The majority of patients with complex regional pain syndrome (CRPS) receive or have received pain medication to manage chronic pain symptoms. Pain medications are also referred to as analgesic drugs. In cases of mild to moderate pain, over-the-counter pain medications may suffice. If over-the-counter pain medication is not helpful, doctors may prescribe stronger pain medication such as opioids. CRPS patients should discuss symptoms with their healthcare provider to determine which type of treatment is best for their specific CRPS symptoms.
Over-the-Counter Pain Medication
Doctors may recommend several types of over-the-counter (OTC) pain medication. These medications are used to ease minor pain and inflammation. Acetaminophen is category of over-the-counter pain medication. Acetaminophen is the active ingredient in the over-the-counter pain medicine Tylenol.
A common form of over-the-counter pain medication is non-steroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen, aspirin, and naproxen. Different types of NSAIDs are also contained in certain prescription pain medications. NSAIDs work by reducing prostaglandins, a family of chemicals that promote inflammation. While inflammation is necessary for healing, it also causes pain. NSAIDs are known to promote bleeding and cause stomach ulcers. This is because prostaglandins also support blood clotting and protect the stomach lining from the effects of acid.
Over-the-counter brand name pain medications include:
- Advil (ibuprofen)
- Motrin (ibuprofen)
- Bayer (aspirin)
- Excedrin (aspirin)
- Aleve (naproxen)
Topical Pain Medication
Topical pain medication may be used to deliver analgesics directly to the patient’s skin. They are also referred to as local anesthetics. Common topical pain medications may include lidocaine patches, analgesic creams, and capsaicin. Many topical pain medications have not been studied during controlled CRPS trials. Side effects of topical pain medication include skin irritation and swelling. These side effects typically dissipate within a few hours of the treatment being removed from the skin.
The lidocaine patch is being increasingly used to manage CRPS pain. The lidocaine patch is commonly used to reduce sharp burning and aching pains. It may also help to reduce discomfort caused by oversensitivity.
Capsaicin is used to relieve neuralgia, a type of pain which stems from the nerves near the skin’s surface. Capsaicin is most commonly known as the active spice-producing ingredient in chili peppers. Capsaicin is available in several forms, including lotions, creams, jellies, patches, and ointments.
Opioids are a class of drugs that aim to reduce activity within the patient’s central nervous system. As a result, pain is reduced. These drugs attach to opioid receptors, which are specific proteins located in the spinal cord, brain, gastrointestinal tract, and other bodily areas. Attachment to opioid receptors reduces the sensation of pain. Patients taking opioids typically experience decreased pain perception, decreased pain reaction, and increased pain tolerance.
Prescribed opioids may include:
Use of opioids, also referred to as narcotics, in treating CRPS is debated. A number of specialists are concerned of the potentially harmful effects of opioids. Opioids may cause side effects such as mental confusion, drowsiness, constipation, nausea, and depression of respiration. Additionally, these drugs can be addictive. For this reason, many believe that opioids should be avoided unless other options have been exhausted, and in cases where use is only needed for a short period of time.
Pain Medication Side Effects
Before taking pain medication or beginning a pain medication regimen for CRPS, patients should be sure that they understand the potential side effects of each proposed treatment. For example, long-term treatment with NSAIDs, both over-the-counter or prescription forms, may cause dangerous complications. NSAIDs may cause issues such as kidney problems, blood clotting issues, bleeding ulcers, and gastrointestinal problems. Acetaminophen has been associated with liver conditions, and can lead to liver failure.
Alper, Brian S., and Charles J. Zelnick. “CRPS (reflex sympathetic dystrophy).” Cortlandt Forum 1 June 2006: 67+. Academic OneFile. Web. 9 Mar. 2014.
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