Medications

The role of medications in treating chronic pain

The development of chronic pain is most likely due to changes within the nervous system, so it is not surprising that medications used to treat acute pain (the pain caused by tissue damage) do not always work for chronic pain; chronic pain medications target the nervous system.

Successfully treating chronic pain is actually about changing the nervous system through practiced and paced physical activity, learning healthier ways of thinking, dealing with emotions and stress.

The goal of using medications to treat chronic pain is to restore your function: help you move again, support your return to schooling, and help you reconnect with family and friends. They are also used to help you sleep better and balance your mood.

Medications are not for everyone: They may, or may not, be right for you. You do not always need medications to move again, get back to schooling, and restore your social and family life.

Your doctor's job is to figure out:

1. If medications right for you or if other treatments would give you the same benefits without any side effects?
2. Which medication would work best for you?
3. When the best time would be for you to take medication; it's not always at the beginning.
4. What medications you are presently taking which may not be beneficial for young people with chronic pain

To work out if medications are right for you, your doctor will consider:

• The research evidence that proves a medication is effective for young people in your situation;
• How useful medications are to treat your particular pain condition;
• The typical side effects of a medication;
• Your goals and needs;
• How the medication may affect your ability to manage your health and move forward with your life, including physical activity, school, friends and family.

If medication is right for you

Doctors weigh the benefits of a medication against its potential side effects before they prescribe.

If your doctor decides that a medication would be helpful for you:

• The simplest type of treatment will be tried first. You will receive information about the medication.
• You may have one or more side effects.
• Your doctor will prescribe you the lowest effective dose of medication to minimize its side effects.
• Medications will be re-assessed regularly to ensure that they are actually helping to restore your function.

Side effects

A side effect is an additional or unintended effect of a drug. Often, a side effect is unpleasant or harmful. For example, the side effect of a drug for pain relief may be that it makes you feel sick or nauseous.

A dose is the amount of medication you take each time. It’s usually in milligrams (mg) or milliliters (mL). The frequency is how often you take the medication.

The larger the dose, the greater potential for side effects.

Because everyone is different, medications don’t always have the exact same effect on everyone. Your doctor will monitor how a medication works for you. If you have bad side effects, or the medication doesn’t do what it’s supposed to, your doctor may change it. It’s common to try different medications and different dosages until you get the right combination.

Off-label use of drugs

Medications are usually developed to treat one problem or illness. They are licensed and sold with information sheets that discuss how to take the medication to help with that one problem.

But over time, researchers and doctors often discover that the medication is also good for treating another problem, so they will prescribe it, even though it isn’t licensed or marketed for that second problem. This is called "off-label use of drugs."

This is a perfectly acceptable practice, and is common in treating pain. For example, researchers have discovered that some drugs used to treat depression are also great at treating pain.

If you were prescribed an anti-depressant for pain, you’d get an information sheet that talked all about depression and how to take the drug to treat depression.

Don’t panic. Your doctor hasn’t made a mistake. The information on depression doesn’t apply to you. You will get proper instructions from your pharmacist on how to take the drug for your condition. These will be written on the label of your medication.

If you have any questions, you can always ask your pharmacist or doctor to explain more about your medication to you.