Description

Pain is the most under reported and under treated symptom. Even after a thorough medical evaluation and a well developed treatment plan, pain can be a persistent and/or recurrent problem. Having a clear understanding from your doctor or medical provider as to what to expect and when to seek further help is essential.

Knowledge of the medications and treatments prescribed for pain along with their possible side effects will result in the best possible management of pain. Pain is usually divided by severity.

Mild pain is usually treated by anti-inflammatory medications (such as Ibuprofen), aspirin, acetaminophen, or steroids. Non medication treatments may include: application of hot or cold packs, repositioning, range of motion, exercises, massage, elevation, splints, and over the counter topical preparations for arthritis and sport related injuries, and acupuncture.

Moderate pain is usually treated with narcotics mixed with acetaminophen such as codeine, propoxyphene, hydrocodone, or oxycodone. Severe pain is usually treated with narcotics such as Morphine (long or short acting), oxycodone (long or short acting), fentanyl, or methadone.

Helpful tips

• It is important to keep track of how many doses of pain medicine are required (taken) each day. Your medical professional will need to have accurate information to adjust the dose and treatment plan.
• How effective is the medication when taken? Does it relieve the pain completely or partially?
• How long does it take before the medication starts to work?
• What kind of side effects are occurring? All medications have side effects. Discuss possible side effects with the prescribing medical provider and/or pharmacist. A list of possible side effects are included with your new prescriptions. Serious side effects of aspirin, anti-inflammatory medications, and steroids include gastrointestinal bleeding. Monitor for blood in the stool and easy bruising. Expected side effects of narcotic medications include nausea, constipation, sedation, confusion, and itching. Side effects requiring immediate medical attention include hallucinations, tremors, seizures, uncontrolled muscle jerking, and respiratory depression.
• Constipation is common with narcotic medications. A stool softener and/or laxative to have on hand may be helpful.
• Nausea is also common with narcotics. Make a plan with your medical provider.
• Sedation occurs with starting and with increasing the dosage of narcotic medications. Sedative side effects will wear off in two to three days if the dose remains the same. If sedation is so severe that meals are missed, notify your medical provider.
• Many combination narcotic pain medications have Acetaminophen in it. The maximum daily dose of Acetaminophen is 4 grams (4000 mg) due to toxic effects to the liver. When pain escalates, it is best to discuss changes in medications with your medical provider.
• Pay attention to when pain occurs. If activities consistently cause pain, it would make sense to take a dose of pain medications prior to that activity.
• Many people are concerned about becoming addicted to narcotic pain medications. If you have physical causes for pain and are taking narcotic pain medications as prescribed, addiction is not possible.
• Take the pain medication with a full glass of water and take it with food.
• Do not combine your pain medications with other prescribed or over the counter medications unless authorized by your medical provider.
• Do not crush long -acting narcotic pain medications. Discuss difficulty swallowing with your medical provider. Medications come in many forms. Other routes of administration may be possible.

Discussion

You should have a clear understanding of pain and the treatment plan as prescribed. If pain persists, becomes more frequent, increases in severity, or new sites of pain develops, make a follow-up appointment with the physician or medical provider to discuss a new treatment plan or possible referral to a pain specialists.

Related topics

Observing and Reporting Pain
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