Its been nearly 15 years since the last document was presented to the public on chronic pain management, but the "American Society of Anesthesiologists Task Force" and the "American Society of Regional Anesthesia and Pain Medicine" have now published an up to date guideline for treating chronic pain.
It states that in the US chronic pain is becoming more prevalent, but this could be due to a mixture of problems including depression that causes it. However they do say that the studies they undertook were on people on different types of drugs over a few weeks or months, and not a lifetime of taking them which some chronic pain sufferes have to do.
1. Anticonvulsants - there are certain anticonvulsants that can be used for neuropathic pain.
2. Antidepressants - tricylic - I have already written about this one before but they feel that this can provide effective pain relief for a variety of chronic pain ( I have to agree).
3. Benzodiazepines - this is one drug that they are a bit hesitant about its abilities to help pain.
4. NMDA - receptor antagonists, not one I've heard or read about in the UK much but anyway the results have been equivocal but it appears that NMDA may benefit those with neuropathic pain.
5. NSAID'S - anti-inflammatory drugs which I'm sure most of us will have used at some stage in our lives, appear to be the most effective in patients with chronic back pain (Again, I agree, but long term use plays havoc with your stomach).
6. Opiods - again I'm sure most chronic pain sufferers will already be on some type of Opiod but it does state that the slow release type ( which I take) provide effective relief for pain in patients with low back pain or neuropathic pain, whereas immediate release opiods provide relief for back, neck, leg and neuropathic pain. So, if you have not tried these yet, they must be worth a go. I find the side effects minimal on these.
7. Topical agents - Capsaicin and Lidocaine appear to have an equivocal effect on patients with neuropathic pain, but they do feel these drugs could be tried for patients with other types of pain. Lidocaine infusion is another drug which I have written about before and which keeps popping its head up here and there and is one I am definitely going to ask my pain consultant about when I see him in June. What I seemed to have read about this drug is that it really just gives you a bit of a retbite from your pain, but doesn't last long enough for chronic pain sufferers, but for me a restbite is a restbite and the sort of things I could do without pain for however long would be very worthwhile trying.