Posted in Arthritis, Chronic lower back pain, chronic pain, Inflammation, Knee pain, Muscle and joint stiffness, Rheumatoid Arthritis

Options for Pain Relief

PART 2

Exploring Anticonvulsants, Muscle Relaxants, and Corticosteroids

In part one of this series of Options for Pain Relief, I wrote about NSAIDs, acetaminophen, and antidepressants. This post focuses on anticonvulsants (anti-seizure) medications, muscle relaxants, and corticosteroids. Because there is so much information regarding Opioids and Marijuana for treatment of chronic pain, I’ve decided to write two separate posts for each of these. The next post (Part 3) will be devoted to the pros, cons, and debates of Opioid use for chronic pain treatment.

Now, let’s discover how anticonvulsants, muscle relaxants, and corticosteroids are used as a relief for chronic pain.

ANTICONVULSANT (antiseizure) MEDICATIONS

Anticonvulsant medications are used for specific types of nerve pain (burning, shooting pain) and must be taken on a daily basis or as prescribed by your physician. Whether pain is experienced or not, this medication must be taken as directed for maximum results. This medication is not intended for an “as needed” dosage.

Some common side effects include sleepiness (which may improve the longer the medication is taken) and weight gain (one reason I stopped taking this medication), dizziness, and fatigue. If you suffer from kidney stones or glaucoma tell your doctor as anticonvulsants are not recommended for patients with these conditions. Newer anticonvulsant drugs do not require liver monitoring, however, if you have a kidney disease use caution when taking this medication.

Anticonvulsants are another example of a medication that is developed to treat one condition and is used to relieve the symptoms of an entirely different condition. Dual purpose anticonvulsants help patients manage their seizures while also helping chronic pain patients manage their pain. Studies provide conflicting views of treating chronic pain with anticonvulsants. Although there are studies advising other forms of treatment for chronic pain, other studies indicate that anticonvulsants are vital for managing chronic pain because of fewer long-term side effects.

Listed below are frequently prescribed Generic forms of anticonvulsants: (the brand name is noted in parenthesis)

  1. Gabapentin (Neurontin)*
  2. Carbamazepine (Tegretol)*
  3. Pregabalin (Lyrica)
  4. Phenytoin (Dilantin)
  5. Topiramate (Topomax)

*FDA approved the medication for treating chronic pain.

Many patients experience lower pain levels with anticonvulsants. Your doctor may use the trial-and-error method to find the drug form and dosage that treats your pain. Be sure to inform your doctor of side effects other than those he advised when taking anticonvulsants. Read the paperwork accompanying your medicine thoroughly, making note of any restrictions (no alcohol, etc.) while taking this medication.

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MUSCLE RELAXANTS

In the United States alone, an estimate of $100 Billion is spent annually for chronic pain management.  And among the numerous forms of chronic pain, one form is the Musculoskeletal pain. Its symptoms and discomfort are felt within the muscles, nerves, tendons, bones, and ligaments of the body. These symptoms may develop as an acute onset (rapidly and grow to severity quickly) or as chronic pain (slowly and long-lasting.) Like most chronic pain, Musculoskeletal pain that continues for three months or more is considered ‘chronic.’

Chronic musculoskeletal pain may be widespread or centered in one area of the body. Some of the more common parts of the body include lower back pain, myalgia (muscle pain), tendinitis, and stress fractures. The causes are as varied as the types of musculoskeletal pains – injury, overuse, poor posture, arthritis, and/or prolonged confinement.

To effectively treat the symptoms of pain and discomfort muscle relaxant medications may be used. Unlike their name, muscle relaxant drugs don’t act on the muscles themselves. Instead, the impact of the effects center on the central and peripheral nervous system.

Reported symptoms treated with muscle relaxants include:

  1. Bone Pain (dull, deep, penetrating pain)
  2. Connective Tissue Pain (felt within tendons or ligaments)
  3. Muscle Pain (less intense than Bone Pain, but causes range from injury to tumor)
  4. Tunnel Syndromes (result from compression of nerves)
  5. Joint Pain (aching, stiffness, swelling or burning within a joint(s))
  6. Fibromyalgia (ligament, tendon, muscle pain)

The most commonly prescribed muscle relaxant medications are Baclofen, Carisoprodol, and Chlorzoxazone. All three work on the central nervous system, but each is prescribed for different pain problems. Baclofen is prescribed for muscle spasticity which occurs as a result of multiple sclerosis and spinal cord injuries. Carisoprodol is more commonly prescribed for the treatment of several musculoskeletal system disorders that cause acute pain. And Chlorzoxazone is typically prescribed for lower back pain and muscle spasms. Only one of these medications have received rare reports of acute liver injury. Chlorzoxazone use may be associated with liver injury, but, again these reports are rare.

However, two muscle relaxant drugs have been associated with causing acute liver damage (severe to fatal.) If you are prescribed either of these drugs, speak to your doctor extensively regarding this warning. The drugs are:

Dantroline (for chronic spasticity)   and

Tizanidine  (for acute symptoms of muscle spasms or chronic muscle spasticity)

The normal side effects of dizziness, drowsiness, and headaches accompany most of the drugs mentioned above. As with all medications prescribed or discussed in your doctor’s office, research the side effects online if your doctor fails to discuss them with you. It is your right to know exactly what you are putting into your body and the effects that may accompany those medications.

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CORTICOSTEROIDS

Administered in the form of a pill, a topical cream, or an injection, another class of anti-inflammatory drugs is Corticosteroids. As a stronger drug used to control severe swelling and pain, corticosteroids are prescribed for specific pain conditions. They were created to act like the natural steroids in your body. By altering the immune system, they control inflammation that causes decreased movement and pain in most joints and muscle tissues.

These drugs are periodically administered to treat cases of acute pain or flare-ups. Another common treatment is chronic swelling in the tendons and joints. To reduce pain and escalate joint and tissues flexibility, corticosteroids are used for the following conditions:

*Osteoarthritis

*Rheumatoid arthritis

*Synovitis

*Tendonitis

Common types of corticosteroids:

**Hydrocortisone

**Prednisone

**Methylprednisone

**Cortisone

And the possible side effects include:

-Headaches

-Nausea or vomiting

-Sleep problems

-Dizziness

-Changes in the skin (acne, redness, increased hair growth)

-Mental changes (anxiety, mood swings, depression

Again, let your doctor know of any extreme side effects including hands, feet, or face swelling, eye pain or other visual changes, a rash that will not disappear, new muscle pain/weakness, and/or tarry bowel movements.

Corticosteroids do work but injections are limited to a maximum number every six to twelve months each year. Pills are given in large increments and dwindle down to nothing in a matter of six to ten days. And topical creams are usually applied as needed or per your doctor’s orders. Be sure to talk extensively with your healthcare physician to understand the side effects and the likelihood you’ll receive pain relief with corticosteroids.

Next week I will post Part 3 of Options for Pain Relief – Opioids. Thank you for your patience and I hope you enjoy reading this information!

Carolyn

 

Author:

After training for copywriting, I am currently blogging for a living! So far working with a company that outsources for other companies and I've become the "preferred writer" for two companies!!! I'm very excited about having my own blog site and look forward to adding interesting info for you!

6 thoughts on “Options for Pain Relief

  1. This was a very wonderful and well written post! It is truly amazing what we can learn to deal with in life and the strength we all have, that is sometimes hidden. I have been battling Multiple Sclerosis for 16 years now and it has had its ups and downs, but I try to hold on to my positive attitude. I started my blog 2 months ago and it has been a great experience. I have been able to communicate with so many wonderful and amazing people that really understand what I go through. I look forward to reading more of your posts! Take care!!

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    1. Thank you! I plan to follow you because of your wonderful and positive attitude! Writing out our feelings, thoughts, and ideas truly help us with the managing of our hidden illnesses of pain. I’ve dealt with back pain since I was 17 and Scoliosis was discovered. Unfortunately, the doctors did not continue to watch my curvature and when I turned 35 my curvature was 65 degrees within 1/2 inch of puncturing my lung. Had Harrington Rods implanted to help straighten my spine and it worked! However, lower back pain was filled with arthritis and that has been my chronic pain for all of these years.

      You are an inspiration to me and I look forward to reading your blog! Have a wonderful week!!

      Carolyn

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      1. Oh Carolyn, I am so glad to hear that my positive attitude has been good for you. It is amazing how writing about what you are going through and making a connection with others can help. It makes you feel not as alone. Such a young age to deal with so much. I was 19 when I was diagnosed with MS and now I am almost 36. Not a day goes by that I do not have pain. But, I have learned it doesn’t help pain to dwell on it. I am glad they were able to do something to straighten your spine but I hate you have to deal with that lower back pain.

        I am so happy to hear that I have been able to inspire someone. My goal of this blog is to learn from others but also help people. I want to be able to inspire and encourage others! I hope my blog will be beneficial to you! Take care and please reach out to me if I can do anything for you!

        Liked by 1 person

      2. You are so very welcome! I really hope that if you choose to follow my blog, I will be helpful to you! I have set a goal for myself that I will keep because, well I am stubborn and determined! I am going to do one post everyday for a least one month!! Take care and have a great evening!

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      3. I hope you had a nice relaxing day! I decided that I am challenging myself to do one blog daily for at least one month! If you choose, you may already be, but if you choose to follow my blog, I hope you enjoy it!

        Like

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