Many may be wondering why their doctors have to prescribe different types of medications to help their pain. The purpose for this is that pain signals goes through different parts and paths of the nervous system, travelling up and down the spinal cord and reaching the connections of our brain.
Each of these sections and parts have different receptors and terminals that enhance or reduce pain signals passages. Different receptors are responsive to different medications. As a result, if one wants to get a better overall effect and covering multiple receptors of different kinds, one has to use different medications together to achieve that. This is called multimodal therapy.
Anti-inflammatory, opiates, antidepressants, anti-epileptics, THC products and so on can be used in combinations to cover different receptors to provide better pain control. This has to be done in a correct and clever way. It is different from Poly-pharmacy when too many medications are thrown at a patient without consideration of effects and side effects. Multimodal therapy, if done correctly, can have a better pain control and the patient would end up needing lower doses of each medication, especially less narcotics. This is called narcotic sparing effect.
Some medications like Tramadol and Tapentadol are popular choices because their molecules has effect on different receptors. This provides the multimodal therapy with one medication and therefore makes it simple when indicated. So using some medications together is not always a bad thing and it can actually be a very valid choice.
Risk assessment, proper medication choices, proper dosing and appropriate ongoing evaluations are essential for a combination multimodal pain therapy by a knowledgeable physician.
