Chronic Pain Relief: New Treatments
New advances in drugs and technology mean there are now better solutions for chronic pain relief.
Medications: First Step in Chronic Pain Relief continued...
Pain relief creams. Topical painkillers like Zostrix, which contains capsaicin, are often helpful. Capsaicin works by reducing transmission of a pain-relaying chemical called substance P to the brain. Products with these ingredients also work: salicylate (found in products like Aspercreme and Bengay), a substance that decreases inflammation and relieves pain; and counter-irritants like camphor, eucalyptus oil, and menthol, which relieve pain by causing either coolness or heat at the pain site.
Skin patches. A transdermal patch that contains lidocaine can offer chronic pain relief. The patches are FDA-approved for chronic nerve pain from shingles, a condition known as postherpetic neuralgia. Lidoderm and Lidopain are two lidocaine skin patches, available by prescription. Capsaicin also comes in a patch applied by your doctor called Qutenza. It can be used every three months.
Narcotics: Serious Medicine for the Worst Chronic Pain
When pain is severe, pain specialists take treatment to the next level. Narcotic pain medications like codeine, fentanyl, morphine, and oxycodone work on the nerve cells' pain receptors and are very effective in controlling severe chronic pain.
But use of narcotics has always been controversial. "There's been a perception among many doctors that they will get into legal problems if they undertreat or overtreat pain with opiates," Chan tells WebMD. "That is a factor of not having adequate education about these medications. These are very effective for the right patients. We have to use them carefully, but they can be used long-term."
"There is a small risk of addiction," Chan says, "but studies show that used appropriately, the risks are small."
When prescribing narcotics, pain specialists often prescribe combinations of medications -- taking advantage of new extended-release antidepressants, for example.
"Combining medications lets us reduce the amount of narcotic," Abdi tells WebMD. "It also lets us provide better pain relief, because the mechanism of narcotics is different from drugs like antidepressants and anticonvulsants." This approach is critical in treating nerve injury-related pain, as with diabetic neuropathyneuropathy, he adds.
Ultram ER is a non-narcotic drug which works on opioid receptors. It is indicated for moderate to moderately severe chronic pain when continuous pain treatment is needed.
The synthetic narcotics don't seem to have a risk of addiction, Abdi tells WebMD. "They are very effective in treating a lot of different types of pain syndromes. A lot of physicians prefer to utilize them before progressing to narcotics."
Among the newest narcotics for chronic pain relief:
The Duragesic transdermal skin patch is a narcotic treatment for moderate to severe chronic pain. It provides continuous delivery of the narcotic fentanyl for 72 hours.
More options for pain flare-ups. There are also two fast-acting medications containing the narcotic fentanyl. It was developed for cancer patients who have breakthrough pain -- and who are already taking opioid medications for cancer pain. Actiq comes in a "lollipop" form and Fentora is a tablet that dissolves in the mouth.