Drugs Used to Control Chronic Pain continued...
When used at appropriate doses with careful monitoring, these drugs can be safe and effective treatment for chronic pain. But be sure to discuss the risks, benefits, and research behind any drug with your doctor.
• Anticonvulsants. Several drugs originally developed to treat epilepsy are also prescribed for chronic pain. These include first-generation drugs like carbamazepine ( Tegretol) and phenytoin ( Dilantin), as well as second-generation drugs like gabapentin ( Neurontin), pregabalin ( Lyrica), and lamotrigine ( Lamictal). Gabapentin and Lyrica are FDA-approved to treat pain.
The first-generation drugs can cause an unstable gait (ataxia), sedation, liver trouble, and other side effects. Side effects are less of a problem with second-generation drugs.
• Opioids. Codeine, morphine, oxycodone, and other opioid medications can be very effective against chronic pain, and they can be administered in many different ways, including pills, skin patches, injections, and via implantable pumps.
Many pain patients and even some doctors are wary of opioids (also known as narcotics) because they have the potential to be addictive. Except for patients with a history of addictive behavior, pain experts say the potential benefit of narcotic therapy for chronic pain often outweighs the risk.
"It’s a matter of balance," says Chou. "People do need to be concerned about the risk posed by opioids. But as a physician, I think it is inappropriate not to use medications that can help people, if the risks can be managed."
Generally, doctors who prescribe opiod treatment monitor patients with chronic pain carefully.
Nondrug Treatments for Chronic Pain
In addition to drug therapy, several nondrug treatments can be helpful for chronic pain, including:
• Alternative remedies. Although doctors don’t know exactly how it works, there is good scientific evidence that acupuncture can offer significant relief from chronic pain. Other alternative remedies proven to work against pain include massage, mindfulness meditation, spinal manipulation by a chiropractor or osteopath, and biofeedback, in which a patient wearing sensors that record various bodily processes learns to control the muscle tension and other processes that can contribute to chronic pain.
• Exercise. Low-impact forms of exercise like walking, bicycling, swimming, and simply stretching can help relieve chronic pain. Some people find it particularly helpful to participate in a structured exercise program given by a local hospital.