Comprehensive Pain Management at UT Health Austin instead uses an interdisciplinary approach that treats the whole patient.
The goals of our interdisciplinary program are (a) to decrease patients’ pain and disability and (b) to improve their function, health and well-being, and quality of life.
As part of your interdisciplinary pain management plan, a pain management specialist may prescribe one or more types of pain medications.
The medications that we prescribe work in different ways and serve various purposes, which include reducing inflammation, altering the perception of pain, or decreasing nerve activity and sensitivity.
The types of pain medications prescribed in our practice include Acetaminophen, Non-Steroidal Anti-Inflammatory Drugs, Topical Analgesics, Anticonvulsants, Antidepressants, Muscle Relaxants, and Opioids.
Acetaminophen by itself can effectively treat mild to moderate pain. It is sometimes combined or taken with other pain medications.
Acetaminophen is generally safe at recommended doses. However, long-term daily use and higher doses of acetaminophen can cause kidney and especially liver damage. Patients with liver disease or who drink alcohol regularly should avoid taking any acetaminophen, except if instructed to do so by a physician.
Non-Steroidal Anti-Inflammatory Drugs
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) reduce inflammation and the pain caused by it. Lower dose and less potent NSAIDs can be obtained over-the-counter without a prescription, while other forms require a prescription.
An NSAID can often be very effective in treating pain, either by itself or in combination with another type of medication. However, long-term, daily use or higher doses of an NSAID can increase the risk of gastrointestinal bleeding, kidney damage, a stroke, or a heart attack.
Topical Analgesics are absorbed through the skin and are particularly useful in reducing localized areas of pain. A topical lidocaine patch acts by numbing the area of pain and sensitivity, and it seldom causes any major side effects. A topical NSAID gel or patch can successfully treat localized pain without the same risks as an NSAID pill taken orally.
Anticonvulsants or Antiepileptic Drugs
Anticonvulsants or Antiepileptic Drugs act as pain medications by decreasing abnormal nerve activity and sensitivity. They work by calming the transmission of a pain signal created and carried by a nerve or the spinal cord. These medications are called “anticonvulsants” or “antiepileptic drugs” because they can also be prescribed to treat a seizure disorder. Both nerve-related pain and seizure disorders are characterized by overactive nervous system signals.
Antidepressants can decrease pain sensitivity in patients. The same chemicals in the brain and spinal cord can be decreased in patients with depression or chronic pain. An antidepressant is thus often prescribed to a patient who is not depressed, and in some individuals, it can be more effective in controlling pain than other types of medications.
Muscle Relaxants are used to treat muscle spasms or chronically tight muscles. For chronic muscle spasms, a muscle relaxant is usually most beneficial when it is combined with other forms of treatment like physical therapy, massage therapy, transcutaneous electrical nerve stimulation (TENS) unit, trigger point injections, acupuncture, or biofeedback.
Opioids work by altering the perception of pain by reducing the intensity of pain signals sent to the brain. An opioid can be a part of a pain treatment regimen, but certain types of pain are often not well-controlled with an opioid. Additionally, despite their beneficial effects, their side effects and risks often make opioids not a good longer-term option for many patients.
Opioids can cause constipation, itching, bladder dysfunction and drowsiness, as well as memory problems, depression, hormone imbalances, loss of libido and sleep disturbances. When taken with alcohol or a benzodiazepine, or at a higher dose, an opioid can cause a patient’s breathing to slow or to stop completely. Longer term use of an opioid can result in tolerance, dependence, misuse, abuse, or addiction.
Treatment with any opioid is thus very carefully chosen and planned, and then closely monitored by a pain management specialist as part of our interdisciplinary approach to treating pain.