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Chronic Pain Relief: New Treatments

New advances in drugs and technology mean there are now better solutions for chronic pain relief.

Pain Specialists: Experts in Chronic Pain Relief continued...

It's an exciting time in pain management -- and there are more advances coming. "Our knowledge has increased tremendously in the last few years," says Salahadin Abdi, MD, PhD, chief of pain medicine at the University of Miami School of Medicine. "We still have a lot to learn, but research has given us clues in developing even newer treatment options."

There's one big problem: Many people don't know that there are medical doctors who specialize in treating pain, Abdi tells WebMD. "We do exist and we can help. But unfortunately, we see many patients in the later stages of chronic pain when it is more difficult to treat. The earlier we start treatment, the better chance we have of being successful in relieving pain."

Medications: First Step in Chronic Pain Relief

When treating pain, doctors typically start with oral painkillers like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil, Motrin, Naprosyn, and Voltaren. These reduce inflammation and relieve pain, especially related to arthritis, tendinitis, nerve injury, mild to moderate cancerpain, and other forms of chronic pain.

Finding which drugs work for your chronic pain will likely be a trial-and-error process -- although specialists are honing in on the solutions. "There is no magic bullet," Chan says. "Some medications work better with specific types of pain. We try different drugs or combinations of drugs until we arrive at what is optimal. Individualized treatment is very important."

When pain is severe, doctors turn to stronger pain relief medications:

Anticonvulsants. Drugs used to treat seizure disorders have been effective in chronic pain relief. It's still unclear how they control pain, but the drugs are believed to soften the effects on nerve-related pain such as postherpetic neuralgia from shingles. These include Lyrica, Neurontin, and Tegretol.

A new generation of anticonvulsant drugs is looking promising for chronic pain relief, says Gallagher. "There's a lot of work being done to improve these drugs, make them more convenient to take -- with fewer side effects."

Antidepressants. Low doses of common antidepressants are being prescribed for many chronic pain problems. These drugs adjust levels of brain chemicals, which is thought to be their mechanism for helping to control pain.

Antidepressants often help when patients don't get complete chronic pain relief from other treatments. They relieve pain whether the person is depressed or not. The doses needed to treat pain are usually lower than doses used for depression treatment.

  • Elavil, Pamelor, and Norpramin are tricyclic antidepressants prescribed to help treat pain, especially cancer pain, nerve pain from diabetic neuropathy, and postherpetic neuralgia pain from shingles. They affect levels of the brain chemicals norepinephrine and serotonin.

  • Cymbalta is a serotonin and norephinephrine reuptake inhibitor (SNRI), which increases availability of the brain chemicals serotonin and norepinephrine. Cymbalta is FDA-approved for the treatment of diabetic neuropathy, fibromyalgia, and musculoskeletal pain like that of osteoporosis and chronic low back pain.

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