When you get hurt, say, cut your leg or break a bone, pain is one of the first symptoms of the injury. This pain, known as acute pain, lasts until the wound heals or the bone mends, and then it goes away.


Chronic pain, though, is a different beast. The pain lasts three months or more, it may always be present or come and go, and it continues long after you recover from the injury. In fact, your nerves may no longer even be sending out pain signals.


This lasting pain can interfere with work, school, your social life, and even being able to take care of yourself. It can be so persistent it leads to depression, anxiety, and/or difficulty sleeping, all of which makes the pain worse and the cycle harder to break.


At Umbrella HealthCare in Phoenix, Arizona, our medical team, led by Dr. John Lewis, offers medical pain relief that uses a combination of physical therapy, medications, and injections to help you manage your chronic pain, in whichever body part is affected. When is medication the correct choice to treat chronic pain, and what options are available? Keep reading to discover the answers.


What conditions can lead to chronic pain?


As we’ve mentioned, chronic pain can originate from an acute injury. However, it can also be caused by other medical conditions and degenerative changes related to aging. Some common culprits include:

  • Arthritis in any joint
  • Low back or neck pain
  • Tension-type, cluster, or migraine headaches
  • Tissue damage near a cancerous tumor
  • Musculoskeletal pain (e.g., fibromyalgia, chronic fatigue syndrome)
  • Peripheral neuropathy (nerve damage, often found in diabetics)
  • Bulging or herniated discs
  • Degenerative disc disease
  • Spinal stenosis

Some 25% of adults live with chronic pain of one type or another, and it’s possible to have more than one (comorbid) chronic pain condition at a time.


When to consider medication for your chronic pain


For mild to moderate pain, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, or pain relievers like acetaminophen, usually do the trick. If they’re not sufficient to control your pain, Dr. Lewis may prescribe a stronger painkiller (i.e., narcotics), though only for a short period, as they can be highly addictive. He might also prescribe a muscle relaxer.


Topical analgesics are medications applied to and absorbed by the skin. You can find them as creams, lotions, and patches. Some over-the-counter remedies include trolamine salicylate (Aspercreme) and capsaicin, a skin irritant that interferes with pain perception.


Prescription options include the anesthetic lidocaine and Voltaren, a topical gel.


Antidepressants may be used “off label” to treat chronic pain, and they’re believed to control chronic pain in two ways. First, they change the way the brain perceives incoming pain signals, so those signals aren’t recognized as pain. Second, they may decrease pain-related anxiety and help regulate sleep.


Not all antidepressants are useful as chronic pain medications. Tricyclic antidepressants (TCAs) like amitriptyline and nortriptyline, selective serotonin reuptake inhibitors (SSRIs) like duloxetine, and some others can serve double duty, treating both chronic pain syndromes and nerve pain. Monoamine oxidase inhibitors (MAOIs), though, aren’t nearly as effective in pain control.


Off-label anticonvulsants such as gabapentin and pregabalin can also be effective. Though generally used to control seizure disorders, they can be useful as pain medications because they work by inhibiting the nerve transmissions that cause nerve-related pain sensations, such as those caused by diabetic peripheral neuropathy.


Cannabidiol (CBD), one of the non-psychoactive ingredients in hemp, can be applied topically, taken in pill or gummy form, or used as a vape, and it can have both pain-relieving and calming properties.


Medications, including corticosteroid injections, are also a good way to inhibit the pain enough that you can engage in physical therapy, which can support and strengthen musculoskeletal tissue, providing even more relief.


Are you in constant pain but can’t get the relief you need? Umbrella HealthCare can help. To schedule a consultation with Dr. Lewis, give our office a call at 623-242-1389, or book online with us today.

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