Explaining Your Pain

Latest Findings

The future is bright in terms of treating pain, says Scott Fishman, M.D., chief of the division of pain medicine at the University of California at Davis and author of The War on Pain (Quill, 2001).

"We have a better understanding of the impact pain has on someone's life," he says. "We're now decoding pain through neuroscience and understanding how the language of pain is relayed to the brain. We're seeing new breakthroughs daily: new pain receptors we didn't know existed and new effects of drugs."

Some people with neuropathic pain, which is caused by nerve injury, can benefit from the anticonvulsant drug Neurontin (gabapentin), even if they don't have convulsions. Antidepressants can block pain in patients who are not depressed. "The same molecules involved in regulating mood may be involved in regulating pain," says James Campbell, M.D., professor of neurosurgery at Johns Hopkins University and chairman of the board, American Pain Foundation.

Scientists have developed drugs that may be better pain medication for some patients than the common choices of aspirin, ibuprofen, and naproxen sodium (nonsteroidal anti-inflammatory drugs), which can cause a range of problems from upset stomach to serious gastrointestinal bleeding. The newer drugs include Vioxx (rofecoxib) for arthritis pain and menstrual pain and Celebrex (celecoxib) for arthritis. They inhibit COX-2 enzymes, which trigger pain and inflammation, without blocking COX-1 enzymes, which protect the stomach lining.

There are faster ways to stop pain too. For instance, Actiq (a form of the opiate fentanyl) is available as a flavored lozenge that dissolves in the mouth. This medication offers relief for cancer patients whose severe pain has broken through their regular narcotic treatment.

Continued on page 3:  Involve Your Pharmacist