USA
More from the book "Managing Your Pain Before it Manages You" by Dr. Margaret Caudill:
"New techniques such as positron emission tomography (PEG) and functional magnetic resonance imaging (fMRI) allow scientists to look at the brain in action. They have been able to study how and where the pain message is processed in the brain. New ideas for altering the pain system's response are emerging, including new uses for older medications. For example, some anti-seizure medicaations as well as some antidepressants have been found to have separate positive effects on nerve and brain pain pathways.
In addition, researchers are trying to create opioids without the addiction side effect and to find more convenient and targeted medication delivery methods. Genetic explorations have begun but will most likely take a decade or more to translate into treatment options.
Medications may be used to alter pain nerve irritability in the body (peripheral nerves) and in the central nervous system (spinal cord and brain). Many of these medications are used off label. Drugs with off label use for chronic pain include tricyclic antidepressants, such as amitriptyline (Elavil), imipramine and nortiptyline. Caclofen, a muscl relaxant is sued by somre for diabetic neuropathy. Good research evidence now exists that amitriptyline helps chronic pain, but it is still not approved by the FDA for that purpose.
Several anti-seizure medications have received FDA approval for use in neuropathies. Neurontin is approved for neuopathic pain and post shingles neuropathy, Gegretol for trigeminal pain, klonopin for neuralgia, and Lyrica for diabetic neuropathy, post shingles neuropathy, and fibromyalgia. Gabitril and Dilantin are used off label for pain but are not first choices because of lack of evidence that they are effective.
Zostrix is an ointment made from the active ingreditent in red chili peppers (capaicin). It is used for pain associate with diabetes, shingles, osteoarthritis, and rheumatoid arthritis. A patch saturated with 5% lidocaine (Lidoderm) can be applired directly to the skin of those suffering from post shingles pain.
Nerve blocks with Novocain like substance and steroids have been injectied in an attempt to quiety the firing of irritable nerves. Reviews of studies of epidural steroids and other local injecions for low back pain have not yet demonstrated effectiveness, and facet joint injections are considered ineffective and possibly harmful.
Electircal stimulation of the peripheral nerves, spinal cord, and brain to override the pain messages may be used to reduce chronic pian. There may be short term positive benefits of electrical stimulation in failed back surgery syndrome and complex regional pain syndromes but more studies have been recommended.
Finally, Imitrex and numerous other triptan-like medications are FDA approved for treatment of migraine and cluster headaches. These medications are thought to work by activating serotonin receptors in the blood vessels. This causes narrowing of the blood vessels in the head and brain that contribute to the headache syndromes.
In the next decade, long acting anesthetics may be available to block sensory nerves for months instead of minutes. Drugs will be developed to disarm the mechanisms in the central nervous sytem that serve to wind up and magnify pain and make it persist. There will be a new understanding of ways to prevent pain from becoming chronic. It is a world wide effort."
I have used elavil for sleep, but it took a huge dose and I gained 30 pounds in a short amount of time. I tried TENS unit but it did nothing for me. I take nothing for pain now, but do use the lidoderm patches on my low back where my surgery was done and it helps a lot. I only use them during bad flare ups. I used imitrex for many years to successfully knock out migraines, but since starting on CoQ10 at 300 mg a day, I have not had a migraine in 4 months or better which is wonderful! I know a lot of people are having success with Lyrica and cymbalta, but my pain is not bad enough to go through the side effects. I did read in a fibro newsletter about a lady who was in the trials for milapricin which is the newest drug approved for fibro and she said it helped her symptoms tremendously plus she lost 30 pounds so there may be hope in that one for some who are not successful with others.
sue in ohio
"New techniques such as positron emission tomography (PEG) and functional magnetic resonance imaging (fMRI) allow scientists to look at the brain in action. They have been able to study how and where the pain message is processed in the brain. New ideas for altering the pain system's response are emerging, including new uses for older medications. For example, some anti-seizure medicaations as well as some antidepressants have been found to have separate positive effects on nerve and brain pain pathways.
In addition, researchers are trying to create opioids without the addiction side effect and to find more convenient and targeted medication delivery methods. Genetic explorations have begun but will most likely take a decade or more to translate into treatment options.
Medications may be used to alter pain nerve irritability in the body (peripheral nerves) and in the central nervous system (spinal cord and brain). Many of these medications are used off label. Drugs with off label use for chronic pain include tricyclic antidepressants, such as amitriptyline (Elavil), imipramine and nortiptyline. Caclofen, a muscl relaxant is sued by somre for diabetic neuropathy. Good research evidence now exists that amitriptyline helps chronic pain, but it is still not approved by the FDA for that purpose.
Several anti-seizure medications have received FDA approval for use in neuropathies. Neurontin is approved for neuopathic pain and post shingles neuropathy, Gegretol for trigeminal pain, klonopin for neuralgia, and Lyrica for diabetic neuropathy, post shingles neuropathy, and fibromyalgia. Gabitril and Dilantin are used off label for pain but are not first choices because of lack of evidence that they are effective.
Zostrix is an ointment made from the active ingreditent in red chili peppers (capaicin). It is used for pain associate with diabetes, shingles, osteoarthritis, and rheumatoid arthritis. A patch saturated with 5% lidocaine (Lidoderm) can be applired directly to the skin of those suffering from post shingles pain.
Nerve blocks with Novocain like substance and steroids have been injectied in an attempt to quiety the firing of irritable nerves. Reviews of studies of epidural steroids and other local injecions for low back pain have not yet demonstrated effectiveness, and facet joint injections are considered ineffective and possibly harmful.
Electircal stimulation of the peripheral nerves, spinal cord, and brain to override the pain messages may be used to reduce chronic pian. There may be short term positive benefits of electrical stimulation in failed back surgery syndrome and complex regional pain syndromes but more studies have been recommended.
Finally, Imitrex and numerous other triptan-like medications are FDA approved for treatment of migraine and cluster headaches. These medications are thought to work by activating serotonin receptors in the blood vessels. This causes narrowing of the blood vessels in the head and brain that contribute to the headache syndromes.
In the next decade, long acting anesthetics may be available to block sensory nerves for months instead of minutes. Drugs will be developed to disarm the mechanisms in the central nervous sytem that serve to wind up and magnify pain and make it persist. There will be a new understanding of ways to prevent pain from becoming chronic. It is a world wide effort."
I have used elavil for sleep, but it took a huge dose and I gained 30 pounds in a short amount of time. I tried TENS unit but it did nothing for me. I take nothing for pain now, but do use the lidoderm patches on my low back where my surgery was done and it helps a lot. I only use them during bad flare ups. I used imitrex for many years to successfully knock out migraines, but since starting on CoQ10 at 300 mg a day, I have not had a migraine in 4 months or better which is wonderful! I know a lot of people are having success with Lyrica and cymbalta, but my pain is not bad enough to go through the side effects. I did read in a fibro newsletter about a lady who was in the trials for milapricin which is the newest drug approved for fibro and she said it helped her symptoms tremendously plus she lost 30 pounds so there may be hope in that one for some who are not successful with others.
sue in ohio
