The pain medications are those drugs that have a modulating effect on it and refer mainly to the family of analgesics although it will always depend on the type of pain, as explained, Diego Ayuso, general secretary of the General Council of Nursing. “For example, the pain produced by a nerve injury has an expression in the form of electrical sensations such as cramps and tingling that has a different treatment than when the cause is a sprain or a blow,” he says.
Antidepressants are also commonly used, although in any case, these medications must be prescribed by a pain specialist and always in low doses so that the improvement is continuous but minimizing side effects. “In certain cases, and not only cancer patients, the only alternative is the use of opioids, derivatives of morphine, which if used correctly are very safe and there is no risk of addiction,” he acknowledges. For the classification of pain, Ayuso mentions the one made by the World Health Organization (WHO) that related each type to the use of a medication.
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- Mild pain: non-opioid analgesics.
- Moderate pain:minor opioids and non-opioid analgesics.
- Severe pain: potent opioids and non-opioid analgesics.
In addition, in all cases treatment should be complemented with adjuvants such as antidepressants, anticonvulsants or phenothiazines.
Medications for pain in chronic patients
Undoubtedly, people with chronic diseases are those that require prolonged control of this problem. Ayuso insists that it is difficult to specify in which cases it is more necessary since pain is a symptom that something is not working correctly in the organism. However, the general secretary of the General Council of Nursing highlights some such as osteoarthritis , arthritis , fibromyalgia , migraines , chronic fatigue syndrome, osteoporosis, exogenous depression (caused by an external factor), diabetes , the vascular disorders , the herpes zoster and most types of cancer.
In his experience, analgesics such as paracetamol, non-steroidal anti-inflammatories such as ibuprofen and naproxen and analgesics based on minor or major opioids are the most used in people with chronic diseases with mild or moderate pain. “The therapy can be completed with other medications such as corticosteroids, antidepressants, anxiolytics, anticonvulsants or so-called neuroleptics. All of them will enhance the effectiveness of analgesics and treat some symptoms that usually appear accompanying the pain, “he says.
On the use of opioid derivatives, Ayuso says that the most powerful against pain are those that include codeine, fentanyl, morphine and oxycodone.
Drugs for pain in cancer patients
As mentioned, another important group of people who require the use of this medication are those affected by any type of cancer. In this regard, this expert insists that patients should not endure any pain as well as have to be well informed about possible side effects to easily identify them and not cause complications.
“The main drugs administered against pain in people with cancer are non-opioid analgesics, opioids or narcotics and others such as anticonvulsants or antidepressants for neural pain or steroids for swelling, always following a scale of less to more”, details
In his opinion, the nursing staff plays an important role in the control of pain both by the assessment of the same, the health education imparted to the patient and the adherence to the treatments.
Other alternatives to treat pain
In the case of people with chronic pain, Ayuso indicates that there are other complementary therapies or act when the medication does not work.
The electrical stimulation
The sensation of pain in certain areas can be reduced with the use of stimulating devices that work very well if they are applied on the skin, although other more sophisticated ones take effect when they are applied close to the nervous system: nerves, spinal cord, brain, “he describes. However, Ayuso remembers that these more invasive techniques are performed only if other simpler methods have failed to try to relieve pain.
The exercises and controlled movements of the extremities with pain usually help to restore the elasticity of the joints and muscles, which contributes to improve the quality of life of the patient.
Pain treatment programs
“Some units for the treatment of pain carry out special programs, such as the School of the Back, which last from two to four weeks, during which the patient is taught to live with his pain, even if the pain does not disappear completely”, ensures In their experience, these programs are more common in the United States, but they are reaching Europe.
“Since pain can have a psychological effect on the patient’s life, psychological support is usually added to pharmacological treatment. Sometimes talking to a psychologist can help a person survive better with the negative effect that pain can have on their social life. Relaxation or bio-feedback are two examples of methods used by some psychologists in these cases, “he says.
There are several cases of pain where the best formula to placate it is a nervous block. “These are very sophisticated techniques to reach the nerve that causes pain, consisting of needles guided by X-rays or CT, which perform a partial, temporary or permanent interruption of the nerve that carries the pain. This interruption can be done with chemicals, cold or heat, “he concludes.