Oral Medications:
By Prescription and Over-the-Counter

Therapeutic Relief for Chronic Pain Sufferers

Pain that lasts for longer than 3-6 months is considered to be chronic pain. Pain can make life difficult and sometimes miserable. Our medical team understands that different disorders are painful and want to help you manage your pain and related symptoms.

There are different types of pain syndromes, and medications can help with the symptoms to varying extent. Most pain medications have side effects that need appropriate management.

Medication - Overview

Listed below are common types of drugs prescribed or recommended and available over-the-counter (OTC) to treat symptoms. Sometimes, drugs are combined, such as an NSAID and muscle relaxant or opiates in order to provide maximum results. Your doctor will explain which medications you can and cannot combine, as well as other information about drugs to treat your particular problem.

Type	Purpose
Narcotics (Opioids)	Short-term acute pain control
Muscle relaxants	Relieve muscle spasms and cramping
NSAIDs*	Reduce inflammation and pain
Sedatives	Promote sleep
Transdermal analgesics	Pain control delivered through a patch

*Non-steroidal anti-inflammatory drugs

• Narcotics (Opioids)
  Narcotics are used for a short time to control acute pain. Acute pain is sometimes described as severe and sharp, such as pain after surgery.
  
  Narcotics taken for a long time may cause your body to develop a drug tolerance, meaning it takes a larger dose to control pain. Under certain conditions, long-term opiates are prescribed for patients in chronic pain who understand the strict parameters in our office for these medications.
• Muscle Relaxants
  Muscle relaxants help relieve muscle tightness, spasms, and cramping. Acting on the central nervous system, these drugs cause a relaxing effect in muscles. At times, these medications can cause sedation.
• Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
  Many spinal disorders cause soft tissue inflammation, which can lead to nerve inflammation and pain. Whiplash or overuse injuries also affect soft tissues and cause swelling and muscle pain. Non-steroid anti-inflammatory drugs help reduce inflammation and pain. However, these medications are often implemented on a strict, limited regiment due to the expected side effects from long-term use.
• Sedatives
  Back or neck pain can make getting to and staying asleep difficult. Your doctor may prescribe a sedative to help you sleep. These drugs should not be taken long-term, as they can be habit-forming.
• Transdermal Analgesics
  Certain pain-relieving drugs are available in transdermal patch form. The drug is delivered over time through the skin. Transdermal patches allow some patients to avoid the gastrointestinal irritation caused by oral medication.

Side Effects
Whether your medication is prescribed (Rx) or over-the-counter, there are risks -- side effects, drug interactions, and liver damage. Therefore, be sure to tell your doctor about any allergies, current medications taken (Rx and OTC), vitamin, and herb use. When you obtain a new medication, take time to read the information provided by your pharmacist. It is helpful to have a comprehensive list of your medications.

There are certain side effects you should immediately report to your doctor or present to the emergency room. Such as:

Black, tarry stools Behavioral changes Cold, clammy skin Experience hallucinations Facial swelling Fast or slow heartbeat

Hives, skin rash, itching Severe confusion or fatigue Severe weakness Trouble breathing Trouble urinating Yellowing of the skin or eyes

Pain Diary

We recommend you keep a daily journal of your pain level and other symptoms. The pain diary will help provide your doctor with detailed information about your treatment progress when you come back for your follow-up office visit.

This information will help us adjust your medications appropriately.  Pain medications will never provide 100% pain relief, and can cause side effects.  We will work closely with you to optimize your pain medications.

In addition, you may want to rate your pain each day (morning, noon, evening) on a scale of zero (no pain) to 5 (moderate pain) to 10 (worse pain possible).  Also, make a note of:

• Activities that make pain better or worse
• Side effects (i.e. nausea, vomiting, constipation)
• Amount of medication taken and when

Conclusion

Our practice is committed to helping patients in our care to relieve pain and symptoms. We carefully and thoroughly assess your condition and treatment progress so the medications prescribed or recommended help you quickly for a safe recovery.