Medication

Medication can provide some relief. Not all pain can be cured.
It is safer to use as little medication as possible and to avoid medication that has serious side effects. All medications have some sort of side effect. I remember a professor telling me that if a medication doesn’t have a side effect, it doesn’t have an effect.
This is a from PainBC
https://youtu.be/avZBNRBTpio

It makes sense to use medication if your pain is causing you distress. For instance, say you aren’t sleeping well or waking because of pain. Trying Acetaminophen, as an adult you can easily take 1gram (or 1000mg) at night, could be strong enough to improve sleep.

Analgesics like Acetaminophen, and Anti-inflammatories like Asprin, Naproxen, Ibuprofen, Celebrex and Meloxicam.

Not all pain can be managed with NSAID or over the counter drugs. Severe pain requires a multimodal approach which may include opioid treatment. The new opioid guidelines and restrictions have led to patients in severe pain suffering unnecessarily. This an article from The Washington Post

Acetaminophen is safe unless you take more than 4g (4000mg) per 24 hours. Then it can be dangerous.

If you find you need this medication often – better to take it regularly. Get on top of the pain. You’ll need less medication that way

Anti-inflammatories

Anti-inflammatories, on the other hand, can be dangerous even with small doses. It depends on your body and your luck. Up to 6% of people can develop heart complications from an NSAID and they are more likely to upset your stomach. it can also raise blood pressure and other side effects.

If you are taking preventative ASA (Asprin) and you want to take an Anti-inflammatory (NSAID) then likely take asprin rather.

Always talk to your healthcare professional before taking medications.

Your pharmacist can be very helpful too.

There are instances when pain is moderate to severe where medication with side effects will have to be considered. I think there has to be a balance where the side effects of the pain have to be weighed against the side effects of medication. That is why it is so important that you are able to communicate your pain to your doctor/healthcare provider. Have the conversations necessary to make reasonable choices.

Here are some articles you may find interesting about medication and also the effects of not having adequate pain control Pain BC website

Different types of medications – Check with your healthcare provider: I don’t have place here to talk about ALL THE DIFFERENT INDICATIONS AND SIDE EFFECTS.

Antidepressants

Antidepressant drugs that in low doses are used for pain, rather than depression (To treat depression you need high doses of these drugs) These medications are also used for cancer pain: Amitriptaline, Nortriptaline, Venlafaxine, Prisiq.  Amitriptaline and Trazodone can help sleep and with good sleep you can have less pain.

Some anticonvulsants have been linked to improved pain, like Gabapentin and Lyrika. They do have many side effects but can benefit some people.

Hydroxychloroquine is a pill used for malaria that can be used for severe arthritis with an inflammatory component. Can be used for psoriasis arthritis.

Many treatments for inflammatory arthritis like rheumatoid arthritis can be tried: like Methotrexate plus hydroxychloroquine plus and Sulfasalazines  before biologicals.

Antidepressants can help chronic pain in some instances. Their sedating side effects can help you sleep and build restorative chemicals. Improved sleep helps you cope with the stress of chronic pain.
Many people with pain suffer from anxiety and depression either from the pain or maybe you have inherited depression from you parents, or have it because of stress.

How do antidepressants work?

Antidepressants can help pain: https://bit.ly/2FbtPrS

Sometimes anxiety is so over-powering that depression is not noticed. If you would like to try anti-depressants but are very anxious, ask your doctor to consider a two week course of benzodiazepines to help you through the worst. After two weeks the side-effect of increased anxiety goes down and in six weeks the effect is usually noticeable.

Some people feel numb or “dead” on anti-depressants. I wonder if that is not because chronic pain or chronic stress has led to PTSD. Our brains then only feel alive in a state of chaos. On anti-depressants, the calm feelings make you feel uncomfortable as your brain seeks the energy and excitement of chaos. Check out  Stress Anxiety and PTSD

Antidepressants do not cause a physical addiction.  They do have side effects. Speak to your health care provider.

Serotonin can be found in medications other than antidepressants. If you take too much, you may develop toxicity

Speak to your health care provider if you have: tremors, increased reflexes, muscle spasms, dilated pupils, sweating, fast heart rate, increased breathing rate, agitation, over-excitement, restlessness, or confusion.

 Opioids

Opioids carry significant risk and should be reserved for people suffering from severe or moderate to severe pain. Consult your health-care provider and, if necessary, bring family members along to advocate for you if your pain is severe enough to warrant opioids.

Under-treatment of pain carries significant risks to individuals. Use forms to help communicate your pain. Forms relating to Pain

Buprenorphine and Methadone
Using the steps provided, it is possible to improve your quality of life, but if the pain is overwhelming, then medication may be needed to enable you to use the tools.

Activity helps – but remember pacing. Step 5 Pain and Pacing

Ideally find activities that you enjoy doing. When you are unable to manage activities due to pain, then your health-care provider should be your advocate. Use  Forms relating to Pain to ensure good communication if you need stronger medication, like  opioids. Browse through http://chronicpainmanagement.ca/?s=MD+tools

Using forms ensures easier, quicker and more effective communication with your health-care provider. Your local library may be able to help you print the forms to hand to your health-care provider.