Medicines for the treatment of chronic pain

Medications for the treatment of chronic painTo treat chronic pain, medications are usually mandatory. Since there are a large number of them, only a few can be presented here as examples. Overall, it's important to note that medications are only one component of pain management, and other therapy methods are often essential for sustained therapeutic success.

Pain has an important function in the human body. To indicate injuries or disorders in the body. To enable rapid reactions. The pain of touching a hot stove top thus leads to the immediate pulling away of the hand.

As "Chronic painThe term "pain" is used to describe pain that for longer than three to six months exist. They have often lost the direct warning function. Are a great burden for the affected pain patients. They lead to a significant reduction in quality of life, well-being and mood, as well as impairment of social contacts. Thus, chronic pain is often no longer merely an accompanying symptom of a disease, but develops into a independent disease. The therapy is composed of different procedures, in a way it relies on different pillars. One of them is Painkillers.

Pain medications are usually part of any pain therapy. The choice depends on the suspected cause of pain and its intensity. The World Health Organization (WHO) tiering scheme classifies pain medications and pain management into three tiers. In addition, there are sog. Co-analgesics, which do not belong to any of the three groups, but are used together with other measures, z.B. Physical therapy, etc., Perform important functions. Includes active ingredients such as paracetamol. Acetylsalicylic acid as well as other non-steroidal anti-inflammatory drugs (z.B.B. Diclofenac, Ibuprofen). Metamizole also belongs to this group.

Opioids are medications that act on the body's opioid receptors. These opioid receptors are located at important switching points in the pain-conducting and pain-perceiving system of the body. Thus, by influencing these opioid receptors, a direct Pain relief are reached. However, because there are different opioid receptors in the human body and they are not only located in the pain system, opioid use can lead to different Side effects such as an influence on intestinal activity with the occurrence of constipation (Constipation) as well as an effect on the "vomiting center" with the appearance of Nausea or vomiting. Additionally, in the early stages, confusion, difficulty concentrating, etc., can be. occur. The important thing to remember about side effects is that, when properly indicated subside again after a short period of time or disappear completely. Only the constipation has to be treated permanently over the entire period of use. Pain patients rather rare. Occurs primarily when taking short-acting preparations. Again, if the graduated schedule is used correctly and the indications are correct, dependence in the sense of "drug addiction" does not occur.

Second stage "Low-potency, so called. weak opioids"

– Stronger-acting agents than level 1 medications, all of which are derivatives of morphine z.B.: Tilidine and dihydrocodeine. – As a rule, they are not used alone, but always in combination with level 1 drugs if these are not sufficient.

Third stage "strong opioids"

– These include buprenorphine, hydromorphone and morphine. – Again, this is almost always combined with level 1 medications because it allows the morphine dose to be kept low. – But analgesics of level 3 are NEVER combined with those of level 2!

Complementary "co-analgesics"

An important point with this group is the correct education of the patients, because these agents are used as co-analgesics outside the standard indications. Also patients Without depression can thus benefit greatly from antidepressants. And anticonvulsant drugs help those affected who do not have any epilepsy disorder at all! Since chronic pain is often triggered or maintained by painful muscle tension, so-called "opioids" are also used in pain therapy when indicated Muscle relaxants for use. A choice can be made between rather "centrally" effective drugs and rather "Peripheral" effective drugs, such as z.B. tolperisone. Muscle relaxants can be an effective aid in painful muscle tension, but should be Do not replace relaxation exercises and adequate gymnastics.

– Antidepressants (medication for depression) for better pain management and for neuropathic pain, which comes directly from the nerve pathways. – Anticonvulsants (antispasmodic drugs) also for neuropathic pain – Corticoids – Or centrally acting muscle relaxant drugs for spasmodic spastic pain

Which medications, procedures and methods help a person affected by pain depends on the underlying disease, the psychological condition and the accompanying complaints. In order to be able to assess this BEFORE a detailed discussion consultation with the physician, and a series of examinations will take place. The most important therapy is the treatment of Cause of pain and not only the pain symptoms! Therefore, in principle, pain medication should be taken only under medical supervision.

In the therapy of chronic pain, a distinction is made between short- and long-acting drugs. Drugs with a long duration of action and the most consistent drug release are preferred as base medications, such as z.B. the so-called retard tablets, which can be effective for eight to twenty-four hours. The so-called pain patches should be prescribed as first choice only when regular tablet use is not possible!

Drug treatment is determined based on the severity and acute nature of the pain. (Photo: Unsplash)

advantages of long-acting Painkillers are u.a. a drug level as even as possible in the body, a continuous effect also late at night resp. Early in the morning and a "re-education" of the pain memory thereby sought. These medications are then always prescribed after a fixed time scheme and not taken "as needed.

As a supplement to the basic medication, then, if necessary, an additional as-needed medication with fast-acting preparations for the treatment of acute pain peaks This makes sense and is also necessary in most cases of severe pain. The blood concentration of the basic medication is usually not able to absorb these sudden pain peaks. Therefore, the on-demand medication always only when needed And never taken by the clock. The duration of action is the basic distinguishing feature here. The basic medication starts slowly, works evenly and for many hours. Demand medication against acute pain peaks works within a few minutes and also lasts only 30 to 60 minutes. Then such a pain spike is usually over again. The basic medication is enough.

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