Management of Neuropathic Pain

This article is all about how neuropathic pain is currently managed and is useful because it explains in one go, how and why the various types of drugs are used. It comes from a commercial Pain Management Centre,(see link below) with no traceable home address on the website and the only contact possibility being a toll-free number. That makes you immediately suspicious but the article is factually correct and therefore of value. It is also true that private, specialist, American health care clinics abound and this sort of advertising is commonplace - in this case, there is no reason to doubt their intentions but contacting them is of course, your own choice.
The lists of medications may also be different to those you are used to and several commonly prescribed medications seem to be missing but can of course be found in other posts here on the Blog or website.

Management of Neuropathic Pain

Today, there is no efficient way to treat neuropathic pain. Because each patient reacts differently to their problem, it usually takes a combination of different pharmacologic treatments. Recently, science has made headway into understanding neuropathic pain by using randomized controlled trials to provide some sort of guideline for treatment.

Antidepressant Pain Treatment

Although an antidepressant may seem odd for treating pain, it is the forerunner in managing neuropathy. Antidepressants work differently for pain sufferers than people that are treated for depression by activating descending norepinephrinergic and seretonergic signals through the spinal cord, limiting pain signals to the brain. People that are prescribed antidepressants for their pain management treatment
may not have suffered from depression.

Below are common antidepressants prescribed for neuropathic pain management:
■Duloxetine
■Venlafaxine
■Milnacipran

Also, tricyclic antidepressants can also work through sodium channels of peripheral nerves.

Anticonvulsant Pain Treatment

Where an antidepressant may work through sodium channels on nerves, anticonvulsants work both through sodium and calcium channels by blocking their neurons.

Below are common anticonvulsant drugs prescribed for neuropathic pain management:
■Neurontin
■Lyrica
■Tegretol
■Trileptol
■Lamotrigine

Opioid (Narcotic) Pain Treatment

Narcotics usually aren’t the first treatment for neuropathic pain but are still
prescribed for their combination and effectiveness. Although opioids are powerful painkillers, patients must exercise extreme care and supervision because of their tendency to be addictive.

Below are common opioid drugs prescribed for neuropathic pain management:
■Methadone
■Ketobemidone

Topical Pain Treatment

Topical pain relievers are typically modest, although they are still prescribed. Lidocaine is the most common including a transdermal patch. Capsaicin may also be prescribed and can help by reversing the degeneration of epidermal nerve fibers.

Cannabinoid Pain Treatment

The active ingredient in marijuana (THC) and its use is one of the more controversial subjects of neuropathic pain treatment. Because it is illegal, marijuana has a harder time finding prominence among medical context.

Neuropathic Pain Management Dependence

Fortunately, the best treatments for neuropathic pain are antidepressants, however doctors can and will prescribe opioids and/or marijuana where it is legal if additional options are needed. Patients who are prescribed these types of treatment need to take care to tell someone about their program. Narcotics and marijuana use can lead to extreme dependence and addiction, and can lead to more powerful drugs that can further damage the body, creating more problems outside of pain management.

Neuropathic Painkillers Addiction

Opiate or narcotic type painkillers prescribed for neuropathic pain are some of the most widespread, addictive, and readily available drugs today. Regular use results in physical and psychological damage and dependence.

There are thousands of people that have used, gone through treatment, and now live normal, healthy lives. If you or someone you know is a narcotic or marijuana abuser due to their neuropathic pain, most likely they are already an addict or are quickly becoming one.

http://pain-management-treatment.com/management-neuropathic-pain

Chronic Neuropathic Pain Management Get Help!

The writer of today's post from kevinmd.com  (see link below)  is a pain specialist who clearly completely understands what it's like to suffer from chronic neuropathic pain. The advice he gives is sound and although he is stating the case for consulting pain specialists; in this case he's right. Many hospital specialists dole out advice and medication from their consultants' chairs in a sterile environment; what they often don't realise is that people need to function in everyday situations in the real world.

Thinking differently about treating neuropathic pain

by Corey W. Hunter, MD

Pain, in any form, can present a difficult challenge for even the most astute pain physician. The complexity of treating neuropathic or nerve pain stems from a variety of reasons, ranging from the lack of an obvious source of the pain to the inability of the patients to explain what ails them, to a arduous history that was poorly managed with the wrong medications, allowing the pain to progress to a seemingly unmanageable state. Many people with neuropathic pain are often given escalating doses of opioids in a fleeting attempt to control their discomfort; it is not until much later that they will seek the help of a pain management specialist.

As many can attest, opioids are rarely a good choice for the sole treatment of neuropathic pain. Neuropathic pain medications, which include certain antidepressants and antiepileptics (indicated for specific types of neuropathic pain), are rarely discussed with these patients in the early stages, and, unfortunately, are often first mentioned late in the disease’s progression. Moreover, the mere suggestion of these medications for the treatment of neuropathic pain is often met with confusion and even mistrust toward the doctor by patients not appropriately counseled by their physicians, leading to reactions like: “I’m not depressed,” or “I’m not crazy, I just need a higher dose of my medication…my pain is a ‘15’ on a scale of 1 to 10!”

The growing neuropathic pain epidemic has created an uphill battle for both patients and the physicians trying to help them. Whereas nocioceptive pain can usually be pinpointed to an actual event (e.g., pain resulting from a broken arm), neuropathic pain can be vague and nondescript in nature. For many physicians, there is no sense of need to tease out the details from the ambiguity; a prescription is provided for an opioid-pain killer and the patient is sent home. Not only will the discomfort most likely continue, but now the patient is subjected to an unnecessary risk for prescription drug dependency–another epidemic unto itself.

Understanding what neuropathic pain is and how it might present itself are the first and most important things to consider. If you believe your pain symptoms are neuropathic, you should ask your doctor these questions:

• My pain is not getting better; could this be neuropathic pain?
• The medications I am taking are not helping; could this be neuropathic pain?
• Are these the appropriate medications for treating neuropathic pain?
• How much experience or training do you have in treating neuropathic pain? Could I get a second opinion?
• Is the medication you are giving me potentially addictive? What else should I know about these medications?
• Can you explain how antidepressants and antiepileptics work to treat neuropathic pain?

Waiting to get appropriate care makes neuropathic pain harder to treat. However, even severe cases of neuropathic pain can be managed effectively by an informed patient with the proper therapies.

Corey W. Hunter is a pain management specialist and serves on The Neuropathy Association’s Neuropathic Pain Management Medical Advisory Council.

http://www.kevinmd.com/blog/2012/04/thinking-differently-treating-neuropathic-pain.html