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Pain and pain management Pain is more than just a feeling of discomfort. It can affect the way you feel overall. It may also lead to mental health conditions, like depression and anxiety. The amount of pain you experience can tell your doctor a lot about your overall health. Acute pain happens suddenly, usually in a matter of days or weeks. It tends to resolve within a few weeks. Chronic pain is ongoing. According to the Centers for Disease Control and Prevention (CDC), pain is considered to be chronic when it lasts beyond 3 monthsTrusted Source. Pain-relief methods range from at-home treatments and prescriptions to over-the-counter (OTC) medications and invasive procedures, like surgery. Pain relief doesn’t usually happen overnight, but it can. Each person’s pain experience is unique to them. To treat the source of chronic pain, you may need to visit your doctor. Use this easy scale to help you describe your pain so you can get the relief you need. What types of pain exist? There are two main types of pain: nociceptive and neuropathic. Nociceptive pain is a nervous system response that helps protect your body. It makes you pull your hand back from a hot stove, so you don’t get burned. Pain from a sprained ankle forces you to rest and give the injury time to heal. Neuropathic pain is different, because it has no known benefits. It may be a result of misread signals between your nerves and brain or spinal cord. Or it could be because of nerve damage. Your brain interprets faulty signals from the nerves as pain. Examples of neuropathic pain include: postherpetic neuralgia diabetic neuropathy carpal tunnel syndrome To get effective pain relief, you first need to find the source of the pain. Learn what causes the most common type of pain. What are signs you need to see a doctor for pain? Make an appointment with your doctor if your pain: hasn’t gone away after 2–3 weeks is causing you stress, anxiety, or depression prevents you from relaxing or sleeping stops you from exercising or participating in your normal activities hasn’t improved with any of the treatments you’ve tried Living with chronic pain can be emotionally and physically challenging. Many types of treatments can help you find relief. TYPES (CLASSES) OF PAIN MEDICATIONS Pain medications are drugs used to relieve discomfort associated with disease, injury, or surgery. Because the pain process is complex, there are many types and drug classifications of pain drugs that provide relief by acting through a variety of physiological mechanisms. Thus, effective medication for nerve pain will likely have a different mechanism of action than arthritis pain medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) act on substances in the body that can cause inflammation, pain, and fever. Corticosteroids are often administered as an injection at the site of musculoskeletal injuries. They exert powerful anti-inflammatory effects. They can also be taken orally to relieve pain from, for example, arthritis. Acetaminophen increases the body's pain threshold, but it has little effect on inflammation. Opioids, also known as narcotic analgesics, modify pain messages in the brain. Muscle relaxants reduce pain from tense muscle groups, most likely through sedative action in the central nervous system. Anti-anxiety drugs work on pain in three ways: they reduce anxiety, they relax muscles, and they help patients cope with discomfort. Some antidepressants, particularly tricyclics, may reduce pain transmission through the spinal cord. Some anticonvulsant drugs also relieve the pain of neuropathies, possibly by stabilizing nerve cells. Types and Drug Classes Uses How Do They Work? Side Effects Warnings and Precautions Drugs List TYPES (CLASSES) OF PAIN MEDICATIONS Pain medications are drugs used to relieve discomfort associated with disease, injury, or surgery. Because the pain process is complex, there are many types and drug classifications of pain drugs that provide relief by acting through a variety of physiological mechanisms. Thus, effective medication for nerve pain will likely have a different mechanism of action than arthritis pain medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) act on substances in the body that can cause inflammation, pain, and fever. Corticosteroids are often administered as an injection at the site of musculoskeletal injuries. They exert powerful anti-inflammatory effects. They can also be taken orally to relieve pain from, for example, arthritis. Acetaminophen increases the body's pain threshold, but it has little effect on inflammation. Opioids, also known as narcotic analgesics, modify pain messages in the brain. Muscle relaxants reduce pain from tense muscle groups, most likely through sedative action in the central nervous system. Anti-anxiety drugs work on pain in three ways: they reduce anxiety, they relax muscles, and they help patients cope with discomfort. Some antidepressants, particularly tricyclics, may reduce pain transmission through the spinal cord. Some anticonvulsant drugs also relieve the pain of neuropathies, possibly by stabilizing nerve cells. SLIDESHOW Back Pain: 16 Back Pain Truths and Myths See Slideshow FOR WHAT CONDITIONS ARE PAIN MEDICATIONS USED? Virtually any disease as well as most injuries and surgical procedures involve some degree of pain. It's not surprising, then, that pain medications, also known as analgesics, are among the most commonly used drugs in the U.S. Different medications are used depending on the type of pain. For minor complaints, such as muscle sprains or headaches, an over-the-counter (OTC) pain reliever will usually do. Prescription pain relievers, especially opiate analgesics -- are normally reserved for moderate-to-severe pain – such as that seen after surgery, trauma, or from certain diseases like cancer or rheumatoid arthritis. Other common "painful" situations in which analgesics find use include labor, back pain, fibromyalgia, and urinary tract infections. WHAT ARE THE DIFFERENCES AMONG THE TYPES OF PAIN MEDICATIONS? Pain medications can be broadly classified into two categories: prescription and nonprescription. In the nonprescription category are several mild anti-inflammatory drugs (ibuprofen, naproxen), as well as acetaminophen. These are mainly meant for use with short-term, acute pain -- menstrual cramps, tension headaches, minor sprains -- what are known colloquially as "everyday aches and pains." Over-the-counter pain relievers, especially acetaminophen, are also sometimes used to treat chronic pain, such as that seen in arthritis. These drugs also lower fever and are often used for that purpose. The prescription arsenal against pain is extensive. It also includes some NSAIDs more powerful than their over-the-counter cousins as well as opioid analgesics. And then there are some unconventional analgesics – drugs that were not originally developed as pain-relievers, but which were found to have pain-relieving properties in certain conditions. For example, fibromyalgia pain medications include an antiseizure drug (pregabalin [Lyrica]) and an antidepressant (duloxetine hydrochloride [Cymbalta]). One major difference between anti-inflammatories and opioid analgesics is that the former have a "ceiling effect" -- that is, continuous dose escalation does not provide concomitant escalation in pain relief. One reason opioids are so useful in the treatment of chronic pain is that as tolerance to a dose develops, the dose can be raised. In fact, there is no limit to how high opioid dosing can go -– keeping in mind that higher doses can be associated with unpleasant and/or even dangerous side effects. WHAT ARE THE STRONGEST PAIN MEDICATIONS? Opioid analgesics, in general, are the strongest pain-relieving medications. The benchmark drug in this class is morphine -- with other opioids falling above or below it in terms of pain-relieving potential. Near the bottom of the list is codeine, usually prescribed in combination with acetaminophen to relieve, for example, pain resulting from dental work. Codeine is only about 1/10th as powerful as morphine. Opioids more powerful than morphine include hydromorphone (Dilaudid) and oxymorphone (Opana). But the strongest opioid in community use is fentanyl which, in its intravenous form, is 70 to 100 times more potent than morphine. Fentanyl is also available as a long-release patch (Duragesic) and as a lozenge that dissolves in the mouth (Actiq). Sufentanil is even more powerful than fentanyl, but its use, at present, is restricted to the intravenous route. However, a transdermal patch containing sufentanil is in clinical trials.

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