She was able order medicines while she was pregnant by clicking a question on a form to say she was not pregnant, although in this instance the pills were not obtained from Doctoru and David could not recall which website they came from. He added that addiction had had a huge impact on his family. Concerns have also been raised about websites allowing people to select medicines including opiates and opioids before a consultation.
Things are almost at a crisis point. This article is more than 3 years old. Regulator wants stricter rules in place to stop multiple orders linked to same address. The General Pharmaceutical Council is consulting on the procedures for supplying opiates. The safeguarding loophole means people can order hundreds of tablets a month. Changing the prescription for regulating pharmacies. Read more. For example, a person suffering a heart attack may feel pain around the shoulders, back or neck, instead of the chest.
The origin and causes of referred pain are still unknown. Effectively managing pain will start with a comprehensive pain assessment.
This assessment will allow the doctor or healthcare provider to characterise the pain, assess its impact, and evaluate other associated aspects, such as medical or psychological issues. This initial assessment will determine whether an additional evaluation is required to fully understand the pain. Pain is very subjective, meaning only the sufferer can describe it adequately.
The healthcare provider will ask about the pains location and duration. They will then seek to identify the quality and severity of the pain, as well as what factors make the pain better or worse. The next step will be to assess the changes that have occurred in the sufferers life as a consequence of the pain.
This assessment will require a physical examination, coupled with a review of the patients medical records. Part of the pain assessment will require discussing all previously tried pain-relief treatments. The doctor or healthcare provider will enquire as to what medicines and conventional treatments have been tried in the past. If the sufferer has been using complementary or alternative treatments, these are also important to discuss. These alternative treatments may include; acupuncture, massage therapy, herbal and nutritional therapies, yoga and chiropractic care.
By providing relevant, comprehensive data, the doctor or healthcare provider can better understand the nature of the pain and the potential benefits from specific treatments. The goals of a comprehensive pain assessment are to:. If the pain is being caused by an underlying disorder, treating said disorder will also relieve the associated pain. For example, if suffering from a bacterial infection, taking the appropriate course of antibiotics should clear up the infection, which should result in the elimination of the associated pain.
If the pain is moderate to severe, it may also be necessary to use analgesics painkillers , until the underlying cause has been treated. Analgesics are effective at relieving nociceptive pain but aren't effective at combating neuropathic pain. If suffering from a mild headache or a muscle strain, an over-the-counter pain reliever will usually be enough to ease the pain.
However, if the pain is more severe, the doctor may recommend something a lot stronger, such as an opioid analgesic. Opioid analgesics are the strongest painkillers, which are only available with a valid prescription. They are commonly used after surgery, for broken bones, burns, cancer, and under various other circumstances where the pain is likely to be severe.
Opioid analgesics work by binding to the opioid receptors in the brain and spinal cord. This causes a reduction in the pain messages being sent to the brain, thus reducing the feelings of pain. An opioid will usually be administered in gradually increasing dosages.
The aim of this method of administration is to achieve the ideal dose, which is when the pain is sufficiently relieved, whilst the side-effects remain tolerable. By taking too high a dose, the side-effects can become too much for the sufferer. Opioid dosages are generally much lower for infants and the elderly. Usually, these side-effects lessen with time. Opioid analgesics should always be taken with great care, as taking too much can be dangerous.
Opioids can also cause addiction - patients who use opioids frequently over long periods, can find themselves dependent on them. For these patients, if treatment were suddenly stopped, they would suffer withdrawal symptoms, which makes it important that their dosage is instead gradually tapered off.
Examples of opioid analgesics include:. Non-opioid analgesics are generally used to treat mild to moderate pain. Unlike opioid analgesics, they are not addictive and their pain-relieving effects do not dwindle with repeated use. Paracetamol is classed as a mild analgesic. It is typically recommended as the first line of treatment for pain, as it is safe for most people to take and side-effects are rare. It is commonly used to treat mild to moderate pain, such as headaches, toothache, strains and sprains.
Paracetamol is also an effective means of reducing fevers caused by viral infections, such as colds and flu. Paracetamol usually starts to work within an hour, with the effects lasting on average for several hours. Do not exceed the recommended dose if it isn't relieving your symptoms. Paracetamols mechanism of action is still not fully understood.
It is thought to work by blocking specific enzymes found in the central nervous system, which in turn, dampen the sensations of pain. Paracetamol is produced by multiple manufacturers in a wide variety of forms, including:. Unlike other pain-relief medication, paracetamol is considered safe to take during pregnancy and breastfeeding. If you are not sure whether paracetamol is safe for you, check with your doctor or pharmacist first — especially if:.
It is always advised to speak to your doctor or pharmacist should you develop any troublesome side-effects as a result of taking paracetamol.
These medicines can be obtained over-the-counter or as a prescription medicine, depending on the strength and dosage. NSAIDs are one of the most common pain-relieving medicines in the world. Low NSAID doses are effective for treating minor ailments, such as muscle aches, headaches, fever, minor strains and other daily discomforts.
These enzymes play an important role in the production of prostaglandins, which are chemicals like hormones. When the body is injured, the damaged tissue releases prostaglandins, which amplify the pain signals from the nerves, as well as causing the damaged tissue to swell. By blocking the enzymes that produce prostaglandins, NSAIDs will effectively reduce the swelling and decrease the sensations of pain.
Ibuprofen— is manufactured by many different companies and is available in a variety of forms, including; tablets , gels , sprays and liquids. Examples of pain relief treatments containing ibuprofen include:.
It is available in many forms and has a number of other uses besides pain relief. It can also be used to help reduce the risk of heart attacks and strokes. Some types of Aspirin can be bought over-the-counter, while others are only available on prescription. Aspirin that can be bought over-the-counter include:. Diclofenac — is used to treat mild to moderate pain, including the signs and symptoms of osteoarthritis and rheumatoid arthritis.
Diclofenac can be bought as a topical gel Voltarol , over- the-counter, or as an oral tablet with a valid prescription. Naproxen — is usually used to treat pain and inflammation caused by conditions like; arthritis, tendinitis, bursitis, ankylosing spondylitis, gout and period pain. Naproxen is available in immediate, slow, or extended-release formulas.
For chronic pain conditions, such as arthritis, the slow or extended release would be the preferred choice, as this form will not work fast enough to treat acute pain. Examples of Naproxen based products include; Naprosyn Tablets prescription-only-medicine , Vimovo modified-release tablets and Feminax Ultra over-the-counter pharmacy medicine. NSAIDs can be taken by most people, however, there are some who will need to be careful about taking them.
It is recommended to ask your pharmacist or doctor for advice if:. However, they should only be used on the advice of a healthcare professional. If deemed inappropriate, your doctor or pharmacist may recommend an alternative method of pain relief, such as paracetamol. These will tend to be more common if you are taking higher doses for long periods of time, or if you are elderly or in poor physical health.
The strengths and formulations of over-the-counter NSAIDs are generally better tolerated than the stronger prescription-only medicines. Anticonvulsants are a group of medicines used to treat seizure disorders, but can, in some cases, be used for pain-relief.
This is because anticonvulsants will also act as an adjuvant analgesic, which means it can inhibit certain types of nerve transmissions.
This action will lead to a reduction of neuropathic pain sensations, such as those caused by diabetic neuropathy or trigeminal neuralgia. Examples of anticonvulsants commonly used as pain relief include:.
Antidepressants can also act as an adjuvant analgesics. Although they aren't specifically formulated as a pain relief medication, they have proven effective at treating certain types of chronic pain. Antidepressants are believed to control chronic pain in two ways. Firstly, they alter the manner in which pain is perceived from the spinal cord to the brain. Secondly, they help to reduce anxiety, which will help to improve and regulate sleep. Antidepressants can be prescribed for pain relief, either in conjunction with other analgesics or on their own.
Adjuvant analgesics, like antidepressants, tend to be less effective in treating musculoskeletal pain, such as joint or back pain. However, they have proven effective at treating neuropathic pain and chronic headaches, such as tension headaches or migraines. Examples of antidepressants commonly used as pain relief:.
Nerve blocks are typically used to help treat neuropathic pain. There are groups of nerves, called a plexus or ganglion, which can often cause pain to specific regions of the body. These nerves can be blocked by injecting medicine directly into the affected area, numbing the nerves and blocking the pain signals sent to the central nervous system. Nerve blocks can be used for various purposes, including:. Transcutaneous electrical nerve stimulation TENS is a method of relieving pain by using mild electrical currents.
A TENS machine is usually a compact, battery-operated device, which has leads connected to adhesive electrodes. These electrodes are attached directly to the skin. The machine, when switched on, will deliver mild electrical impulses through these electrodes to the affected area s of the body. These electrical signals are designed to reduce the pain signals being sent to the spinal cord and brain, which should dull the pain sensations, as well as relaxing the surrounding muscles.
TENS stimulation can also stimulate the production of endorphins, which act as the bodys natural painkillers. TENS machines are a popular method of pain relief that can be used on a wide variety of conditions, including:. It is worth noting that TENS does not cure pain.
Using a TENS machine will only provide short-term relief whilst the device is being used. Also, TENS isn't suitable for everyone. It is important not to use a TENS machine without first seeking medical advice if:. It is commonly accepted that more research is needed to ascertain whether TENS is a reliable method for providing pain-relief.
If you are considering TENS treatment, it is recommended you speak to your doctor or pharmacist first. For some people, complementary and alternative medicines may also prove helpful for neuropathic pain relief. These treatments can include acupuncture and herbal remedies. Most alternative medicine is available without a prescription, however, it is always advised to consult your doctor before starting any new treatments for neuropathic pain. Both acute and chronic pain cannot always be prevented.
However, staying in good physical and mental health is probably the best method for staving off injury or illness, or at least helping to cope with it. Pain is a sensation triggered by the nervous system , usually as a response to an injury or illness. Acute pain is generally assessed by determining its location, intensity, time span, and possible cause. Scales may be used to attain a patient's subjective feeling of the intensity of pain at that moment, or during the last 24 hours or last week.
Commonly, a patient is asked to rate their pain on a visual analogue scale rating pain from 0 to , or a numerical rating scale 0 to 10 is used whereby 0 equals no pain and or 10 equal worst possible pain.
Assessing long-lasting pain is usually more difficult and may require reporting details of the pain as for acute pain , a physical examination, pain questionnaires that include physical and emotional functioning , and specific diagnostic tests. Acute pain is generally easier to treat than chronic pain, which may require input from a pain management team of doctors, nurses, and different therapists.
Pain is treated beginning with the weakest analgesic medicines, working up to the strongest. These medications are usually effective in treating mild or acute pain for injuries and infection as they reduce inflammation.
For moderate pain, weak opioids such as codeine are prescribed, while strong opioids, including morphine, hydrocodone, oxycodone, and fentanyl are taken for severe pain. Opioids work by interfering with impulse transmission.
These stronger analgesics are generally used in cases of chronic pain and may be used alongside medications for mild pain. Medicines used for treating other disorders may also relieve pain. Anti-epileptic drugs, antidepressants, and anaesthetics can be used for treating neuropathic pain. Other medicines reduce inflammation and thus alleviate pain, e. All medicines should be taken as your doctor has prescribed, which is usually at regular intervals over the treatment period.
The type of analgesic and the dose will be prescribed according to the intensity of pain as assessed on a pain scale. Particularly if you are prescribed a strong opioid, your doctor will want to monitor your condition and treatment.
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