When it comes to treating pain, medications, and injections are the commonly prescribed options before surgery. But which one is better and why? Which one should you choose for pain management? If you have these questions in mind, read this article to find out the difference between pain medicine and pain injections and which is the best option for pain management. Visit the best Pain Management Clinic in Brooklyn at Doral Health & Wellness or log on to www.doralhw.org.
Pain management options
Pain medicine is the first form of treatment for chronic pain. Your primary physician, patient management specialist, or pharmacist may prescribe you any of these medications based on your underlying cause and general health. The most common pain medications are divided into the following categories:
- NSAIDs and acetaminophen:
There is a wide range of NSAIDs available, and some of them as over the counter (OTC). NSAIDs are very effective for acute muscular, bone, and arthritic pain. When it is taken for a long period of time or in large quantities, it may negatively affect your kidneys, cause bleeding, or lead to gastric ulcers. Long-term use of COX-II inhibitors has been linked with increased cardiovascular risks, including high blood pressure. Acetaminophen is also available OTC; however, it should be taken carefully (not more than 3000 mg in 24 hours) to prevent liver failure. Some opioid medications also include acetaminophen, which needs to be calculated for the maximum allowed dosage to prevent overdose.
- Antidepressants:
Antidepressants are used to control nerve-related pain, including tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and other sodium channel-blocking medications. These medications are given in lower doses to relieve pain than those who need them for depression. These medications are not meant to be taken as needed but daily, whether you have pain or not. These medications can cause side effects like sleepiness, so you need other medications at night. Another side effect is dry mouth, which is treated with drinking lots of water or fluids. These medications cannot be given to patients who have some type of glaucoma. Additionally, it should not be taken in large doses unless prescribed.
- Anticonvulsants (anti-seizure) medications:
These medications are immensely helpful in treating some kinds of nerve-associated pain. Like antidepressants, it should not be taken as needed but as prescribed daily. Some side effects include drowsiness, which often gets better with starting off with lower doses and increasing the dose slowly over time. Other side effects include weight gain and abdominal pain. If you have kidney stones or glaucoma, make sure you tell your doctor, because these medications are not prescribed for those conditions. Some newer forms of these medications are available, but they need to be used with caution for patients with kidney disease.
- Muscle relaxants:
These medications are prescribed to treat acute muscle spasms and have fewer side effects. The most common side effects are drowsiness and dizziness.
- Injections
Pain injections are used for both diagnosis and treatment of chronic pain for outpatient treatments or sometimes in the hospital. Most injections are given under X-ray or ultrasound guidance. For any nerve block, you need to let your doctor know if you’re allergic to contrast dye or if you may be pregnant. Here are some of the most common pain injections given by pain management specialists:
- Epidural steroid injection: These injections are given to the back or neck. It includes an anti-inflammatory steroid medication, with or without a local anesthetic, into the epidural space close to the area that causes pain. These injections are used for pain affecting the back, leg, neck, and arm/hand. To administer these injections accurately and safely, X-rays are used. Common side effects include soreness of the back or neck at the point where the needle enters the skin. Some temporary numbness may occur, but you should tell your doctor about it if the numbness or weakness lasts longer than 8 hours. These injections may be placed in the lumbar (lower back), thoracic (mid back), and cervical (neck) regions.
- Facet joint injection: This injection assists with movement and stabilization of the spine both in the neck and back. These injections provide relief for neck or back pain, which is performed under X-ray guidance. Patients may feel soreness when the needle is inserted into the neck or back. You need to lie on your stomach for this injection. A needle is inserted in your neck or back in close proximity to the joint, with the help of X-ray visualization. This injection is often used to find what is causing the pain. A long-lasting injection may be required when you have severe pain. One example of long-lasting injection is radiofrequency ablation, which uses an electric current to heat the area of nerve tissue to stop the pain signals.
- Lumbar sympathetic block: This injection is used to treat leg pain caused by complex regional pain syndrome (CRPS) type 1. These injections are also performed under X-ray or ultrasound guidance. Local anesthetic is given near the lumbar sympathetic chain to relieve the pain. You may feel warmth immediately after the injection, which is normal. Back soreness is a more common side effect. If you feel any pain in your leg or your groin during the injection, you should inform your doctor immediately. Some temporary numbness after the injection is normal, but if it lasts longer than 8 hours, you should tell the doctor. You need to lay on your stomach for this injection, which is given at the level of the lumbar vertebrae two and three, in the lower back. The needle is placed under X-ray guidance (near/at the anterior vertebral body to the side of the affected area where the ganglion is located). Sometimes a small amount of dye is injected before ensuring the needle is inserted in the right spot. After the injection, they inject numbing medicine and remove the needle.
- Celiac plexus block: This relieves chronic abdominal pain or cancer in the areas of the abdomen, which causes significant pain. You need to be positioned on your stomach for this injection, where the needle is placed on the area of the back to target the sympathetic nerves of the abdomen. A small amount of dye is injected first to find the right place (using numbing medicine) to the area of a group of nerves called the celiac plexus. For chronic pain, you need to take a series of these injections 3 times. For cancer pain, a single diagnostic injection is used to see whether you need a strong injection dose for the pain or not.
- Stellate ganglion block: This injection is used to treat or manage the complex regional pain syndrome (CRPS) of the hand, arm, or shoulder. It also improves blood flow to the hand or arm in certain conditions that result in poor circulation. Soreness in the neck after the needle was placed is very common. In some cases, droopiness of the eyelid along with a temporarily stuffy nose or sometimes temporary difficulty swallowing or hoarseness of the voice occurs. This injection is also performed under X-ray guidance or ultrasound imaging. You need to lie on your back for this injection. If it is performed under x-ray, the doctor will first inject a small amount of contrast dye to determine the location for the needle to be injected, followed by numbing medicine.
Which option is best for pain management?
The best option for pain management depends on the severity of the pain and the underlying cause that you are diagnosed with. The pain management specialist chooses the best treatment plan based on these factors. During your evaluation, you should work with your doctor and tell them everything they need to know about your health and medical history. With this cooperation and diagnosis tests, the doctor has all the necessary information to create a treatment plan that is suitable for your condition. You can ask questions that concern you. Remember, each treatment has its benefits and risks, so talk with your provider about them first before starting your treatment.
Pain medicine and pain injections are both used for treating pain depending on the severity and underlying cause of pain. Your doctor performs several tests to determine that and then creates a treatment plan that helps you achieve pain relief.
Do you need help with pain management? Visit our pain management specialist in the Brooklyn clinic to get professional medical help. Call us to book your appointment now!! Visit Doral Health & Wellness Pain Relief Department in Brooklyn, to get professional help and guidance on how to manage your problem. Call us on + 1-718-367-2555 to get a consultation. If you need help learning coping methods, register your information and make direct contact with our doctors at https://yuz88hfiyh7.typeform.com/Doralintake. Log on to www.doralhw.org. Or visit us at 1797 Pitkin Avenue, Brooklyn, NY 11212.
