What are the medications for chronic pain relief?

Currently, the drugs used clinically for chronic pain relief mainly include over-the-counter anti-inflammatory analgesics, prescription neuromodulators, and topical analgesics. The specific ones to use depend entirely on the cause and type of pain. It is absolutely not recommended to purchase medicines by yourself.

I met a 62-year-old aunt a while ago. She suffered from sciatic nerve pain due to lumbar disc herniation for almost half a year. I heard from my neighbors at home that ibuprofen was effective in relieving pain. I took it for more than half a month, but my legs hurt and I couldn’t bear down much. On the contrary, my stomach was so burned that I couldn’t even drink porridge. I came to the outpatient department for evaluation and then gave her a low-dose gabapentin. After taking it with a gastric mucosal protector for two weeks, the pain score dropped from 7 to 2, and the symptoms of gastric discomfort disappeared.

The most familiar non-steroidal anti-inflammatory drugs, such as acetaminophen and ibuprofen, are over-the-counter drugs and can be purchased in pharmacies. They are more suitable for mild to moderate pain related to inflammation such as osteoarthritis and chronic muscle strain. However, it is best to ask your doctor before taking them. Do not take them for more than a week. People who have gastric ulcers and Helicobacter pylori infection should try not to take them if they can, so as not to induce gastric bleeding.

If your pain feels like pins and needles, electric shock, and numbness from time to time, such as post-herpetic pain, diabetic peripheral neuralgia, trigeminal neuralgia and other neuropathic chronic pain, ordinary ibuprofen will have basically no effect. In clinical practice, calcium channel modulators such as pregabalin and gabapentin are generally prescribed to regulate abnormal nerve discharges, and the pain relief effect will be much better.

Speaking of which, we have to mention the most controversial opioid analgesics. Previously, some people believed that stubborn, severe chronic pain could be controlled with low-dose opioids, but now more voices in the industry prefer to avoid them as much as possible. After all, the risk of addiction and the side effects of respiratory depression are there, especially in the elderly, who have slow metabolism and are prone to adverse reactions. Nowadays, these drugs are extremely strictly controlled, and doctors will not prescribe them unless it is a last resort.

If the location of the pain is relatively shallow, such as muscle pain in the shoulders, neck, knees, and low back, you can actually give priority to external analgesics, such as flurbiprofen gel patch, diclofenac diethylamine cream, etc. The drugs act directly on the painful area without going through the pain process. Gastrointestinal metabolism, side effects are much smaller. I have a friend who has been working as a UI designer for ten years. He has suffered from chronic shoulder and neck pain for three or four years. He never takes oral painkillers. He carries a tube of topical cream with him. When it hurts, squeeze a little and rub it for five minutes. The tightness will disappear quickly.

Finally, I have to remind you that painkillers are never "taken only when the pain is unbearable." The current treatment concept for chronic pain recommends regular use of medication to control pain to a mild level to avoid long-term nerve stimulation and pain sensitization. To put it bluntly, it is like replenishing the battery of a mobile phone when it has 20% left. Don't wait until it automatically shuts down before plugging it in, which will damage the battery even more. Of course, the prerequisite must be to see a doctor first to clarify the cause of the pain. If it is chronic abdominal pain or chest pain that may be related to organ disease, taking painkillers indiscriminately will cover up the true condition and delay treatment.