Four Pharmacological Categories of Pain
In order to provide adequate pain control we must first diagnosis the
cause of each type of pain so we can use effective medications.
From a pharmacological point of view chronic pain can be divided into
four overall categories:
- Opioid responsive pain - pain that responds well to increasingly
large dose of opioid analgesics, such as codeine or
morphine. An example is soft tissue pain.
- Opioid non-responsive pain - Pain that does not respond to
opioid analgesia regardless how severe it may be. Other
drugs must be used. A good example is differentiation, or
nerve pain, caused by nerve destruction. The burning pain
associated with nerve pain is relived by an anticonvulsant.
muscle pain is relieved by some tranquilizers or injections of a
local anesthetic and a corticosteriod.
- Pain that is partially responsive to opioids - Pain such as bone
pain is only partially responsive to opioids and requires the use
of adjuvant drugs.
- Pain that is opioid responsive but the use of opioids is
inappropriate - pain such as bowel pain, including constipation or
irritable bowl syndrome, is a good example. "Squashed
stomach" is another example.
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