Pain Management Medication

Pain Management MedicationPain management medication can be quite helpful in managing RSD symptoms and in overall chronic pain management.The causes and progression of the symptoms ofRSD disease are not well understood. As a result of this, the body of knowledge available to medical professionals relating to RSD treatment is limited and evolving, so pain management medication tends to be one of the first options used by doctors treating patients. In some ways, the choice to immediately begin a pain management medication regimen is somewhat subjective with understanding guided by a doctor’s experience in treatment or management of RSD cases. Typical evidence-based treatment protocols are non-existent. The approach to treatment, in most cases, depends largely on the specialty of a chosen physician. Based on the history of RSD cases and the progression of the disease, it is well understood that early recognition and treatment are necessary to avoid permanent disability. Unfortunately, the effectiveness of treatment is limited once a patient has reached a stage of ongoing chronic pain. It is this possibility that a patient could endure long-term chronic pain that leads doctors to pursue treating RSD symptoms using pain management medication.

As a patient, you must be informed about the use of pain management medication in treating RSD disease. Pain management is the ultimate goal, as there are no known cures for RSD at this time. Consult with you doctor on their strategy for treating this pain syndrome and its associated symptoms. It is important to understand your course of treatment because the application of multiple therapies at the same time makes it difficult to evaluate the effectiveness of any particular medicine and could compromise your safety through drug interactions. In addition to that, the optimal dose for pain management medication varies greatly among patients. Understanding which medicine is effective vs ineffective and how much should be taken is something that should be properly discovered in a strategic way. It is usually recommended that patients start with a limited number of medicines and gradually increase the doses of their medication to the point of a side effect in order to determine the optimal dose. The dose is then reduced to the next lower level to try to mitigate the negative side effects. When taking medicine prescribed to treat RSD and CRPS symptoms it is important to become familiar with all of the potential side effects so you can effectively communicate your health to your physician. Sequential trials with many different drugs may be required to determine the best treatment for individual cases.
Pain management medication is generally prescribed based on the type of pain that an RSD sufferer may be feeling. Because pain varies, it is important to remember the characteristics of the pain. The various types of RSD-related pain and associated characteristics are:

  • Constant pain
  • Pain causing sleep problems
  • Inflammatory pain or pain due to recent tissue injury
  • Spontaneous jabs
  • Sympathetically maintained pain (SMP)
  • Muscle cramps

Medications commonly used to treat RSD / CRPS based on the type of pain include:

  • For inflammation - Anti-inflammatories (e.g. aspirin, ibuprofen, naproxen, etc).
  • For constant pain (non-inflammatory) - Blockers (e.g. tramadol)
  • For constant pain, spontaneous jabs or sleep disturbances - Anti-depressants (e.g. amitriptyline, doxepin, nortriptyline, trazodone, etc), Oral lidocaine
  • For spontaneous jabs - Anti-convulsants (e.g. carbamazepine, gabapentin, etc.)
  • For the treatment of sympathetically maintained pain (SMP) - Clonidine Patch
  • For muscle cramps - Klonopin (clonazepam), Baclofen
  • For localized pain related to nerve injury - Capsaicin cream (though its effectiveness in RSD/CRPS treatment has not been fully determined)

The use of narcotic medicines (e.g. Darvon, Vicodin, Loratab, Percocet, morphine, codeine, etc) to treat RSD / CRPS is debated and there are potential hazards. Long-term use of these medications can result in addiction.

For more information on treatment and medicines, visit the RSD Foundation’s page with Clinical Guidelines for treatment.

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