Pain medications are an important part of any pain management program in pain clinics. The safety and effect of medications are evaluated by the regulatory organizations like Health Canada or FDA before they can come to the market. However every once a while we see after marketing problems. For example, Vioxx was a good analgesic but it turned out to be bad for the heart in many patients. The problem is that Chronic Pain is a multi-factorial disease. It means that many reasons may add to each other to cause our pain to become chronic. As a result we call a big group of Chronic Pain: MIXED PAIN.
Multiple reasons for the pain would require multiple medications. Once we combine different medications, although we may benefit from their adding effects, we may suffer from their side effects as well. High doses of pain medications are known to cause side effects. Narcotics are a good tool for pain management but they have become the first drugs of abuse in many large cities. Today we know that long term high doses of narcotics can cause health problems like hormonal imbalances.
Pain medications at their best combination and doses, are just one component in the wide range of strategies for Pain Management. All of these problems would require guidance from an experienced and well informed pain physician to help the patients with good choices and combinations. Do not forget, just because you are attending a Pain Clinic does not mean that you should be passive about your care. You should inform yourself, ask questions and give feed back to your doctor about the effects and side effects of medications. Only with your feed backs your doctor will be able to improve your care.
Dr. Kevin ROD