The Management of Acute, Chronic and Cancer Pain

For thousands of years, doctors have been helping to relieve their patients' pain with a variety of medications and treatments. Like other areas of medicine, a new subset of doctors have become specialists in treating pain. They are focused on managing all types of pain - studying what causes it, how the body reacts to it, how different medications dull or eliminate the pain, and how other treatments can be used to relieve many painful conditions.

What type of training does a pain medicine doctor have?
Like other physicians, anesthesiologists earned a college degree and then completed four years of medical school. They spent four more years learning the medical specialty of anesthesiology and pain medicine during residency training. Many anesthesiologists who specialize in pain medicine receive an additional year of fellowship training to become a "subspecialist," or an expert in treating pain. Some also have done research, and many have special certification in pain medicine through the American Board of Anesthesiology (ABA). The ABA is the only organization recognized by the American Board of Medical Specialties to offer special credentials in pain medicine.

MEDICATIONS FOR MANAGING PAIN

Due to rapid advances in medicine, a wide variety of medications and treatments are available for acute, chronic and cancer pain. Patients often will be prescribed medications before receiving other forms of therapy. In addition, your pain medicine doctor may conclude that a combination of medication and treatments may be right for you. Your therapy plan will be tailored to your specific needs and circumstances.

Your pain medicine doctor may suggest that you use certain over-the-counter pain relievers or may prescribe stronger medicine for your condition. DO NOT MIX PAIN PRESCRIPTION DRUGS WITH OVER-THE-COUNTER PAIN RELIEVERS WITHOUT CONSULTING YOUR DOCTOR. Advise your doctor if you are taking any herbal medicines or dietary supplements.

Common pain relievers - Nonaspirin pain relievers such as acetaminophen (Tylenol®) can relieve headaches and minor pain but do not reduce swelling. They are sometimes used in combination with other drugs to provide greater pain relief.

Anti-inflammatory drugs - Aspirin (Anacin®, Bayer®), coated or buffered aspirin (Ascripton®, Bufferin®) and aspirin with acetaminophen (Excedrin®) may be used to reduce swelling and irritation as well as to relieve pain. There also are non-steroidal anti-inflammatory drugs (NSAIDs, commonly called "N-sayeds") such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®). Anti-inflammatory drugs are used to relieve pain, inflammation and fever. There also are steroidal drugs (like cortisol and prednisone), available only by prescription, that are used to treat more serious inflammatory conditions such as chronic arthritis.

Opioid pain medications - Morphine-like drugs called opioids are prescribed to treat acute pain or cancer pain. They are occasionally used for certain chronic, noncancer pain as well.

Anti-depressants - These drugs were originally used only to treat depression. Studies now show, however, that they also can relieve certain pain. Available only by prescription, they often are used to help you sleep better at night.

Anti-seizure medicines - These medications are used to relieve what some patients describe as "shooting" pain by decreasing abnormal painful sensations caused by damaged nerves.

Other medicines - The doctor may also prescribe other types of medication that will be helpful for your specific pain problems. In addition, medications that counteract the side effects of opioids or treat the anxiety and depression associated with pain may also be prescribed.