What are the types of chronic pain relief drugs

Currently, drugs used clinically for chronic pain relief are mainly divided into three categories: non-opioid analgesics, opioid analgesics, and auxiliary analgesia. The applicable scenarios and side effects risks of different types vary greatly. It is not as simple as "just take a pill when it hurts."

The most familiar ibuprofen, acetaminophen, and celecoxib, which many arthritis patients often take, are non-opioid and are suitable for mild to moderate chronic musculoskeletal pain, such as the daily dull pain of lumbar protrusion, the pain of going up and down stairs with knee arthritis, and the pain of frozen shoulder. I once met a taxi driver who had been driving a taxi for 20 years. He suffered from lumbar prolapse pain for five or six years. Every time it hurt, he would buy ibuprofen and take it. After taking it for more than half a year, he was hospitalized for stomach bleeding. Only then did he realize that this kind of medicine seems safe. Long-term use not only damages the gastric mucosa, but also has cardiovascular risks. Even if it is an over-the-counter medicine, it is best to ask your doctor if you take it for more than a week.

If the pain has reached moderate to severe levels, such as long-term pain from advanced cancer, post-herpetic neuralgia that is so painful that you can't sleep all night, or chronic post-operative pain that makes it difficult to walk normally, the doctor may prescribe opioid analgesics after evaluation. Common ones include oxycodone sustained-release tablets, morphine sustained-release tablets, and fentanyl transdermal patches that do not need to be taken orally. They can slowly release the drug when applied to the chest skin, which is especially suitable for elderly patients with difficulty swallowing. When it comes to opioids, the first reaction of many people is "will they be addictive?" This is also a point that has been discussed in the industry: on the one hand, if it is used indiscriminately without indications, it is indeed easy to develop dependence and addiction. However, now clinically used sustained and controlled release dosage forms for chronic pain. If the medicine is administered according to the doctor's instructions, the addiction rate is less than 1%. There is no need to bear the pain for fear of addiction. However, some experts have reminded that opioids are controlled drugs after all, so it is better not to use low-level ones first to avoid unnecessary side effects.

There is also a type of "auxiliary analgesics" that everyone has rarely heard of. The main treatment in the instructions is not pain relief, but it is much better than ordinary analgesics for specific types of chronic pain. For example, pregabalin and gabapentin are used for neuropathic pain. I had an aunt who had been in pain for more than three months after recovering from herpes zoster. Ibuprofen had no effect at all. She switched to gabapentin and low-dose fentanyl patches, and she was able to go downstairs and dance square dances in less than two weeks. There are also antidepressants such as duloxetine, which are used for fibromyalgia, which causes pain all over the body and no organic problems can be found after repeated tests. The analgesic effect is much better than conventional analgesics.

There are two extreme views now. One is that "the medicine is only three parts poisonous. If it hurts, just carry it and never take it." In fact, long-term chronic pain will cause "central sensitization" of the nervous system. Simply put, the pain threshold is getting lower and lower, and people who don't feel anything after touching it are actually. It always hurts every time, but the longer it goes on, the harder it is to treat it; the other is to take medicine when it hurts, completely ignoring the underlying disease. For example, for lumbar pain, just rely on painkillers without adjusting sedentary habits or doing rehabilitation training. If the pain finally protrudes and compresses the nerve, you still need to have surgery, which delays the treatment. In fact, for patients with chronic pain, there is no best medicine, only the most suitable solution for them. It is much more reliable to find a pain doctor to evaluate the cause and degree of pain before choosing medicine than to buy and eat randomly on your own.