Pain Control at Bay’s Pain Management Center
"It’s hard to describe the pain it’s so painful." This statement sounds
contradictory, but pain, whether acute or chronic, can be so belligerent or
intimidating that descriptive words fail us. Pain is part of the body’s defense
system, instructing neurons in the spinal cord to release glutamate, a
neurotransmitter that relays signals from one neuron to another.
The signals go to the thalmus, where pain perception occurs. From there, the
signal goes to the somatosensory cortex in the brain, where pain is identified,
and the individual responds to the pain. When acute pain occurs, the response
takes seconds. In episodes of chronic pain, the sensation may be constant.
Ever wonder how aspirin works? When pain pays a visit, cells in damaged
tissues make chemicals called prostaglandins that work with an enzyme,
cyclooxygenase, or COX-2, to signal pain. Aspirin stops cells from making
prostaglandins by sticking to the COX-2 enzymes. Aspirin "lowers the intensity"
of the pain signals, and works only where prostaglandins are being made.
Much stronger pain control agents, whether oral, dermal or intradermal, are
used by Bay’s Pain Center specialists to manage debilitating pain.
Used to relieve signs and symptoms of osteoarthritis and rheumatoid arthritis
in adults. Tablet form in 7.5 mg., 15 mg., 7.5 mg/5mL. Examples of other
non-steroidal anti-inflammatory agents include: ibuprofen, naproxen, diclofenac,
nabumetone, and ketoprofen. Mobic is not advised for those with asthma, hives,
or allergic reactions to aspirin or other non-steroidal anti-inflammatory
agents. Side effects can include: indigestion, upper respiratory tract
infection, diarrhea, joint or stomach pain, and nausea.
Another non-steroidal anti-inflammatory agent. One of the more common brand
names is Aleve or Motrin. Naproxen works by managing mild to moderate pain,
fever and inflammation by reducing prostaglandin levels. Naproxen often
prescribed in 250mg, 375mg or 500mg tablets. Naproxen may increase the levels of
lithium and reduce blood pressure. Those taking blood thinners should avoid
Naproxen because it also thins the blood, with excess bleeding leading to
thinning. Common side effects: rash, headaches, dizziness, drowsiness, abdominal
pain, nausea, diarrhea, constipation, fluid retention and shortness of
This is yet another anti-inflammatory agent, similar to ibuprofen and
naproxen. This medication works by inhibiting the production of prostaglandins.
Prostaglandins promote inflammation, pain and fever, supporting the function of
platelets to stop blood clots, and protecting acid damage to the stomach lining.
Usually prescribed in 50 mg/µg or 75/200µg. Used to treat rheumatoid arthritis
and osteoarthritis in patients at risk for developing ulcers. Arthrotec should
be used with caution in patients taking Coumadin, lithium, or methotrexate, and
it can reduce the effect of hypertensive medications.
Neurotinin affects chemicals and nerves in the body associated with seizures
or some types pain, or May cause dizziness or drowsiness. Discuss with your
doctor if you have kidney, level or heart disease before beginning this
medication. Side effects can include: difficulty breathing, lip, tongue or face
swelling, dizziness, poor coordination, blurred or double vision, anxiety,
thought disorders, amnesia, depression, or hyperactivity.
Lyrica affects chemicals and nerves in the body associated with seizures and
some types of neuropathic pain (particularly diabetic peripheral neuropathy), or
postheptic neuralgia. This is expressed as severe pain along the course of a
nerve, or when toxins or inflammation are present. Side effects can include
blurry vision, excessive tiredness, fever, weight gain, swelling of hands or
feet, muscle pain weakness or soreness.
Elavil is a tricyclic antidepressant, affecting brain chemicals that can
cause depression. Elavil is also used to treat chronic pain and prevent
migraines. Side effects: drowsiness, dizziness, difficulty breathing, fast,
irregular heartbeat, high blood pressure, difficulty urinating, dry mouth and
eyes, sweating, nausea, loss of weight or appetite.
Used to relieve moderate to moderately severe pain. Its effect is similar to
narcotics, but with significantly less potential for abuse or addiction. Can
also be used to treat pain caused by surgery, and chronic conditions, such as
cancer or joint pain. Tramadol decreases the body’s sense of pain. Can be
habit-forming. Side effects can include: nervousness, panic, sweating,
difficulty getting or staying asleep, numbness, pain, burning, and tingling in
hands or feet.
This patch provides a continuous delivery of an opoid pain reliever through
the skin. The patches are helpful after surgery, and are used to manage cancer
pain. The transdermal delivery system has proven to be an excellent means of
pain relief delivery. It is a narcotic, and reaches peak level in 24 hours. Some
patients also require a "breakthrough" medication to relieve pain. The most
potentially serious side effect is respiratory complications.
Used as a topical treatment for relief of pain associated with postherpes
neuralgia, or post-shingles pain. Allergic reactions are rare.
Vicodin (related to codeine) is a narcotic analgesic for pain relief. Taken
with acetominophen, it can increase the effects of Vicodin. Used to relieve
moderate-to-severe pain. Side effects: may increase impact of other drugs that
cause drowsiness, and can cause constipation, dry mouth, nausea, vomiting or
A strong narcotic analgesic used to relieve pain, particularly from cancer,
heart attacks, or sickle cell anemia. Kadian depresses the central nervous
system, and can cause drowsiness, dizziness, lightheadedness, or feeling a false
sense of well-being.
A morphine sulfate, Avinza treats moderate-severe chronic pain in patients
requiring continuous 24/7 therapy for an extended time period. Side effects:
constipation, nausea, somnolence, vomiting and headache.
A minimally-invasive surgery procedure to treat progressive vertebral body
fracture. The cause can include osteoporosis or a tumor spread to the vertebral
body. The procedure uses a balloon to restore the vertebral body and shape. Bone
cement is used for strengthening. Prior to implanting the cement, the balloon is
withdrawn. A single stitch can usually close the incision. Kyphoplasty can
prevent more fractures by keeping the spine lined up in its upright
The injection of a local anesthetic or neurolytic agents into or near a
peripheral nerve, nerve plexus or pain-sensitive trigger point. Nerve blocks
relieve pain by interrupting pain sensory pathways and preventing communication
with the brain. Used to treat neck and low back pain, sciatica from herniated
discs, lumbar canal stenosis, pain for peripheral vascular disease, shingles,
myofascial pain syndrome and cancer pain. Nerve blocks can include: trigger
point injections, epidural steroid injections, facet joint injections, stellate
ganglion block (nerves in neck area), lumbar sympathetic block, and intercostal
nerve block (local anesthetic between the ribs).