Pain Management

‘Pain, a more terrible lord of mankind than even death itself’. Dr Albert Schweitzer

Chronic Pain (pain that persists longer than 3 months) afflicts 10-20% of the adult population. One of the most prevalent conditions that healthcare professionals treat is chronic pain. Chronic pain can be debilitating, affecting a person’s quality of life. People suffering from chronic pain report a reduction in social activities and work capacity leading to isolation, depression and anxiety. 

The body’s reaction to unrelieved pain includes:

– Increased heart rate and blood pressure
– Changes to blood gases, namely reduced oxygen and increased carbon dioxide
– Higher levels of stress hormones including cortisol and adrenaline
– Gastrointestinal problems such as slowed digestion
– Musculoskeletal problems such as tension and fatigue
– Emotional problems such as anxiety and depression.

Pain

Forms of Chronic Pain

  • Neuropathic Pain – This pain results from a drug, disease, or injury to the nervous system. Clinical symptoms include the feeling of pins and needles, burning, shooting, stabbing pain and numbness. Diabetic neuropathy is associated with neuropathic pain.
  • Musculoskeletal Pain –  This pain encompasses a wide spectrum of disorders including, ligament injuries, osteoarthritis, myofacial pain, fibromyalgia, neck and lower back pain conditions. Musculoskeletal pain is usually described as a dull and aching pain originating from skin, bones, muscle or abdomen.
  • Migraine – Migraines are headaches that typically last from 4-72 hours. Sufferers may experience nausea and vomiting as well as sensitivity to light or sound. Migraine sufferers frequently report throbbing pain that worsens with normal activity.
  • Fibromyalgia – Fibromyalgia (FMS) is a condition characterized by prolonged aches and pains in the muscles and fibrous tissues. People diagnosed with fibromyalgia usually have chronic fatigue syndrome.
  • Idiopathic Pain – This is a non-specific pain of unknown origin. Patients commonly report pain in the head, neck, shoulders and abdomen. Stress, anxiety, depression and other mental health conditions can adversely influence this type of pain.
  • Rheumatoid Arthritis – Rheumatoid arthritis is an autoimmune disease that causes pain and inflammation of the joints. Other parts of the body can also be affected. Inflammation causes the joints to become painful and swollen, and movement may be restricted. Stiffness in the joints is common, especially in the morning. 
    Osteoarthritis – Osteoarthritis is a disease of the joints. The two bones of a joint are normally protected by smooth, cushioning material called cartilage. In osteoarthritis, cartilage breaks down, causing pain and stiffness in the joint. Osteoarthritis is one of the most common forms of arthritis. 

Treatment

Despite its potentially devastating and debilitating effects, chronic pain is frequently under-treated or treated incorrectly. To adequately treat pain it is essential to do a thorough pain assessment taking into account pain history and any medical evidence to help determine the most therapeutic options. A thorough pain history including location, intensity and characteristics of pain, as well as any factors that aggravate the pain, should be discussed. This will enable the formulation of a comprehensive, individualised treatment.

Commercially available medications often produce unwanted systemic adverse effects and can interact with medication the patient may be taking for other diseases. Due to the risk of theses unwanted effects, healthcare providers and patients are seeking alternative options.

One approach is the topical application of compounded creams, lotions, aerosols or patches directly onto the site of the pain. As a result, they target the site of pain directly. These preparations allow for a higher concentration of the active agent to be used with minimal side effects. Topical Agents are proving to be both effective and safe in reducing pain and improving function in patients with a variety of pain states. Research indicates that topical analgesics create an effective option with minimal risk of significant systemic absorption, drug interactions and a reduced incidence of systemic adverse effects, such as peptic ulcer disease and GI haemorrhage.

Transdermal pain creams allow for topical, high strength combinations that avoid cardiovascular, neurological, anti-cholinergic and GI side effects experienced by taking the individual oral forms. The following ingredients can be combined in a customized pain cream using a transdermal cream base.

Our specialised laboratory produces a wide range of topical creams, ointments, gels, lotions, sprays and patches, to help treat various pain conditions and aid in compliance. Our pain creams incorporate active ingredients which have resulted in effective pain relief as shown in comprehensive, evidence based studies.

Please contact us for more information or to book a free consultation or pain assessment with our pain specialist.

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