Chronic pain management often requires a multifaceted approach, including lifestyle modifications, physical therapy, and targeted medication therapy. Our doctors prescribe pain medications tailored to specific conditions, ensuring the safest and most effective treatment for each patient.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are commonly used to reduce inflammation and pain. While effective, they can have side effects, particularly with prolonged use.
Potential Side Effects:
Gastrointestinal upset, acid reflux, and peptic ulceration
Increased risk of heart attack and stroke in patients with cardiovascular risk factors
Kidney function impairment in some individuals
Nonselective vs. Cox-2 Inhibitors
Nonselective NSAIDs: Effective for inflammation but may increase stomach acid, leading to acid reflux and ulcers.
Cox-2 Inhibitors: Developed to reduce gastrointestinal risks but carry a slightly higher risk of cardiovascular events.
How Long Should NSAIDs Be Used?
Short-term use (typically less than two weeks) is preferred to minimize risks. Patients should consult their doctor before prolonged use of NSAIDs.
Nerve pain can arise from direct nerve compression (e.g., spinal disc bulge) or abnormal pain syndromes following injury. Early intervention can reduce the risk of developing prolonged episodes of nerve hypersensitivity is key to preventing long-term nerve hypersensitivity.
Common Medications for Nerve Pain:
Amitriptyline (Endep)
Traditionally an antidepressant but effective in lower doses for nerve pain.
May cause drowsiness.
Pregabalin (Lyrica)
Originally developed for seizures but also effective for nerve pain.
Can cause patient to become sluggish or feel like they are “in a fog”
Some individuals can develop significant lowering of mood with increase in suicidal thoughts or behaviours. Monitoring of mental health should be undertaken by your doctor when commencing Lyrica and you should report any thoughts of suicide or self harm as well as unusual changes in mood or behaviour.
Finch’s Paste
A topical cream containing amitriptyline, gabapentin, and ketamine. It is made by a compounding pharmacy
When rubbed into the skin of the acffeted area, the cream is locally absorbed and acts to reduces peripheral nerve sensitivity. It can be prescribed alone or can be used alongside oral medications (for comprehensive( to provide additional pain relief.
Paracetamol (Panadol)
Considered the safest first-line pain reliever for most conditions.
Tramadol & Opiates (e.g., Codeine)
PLAN
Prescribing medications that target specific pain mechanisms while minimising side effects.
MANAGEMENT
Combining medication with physical therapy, rehabilitation, and lifestyle adjustments.
MONITORING
Ensuring that patients understand their treatment plan and are monitored for effectiveness and safety.
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