Pharmacological methods of pain relief are an essential part of pain management strategies and should be used as advised to get rid of the pain while minimising side effects. This blog provides an overview of various pain relief medicine and their mechanisms of action for pain management.
Understanding the mechanism of pain medicine is crucial for developing effective pain management. The significance and prevalence of pain cannot be ignored. It affects a substantial number of people and has implications for both individuals and the broader healthcare system. Working towards effectively managing pain and patient outcomes remains a priority in the healthcare sector. Pain management is considered an important aspect of healthcare. The goal is to remove discomfort and improve the quality of life for individuals experiencing acute or chronic pain. The pharmacological industry constitutes a primary approach to pain management, which includes a broad range of medications that function through different mechanisms. For effective pain management, it is important to understand how pain medication works.
Pain management
Pain often involves physical, psychological, and social factors. A variety of sources may contribute to pain, including disease, inflammation, injury, and nerve damage. Pain can have a direct impact on an individual’s life, affecting their wellbeing by impairing their capacity to perform daily activities, fulfil work requirements, and participate in social interactions. Moreover, pain sensation is a complex process that includes the activation of sensory neurons, the transmission of chemical and electrical signals along neural pathways, and the interpretation of these signals by higher brain centres.
Pharmacological methods of pain management
- Non-opioid analgesics: how does pain medicine work?
These are a class of pain medicines that doctors commonly prescribe to relieve mild to moderate pain. Non-opioid analgesics include acetaminophen, aspirin, and nonsteroidal anti-inflammatory drugs (ibuprofen and naproxen). These medications are widely available, even over the counter, because of their low risk of addiction and dependence.
- Types of non-opioid analgesics: These are classified into three main categories, namely acetaminophen, NSAIDs and topical agents. NSAIDs are the most common non-analgesics. Examples include ibuprofen, naproxen, aspirin, and celecoxib. Acetaminophen is the other non-opioid analgesic commonly used in the management of pain. It does not reduce inflammation, but it is effective in managing mild to moderate pain. It is associated with a low risk of side effects and is often used as an alternative to NSAIDs.
On the other hand, topical agents are new, introduced non-opioid analgesics that are applied to the skin. They block pain signals at the site of application. Examples of topical agents include diclofenac gel and capsaicin cream.
- Mechanism of action: NSAIDs that prevent the activity of an enzyme that triggers changes in the body. The enzyme is known as cyclooxygenase (COX), and it occurs in two forms: COX-1 and COX-2. COX-1 works to protect the stomach lining from acids and digestive chemicals. It also plays a role in maintaining kidney function. On the other hand, COX-2 is produced when joints are inflamed and injured. NSAIDs work by blocking the action of these enzymes, which is why they can ease pain and inflammation.
- Opioid analgesics:
These are considered the most powerful medications in pain management. They are believed to produce a range of pharmacological effects, including sedation, analgesia, euphoria, and respiratory depression. These medications can cause gastrointestinal side effects, respiratory depression, tolerance, hormonal changes, and addiction when used for a long time.
- Types: Opioid analgesics are subdivided into three main categories, namely synthetic opioids, natural opioids, and semi-synthetic opioids. Natural opioids include codeine, thebaine, and codeine. On the other hand, synthetic ones are methadone, tramadol, and fentanyl. The semi-synthetic opioids include buprenorphine, oxycodone, and hydrocodone.
- Mechanism of action: By targeting opioid receptors in various parts of the body, these medications can cause a significant reduction in pain and provide symptomatic relief to patients suffering from moderate to severe pain.
- Adjuvant analgesics:
It is a diverse group of medications that can be given along with other pain management medications to improve their analgesic effects or to treat specific types of pain. These medications include anticonvulsants, antidepressants, corticosteroids, benzodiazepines, and other sedative-hypnotics. These are divided into several categories, including:
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- Anticonvulsants: These medications, including gabapentin and pregabalin, have emerged as promising pharmaceutical agents when it comes to treating neuropathic pain. Moreover, these medications have been shown to improve the quality of sleep, anxiety, and depression. All of which are common symptoms in patients with chronic pain. These medications work by controlling abnormal brain activity. These are found to be extremely effective in various neuropathic pain conditions, including postherpetic neuralgia, neuropathy, and spinal cord injury.
- Antidepressants: These can help relieve the symptoms of depression. The pain-killing mechanism of these medications is not yet understood. But they are believed to increase the neurotransmitters in the spinal cord that decrease the pain signals. But note that antidepressants do not work immediately.
- Local anaesthetics: These include lidocaine and bupivacaine, which are used in the management of chronic pain. They block the transmission of nerve impulses in specific areas of the body, thus causing temporary loss of sensation and pain relief. Local anaesthetics are also effective at treating chronic pain conditions such as postherpetic neuralgia and neuropathic pain. These medications stop the nerves in a certain part of your body from sending signals to your brain. They do not slow down your central nervous system or cause loss of consciousness. If the medication works properly, you won’t feel the pain in a specific area. The onset of the medication depends on the type of medication used, as well as the route of administration. These medications have several advantages in pain management. They also have a rapid onset of action, and their effects can be reversed with the use of specific antidotes, such as naloxone.
- Corticosteroids: They have anti-inflammatory and analgesic effects, which make them extremely beneficial for the management of various types of pain. Corticosteroids decrease the production of pain-inducing substances in the body. These medicines, including dexamethasone and prednisone, can be used in managing inflammatory pain. Corticosteroids also have immunosuppressive properties, which can be beneficial in managing pain associated with autoimmune disorders, such as rheumatoid arthritis. These medications are extremely effective in managing pain related to a range of conditions, including osteoarthritis, rheumatoid arthritis, acute, and chronic pain.
How long does it take for pain medicine to work?
Some pain-relieving drugs start to work within minutes, while others may take several hours or even days to provide relief.
With a better understanding of the mechanisms of pain medications and the use of advanced technologies, researchers are striving to develop more effective, targeted, and personalised medicines for pain relief. Please consult your doctor to get the best medicine for pain relief.
