Chronic Pain

Chronic Pain is pain which lasts for more than one month after an injury has healed; pain that lasts or recurs for more than 3 months or pain associated with tissue injury that is expected to continue or get worse.

TYPES OF CHRONIC PAIN
General somatic pain (pain from the outer body) : Includes pain that is caused by fibromyalgia and chronic back pain. Treatment generally involves the use of Non-Steroidal Anti Inflammatory Drugs (NSAIDs) such as Diclofenac, Aceclofenac etc.

Visceral pain: (pain from the internal organs) - Includes the pain associated with chronic pancreatitis, chronic active hepatitis, gallstones and appendicitis. Treatment may include surgery or the use of pain relief medications.

Bone pain - may be caused by bone cancer, osteoporosis, osteomyelitis or arthritis. This pain can be described as gnawing and throbbing and may require long-term treatment with hormonal therapy or bisphosphonates. NSAIDs and possibly opioids may also be used.

Muscle cramps- May be treated with pain relief medications or muscle relaxants if these are ineffective.

Peripheral neuropathy - Is pain that arises in the nerves leading from the head, face, trunk or limbs to the spinal cord. Sciatica, ruptured spinal discs, cancers, infections such as shingles, diabetes and AIDS can cause peripheral neuropathy. This type of pain is described as a "pins and needles" sensation and is treated with tricyclic antidepressants. More severe nerve pain may be felt as a sharp, stabbing, electric feeling and is treated with anticonvulsants. Treatment of shingles pain may involve topical pain medications and possibly opioids.

Circulatory problems - can cause Chronic Pain. This type of pain may be treated by surgery or with blood thinning or opioid medications.
Headaches: (e.g. migraine, cluster, tension) may be treated with non-opioid or opioid medications and/or oxygen therapy. Sinusitis pain may be treated with antibiotics and decongestants. The pain associated with neuralgia is often treated with anticonvulsants.

TREATMENT OPTIONS
Always consult your Doctor for diagnosis and advice. In no way is this information intended to replace the advice of a medical practitioner. Your Doctor can give you advice about Pain Management medications and therapies.


PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.

Have regular exercise after a physical examination and approval by a Doctor. Walking and swimming are examples of gentle exercise, which may help to reduce pain particularly in the joints, muscles, ligaments and tendons of the body. It is advisable, after checking with your Doctor, to have 20 to 30 minutes of gentle and continuous exercise each day. Regular exercise may help to prevent joint stiffness, muscle wasting and pain to some degree.

Ask your Pharmacist about non-drug methods of pain relief. If your pain is associated with heat and swelling, a cold pack applied to the area may bring some relief. If the pain is associated with stiffness, applying a heat pack and warming linament to the area may help to ease the pain.

Make sure that you are taking the correct pain-relieving medication for the particular pain problem. It is not advisable to continue taking the same pain relief medication without consulting your Doctor or Pharmacist. There may be a more suitable medication for your needs or the dosage may need to be changed. Ask your Pharmacist for advice.

Ask your Doctor or Pharmacist for advice before increasing the dose of a pain-relieving medication.
Never take pain relievers, which have been prescribed, for another person. Not all pain relief tablets are the same. Different pain relievers have different effects, different dose recommendations and are suitable for different sorts of pain. Some types of pain relievers may have side effects, which the patient may not be aware of e.g., Non-steroidal Anti-inflammatory Drugs (NSAIDs), should not be taken by people with an allergy to aspirin.

Consider taking some supplements if the diet is inadequate. When managing pain, the body may require extra nutrients such as B group vitamins. Pain relievers may increase the need for certain necessary vitamins. The following nutritional supplements may be required while using analgesics: For Aspirin: bioflavonoids, vitamin C, vitamin B1, B5, B12, K, folic acid, iron, manganese. For Paracetamol: vitamin E. Damage (ulceration) of the stomach lining is a common side effect of chronic NSAID use. This may increase the body's needs for iron if bleeding occurs.
Aspirin should not be given to children under 16 years of age unless specified by a Doctor.

ORGANISATION & GROUPS:
Indian Society for Study of Pain (http://www.isspap.org/pain-problems.php)