What kind of medication does a pain management doctor give?

Pain management doctors will treat the pain according to its cause or source. There are different TYPES of pain, believe it or not, and they require different types of treatment.

Somatic pain, or pain originating from the body via painful sensory input (because of inflammation, damage, etc) is often treated with Tylenol or Advil if mild (usually not a pain management doc's arena) or opiates like Vicodin, Codeine, Morphine, Fentanyl, etc if severe.

Neuropathic pain, pain that originates from the nerves but without an actual sensory input causing a painful impulse (typically in HIV, shingles, or diabetes) is often treated with drugs like Lyrica, Neurontin, and sometimes anxiolytics as well.

Pain due to an inflammatory process may be treated like somatic pain, because it is a somatic pain, but also may include heavy anti-inflammatory treatment which can include: NSAIDS (in hospital for short term use Toradol is popular). At home these may include OTC NSAIDS like ibuprofen, naproxen, etc. Severe inflammation might require more aggressive treatment to include steroids to suppress the inflammatory response as well as medications to treat pain.

Routes of medication depend on the setting, patient, and need. If pain medication alone doesn't help they will start to look at other therapies such as implanted devices which are intended to "block" pain impulses by maintaining low-level stimulus of the nerves involved in that pain pathway.

If you need pain management talk to the doc about your needs, fears, and questions. Many people fear being on Opiates because they're sedating and addictive, but if you take them for pain (legit need) the chances of dependence are low.

Mr. Magoo- pain signals do NOT originate in the brain, they are received by the brain.

And for the record: Tylenol is extremely hepatotoxic- don't be fooled by it's OTC status! Agreed- Narcotics have some pretty serious side effects, but so does continuous pain, so it's a balancing act and unfortunately no medications (note I didn't say treatments) are more effective at easing somatic pain than opiates.

Thank you, and I hope you find a relief, soon. Pain is a terrible thing to endure long. Report Abuse

As someone who has been in pain for 10 years, I feel compelled to encourage you to try everything before giving into narcotics. When I first fell off the horse and had to have back surgery, I was getting by with 600 mg of Motrin three times a day and Vicoden. After surgery, I did physical therapy.

There was three years in between first surgery and second surgery. In those three years, I continued riding and walking for exercise. The pain never went away and got worse. Had to give up the Motrin because it affected my vision. MD gave me Flexeril because of back spasms. Was sent back to surgeon and taken to OR because I had knocked a screw loose in my back. It made a big hole in my vertebrae and caused damage on the nerve root.

After that trip to OR, my MD took me off Vicoden because my liver test wasn't good. Vicoden has Tylenol in it and it's toxic to the liver. So I was put on Oxycontin. I felt like I had gone from smoking a cigarette to shooting heroin. But MD insists that Oxycontin is easier on liver than Tylenol in the Vicoden.

Just went back to OR in May 08 because I broke my back. Don't know how I broke back, but now I have osteoarthritis in my spine, bone spurs pinching nerves and nerve damage. Just had bilateral spinal fusion with some removal of bone in spine to release nerve. I have tried to wean off all drugs, but not successful. Without Flexeril, I have spasms. MD has tried to increase Oxycontin dose, but right now we are trying lower dose of Oxycontin with Norco in between. Also on Elavil for nerve pain and depression.

Have asked multiple times to go to rehab, be weaned off pills and eval true pain level. Rehab has been denied by MD - thinks it's a waste of money since I have obvious sources of pain. Pain signal actually comes from brain. Tried spinal cord stimulator, but still needed pills. Some success with acupuncture, but insurance will only pay for 5 sessions a year and I need it every other day to be successful. Massage is good to work out knots in back, but I have to pay for that since insurance won't cover it.

All of this has been from my primary MD and pain management MD. The pills do not make me feel good - constipation, sick to stomach feeling, my family swears narcotics are killing my brain (can't remember a thing, massive mistakes in check book....) and narcotics sap all my energy away. Moral of story: try all non-narcotic treatments before going on narcotics. Once you're on them, it's hard to go back.

Mr Magoo is a copy of me. osteoarthritis in the severe degenerative stages alon with severe degenerative neurological damages. I've had surgery twelve times on my back. 32 screws eight bone drafts, for from cadaves. A spine stimulator and still on Vicodin and Nurontain. The pain from one to ten always hovers around the eight to eleven mark. I have got up at one in the morning and cried, my spouse holding me, the pain has been so bad.

No one, I'll say it again, No one out there can look down at us and say there's another way without drugs. Unless you have walked in our shoes, you don't know what pain is.

The same as any other dr...Pain management coordinates all your medications, so you don't od on a bad combination....