Pain is not only a distressing experience, but above all an alarm signal informing us about potential threats or existing tissue damage. The few people in the world who are genetically incapable of experiencing pain are exposed to constant injuries and usually die prematurely.
Pain can be acute and transient, or chronic, sometimes for many years. Neurohormonal mechanisms of the formation, conduction, reception and fixation of pain stimuli differ, therefore, in certain situations, different methods of treatment are used to combat pain of different types.
The basis of pharmacological therapy is the use of the so-called analgesic ladder. At three levels of pain relief, there are drugs that are increasingly potent in relieving pain.
In the first place, in the case of mild pain (headache, toothache, menstrual pain), paracetamol and non-steroidal anti-inflammatory drugs (ibuprofen, ketoprofen and many others) are used. Non-opioid painkillers, e.g. tramadol, are more potent, and the strongest are opioid, narcotic drugs, such as morphine – often used in chronic cancer pain. These drugs can be taken in various forms, most notably in the form of tablets and intravenous solutions (in hospitals), subcutaneous and intra-articular injections, and opioids are also available in the form of patches or delivered through a thin catheter directly into the epidural or subarachnoid space of the spinal cord.
Check how moderate or severe pain relievers work
Treatment of chronic pain often requires the use of additional drugs, the so-called coanalgesics, the basic action of which is completely different: antidepressant, anticonvulsant, anxiolytic. This indicates a large share of mental and personality factors in experiencing and perpetuating pain of this type.
There are also treatments that can reduce or relieve pain. They include damage (permanent or temporary) of nerves by high temperature (thermolesion), cold (cryolysis), destruction of the nerve plexus using, for example, alcohol (neurolysis), and anastomosis of the severed nerve. Transcutaneous nerve electrostimulation is also very effective.
med. Aleksandra Czachowska
Also read: My life with pain