Pain MedicationsMedical Author:
Standiford Helm Ii, MD
Standiford Helm Ii, MDDr. Helm has been practicing interventional pain management since 1982. Dr. Helm is a diplomate of the American Board of Anesthesiology with subspecialty certification in Pain Medicine and of the American Board of Pain Medicine. Dr. Helm is a Fellow of Interventional Pain Practice (FIPP), the only certifying agency which tests the ability to perform interventional pain procedures. Dr. Helm is also an examiner for FIPP. Medical Author:
John P. Cunha, DO, FACOEP
John P. Cunha, DO, FACOEPJohn P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey. Medical Editor:
Melissa Conrad Stöppler, MD, Chief Medical Editor
Melissa Conrad Stöppler, MD, Chief Medical EditorMelissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
What Is Pain?Pain is an unpleasant sensation. Pain can be sharp or dull, burning or numbing, minor or major, acute or chronic. It can be a minor inconvenience or completely disabling. Both the area of the injury and how the brain deals with signals from the area of pain affect the sensation. Generally, medications try either to stop the transmission of pain from the site of injury or to affect the brain directly. The effects of pain medication are different for different people. Also, the tolerance of pain varies greatly from one person to another. For this reason, one medication will not be right for everyone with the same injury. For example, some people are quite happy with an over-the-counter medication for an ankle sprain, while others will need a more powerful prescription pain reliever. The right pain medication depends on the person experiencing the pain, not on the condition that is causing the pain. Nonsteroidal Anti-inflammatory DrugsThe most common nonsteroidal anti-inflammatory drug (NSAID) for pain is ibuprofen. Three NSAIDs are available for purchase without a prescription in drug and grocery stores:
Ibuprofen
Essentially, aspirin and ibuprofen are short-acting, while the effects of naproxen last longer. This difference means that sometimes it takes three to four doses of naproxen before an effect is noted. Because of this difference, it may be better to use ibuprofen for more immediate relief from pain and to use naproxen for long-lasting relief. Many NSAID medications are available only with a prescription. These include the following:
This class of drugs is one of the most marketed types of medications by drug companies. No clear evidence exists that the prescribed medicines costing a dollar a pill or more are any better than those that cost less than a penny a pill. Different NSAIDs are also marketed as being better for certain conditions. An example of this is indomethacin (Indocin) as a recommended treatment for gout. There is no proof that this holds true, but some evidence shows that different families of NSAIDs may have a selective effect on a person-to-person basis. The main side effect of these types of medicines is that they can cause bleeding in the stomach. This bleeding usually occurs after long-term use but can also occur with short-term use. Long-term use can also affect the kidneys. For these reasons, acetaminophen is probably much safer for long-term use, although taking too much acetaminophen can cause liver or kidney damage. When you take pain medication, be sure to check whether it contains acetaminophen so that you do not take more than is recommended by mistake. NSAIDs have both a pain-relieving and inflammation-stopping effect. Generally, the pain-relieving effect does not increase with higher doses; thus, 400 mg of Motrin has just as much pain relief as 800 mg of Motrin. A person is more likely to suffer a significant stomach problem with the higher dose.
A new NSAID: Cox-2 inhibitors
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Temporomandibular Joint (TMJ) Syndrome »
TMJ Syndrome Overview
Temporomandibular joint (TMJ) syndrome is pain in the jaw joint that can be caused by a variety of medical problems. The TMJ connects the lower jaw (mandible) to the skull (temporal bone) in front of the ear. Certain facial muscles control chewing. Problems in this area can cause head and neck pain, facial pain, ear pain, headaches, a jaw that is locked in position or difficult to open, problems biting, and jaw clicking or popping sounds when you bite. Temporomandibular joint syndrome is also referred to as temporomandibular joint disorder.
The TMJ is comprised of muscles, blood vessels, nerves, and bones. You have two TMJs, one on each side of your jaw.
Muscles involved in chewing (mastication) also open and close the mouth. The jawbone itself, controlled by the TMJ, has two movements: rotation or hinge action, which is opening and closing of the mouth, and gliding action, a movement that allows the mouth to open wider....
Read What Your Physician is Reading on Medscape
Therapeutic Injections for Pain Management »
This article focuses on the use of therapeutic injections to treat acute and chronic pain syndromes.
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