. By use of Opioids for a very long period of time do results in chemical dependency drug tolerance addiction and diversion. In prescribing Opioids, the patient should be examined for risk of drug abuse, or addiction. The family of the patient is examined for substance abuse (Melzack & Wall, 1996).

 Non-steroidal Anti-inflammatory Drugs

This is another group of analgesics. They include drugs such as piroxicam and ketoprofen. Their benefit in treatment of chronic pain is limited. These drugs make the patient to be more functional. The patient feels less pain (Main, Spanswick & Chris, 2000). The disadvantage is that they have adverse effects. There is more joint destruction in using these drugs. This is because they expose the patient to cerebrovascular and cardiovascular risks. They also blockade the bio-synthesis of cartilage in the body (Main, Spanswick & Chris, 2000).

Antidepressants and Antiepileptic Drugs

There are some antiepileptic and antidepressant drugs that are used in the management of chronic pain. They function mainly in the pain pathways of the brain. They are mostly used in management of neuropathic pains. They are also used in treating complex regional pain syndrome. An example of one such drug is gabapentin. The risk of these drugs is that they cannot be stopped without the occurrence of seizures. There are also some drug free ways of managing chronic pain. This is because it has been observed that almost all drugs used to treat chronic pain have adverse side effects (Main, Spanswick & Chris, 2000). If they are narcotics, they become addictive to the patient. They might also bring withdrawal effects on the patient. This is what has made the medical field to deduce some other means or ways of treating pain. Another reason that made the medical fraternity to come up with alternatives to chronic pain treatment is the fact that some patients develop tolerance to drugs. The paper is going to look at some of the alternative ways of treating chronic pain (Main, Spanswick & Chris, 2000).

Physiotherapy, Chiropractic and Manipulating Techniques

This is a way of treating chronic pain. It is a form of physiotherapy that entitles exercising on the part of the patient. In chronic pain management, it has limited efficacy. In some studies, these techniques appear to be successful, while in others they fail (Main, Spanswick & Chris, 2000).

Stimulation Techniques

These techniques have their origin in the orient. They include acupuncture and TENS. They are relatively simple. They are also safe and cheap compared to medicinal treatment of chronic pain. Acupuncture works by stimulating the patient’s body to produce endorphins. Acupuncture also works to stimulate the production of cortisone in the body. This decreases the pain. An analgesic effect is produced that inhibits pain for a period of time. The disadvantage is that there is a strong placebo effect on the patient (Stanos & Houle, 2006).

Nerve Blocks

The idea of blocking pain nerve centers faces a lot of criticism. This method is used for those patients with neurogenic pain and low back pain.

Surgery

This is another way of treating chronic pain in patients with nociceptive pain. This method is not widely recommended by most doctors. It had been previously used in the treatment of injured athletes. In the last few years this trend has changed. (Stanos & Houle, 2006).

Psychology

Psychological chronic pain treatment techniques are tailored for the individual patient. They cannot be offered piecemeal. They include behavioral techniques that are used by trained therapists. The disadvantage of this method is that most therapists do not explain chronic pain to their patients well. They sometimes fill their patients with false promises. This in turn leads to confusion and also disillusionment. It is important for the therapist to understand the natural history of the conditions that caused the chronic pain (Stanos & Houle, 2006).

Conclusion

There is rushing today to use acupuncture and other alternative pain management methods. People should always make sure that they get the right information in dealing with chronic pain (Stanos & Houle, 2006). It has been observed that clinic that deals with acupuncture are mushrooming all over the country. Acupuncture has started getting media attention. The government should step in to investigate the mushrooming of these acupuncture clinics. This is because it has been exposed that nearly all   personnel who operate these clinics do not have any medical training. This is alarming news because acupuncturists today are making all sorts of surgical operations. They are making incisions that go deep into body organs. This is endangering the lives of innocent patients.

It is useful to note that chronic pain is hard to manage. This is because it is always accompanied by another condition like diabetes. (Stanos & Houle, 2006). Patients should seek treatment for the chronic pain and also for the condition that brings this chronic pain. The treatment of chronic pain is controversial because every method of treating the condition has adverse side effects (Stanos & Houle, 2006).If it does not have adverse side effects, it has no treatment value. It is the hope of this paper that medical scientist will work hard to come up with a safe mode of treating this condition.

References

Bogduk, N., Merskey, H. (1994). Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Seattle: IASP Press.

Main, C. J., Spanswick., & Chris, C. (2000). Pain management: an interdisciplinary approach.  Norfolk, UK: Churchill Livingstone.

Stanos, S. & Houle, T.T. (2006). “Multidisciplinary and interdisciplinary management of chronic pain”. Physical medicine and rehabilitation clinics of North America, 17 (2), 435–5

Melzack, R. & Wall, P.D. (1996). The challenge of pain. London: Penguin.