Chronic pain can be incredibly difficult to manage. Each day is different, and it can be hard to determine what your pain levels will be. While movement and daily activities can be difficult with chronic pain, these conditions can lead to more than just physical difficulties.
Planning events or even just planning to make dinner can be nearly impossible. Managing relationships can become difficult, and maintaining a job may not be feasible for some. As a result, many people experience financial difficulties, a decreased quality of life, and even mental health struggles along with chronic pain.
That’s why finding effective treatments is so vital to the wellbeing of each person experiencing chronic pain. Each person’s pain is different, and there’s not one easy answer for how a person can manage their pain. Fortunately, there are many potential pain management solutions that can help with chronic pain.
What Medications Are Used for Chronic Pain?
Oral medications are common enough for those with chronic pain. Chances are you’ve tried many of them, including both over-the-counter and prescription medications.
NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are helpful for moderate to mild pain associated with inflammation or swelling. These work by blocking enzymes from releasing after tissue damage. They can be effective for both short and long-term use to deal with chronic pain. However, they can come with some side effects when taken in doses that are too high.
Acetaminophen
Another oral medication that may help address chronic pain is acetaminophen. It’s frequently suggested as first-line pain relief for moderate to mild pain. For example, acetaminophen is often used to manage back pain and osteoarthritis. It works by blocking prostaglandin, a hormone that can initiate inflammation. However, it doesn’t treat inflammation itself, only the pain involved. Like ibuprofen and other NSAIDs, it’s typically safe in appropriate doses. However, too much can be very hard on the liver.
COX-2 Inhibitors
These over-the-counter medications can relieve a wide range of aches and pains. However, there are prescription options for pain relief as well. COX-2 inhibitors are meant to do the same thing as over-the-counter NSAIDs but without the potential negative side effects. They reduce the risk of stomach damage while still blocking the COX-2 enzyme that gets released into the body after injury. Celebrex is the only COX-2 inhibitor that is currently FDA-approved.
Traditional Opioid Pain Medications
While traditionally used for post-surgical pain, opioids work much like the natural analgesic chemicals released in the brain. When they bind with opioid receptors, opioids can block sensations of pain. Opioids like morphine, hydrocodone, oxycodone, Percocet (an opioid plus acetaminophen), and others can be extremely effective pain relievers. However, they are not intended for long-term use and can be addictive.
Other Medications
In addition, anti-seizure medication and antidepressants have been used to manage pain. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) like Cymbalta and Effexor, as well as anti-seizure medications like Neurontin and Lyrica, may be effective at addressing chronic nerve pain. These medications can help to address nerve oversensitivity and the associated pain.
Compounded Oral Medications and Chronic Pain
When you’re facing chronic pain, it’s vital to utilize a tailored approach to address your symptoms. Unfortunately, one of the primary roadblocks to treating chronic pain is that there is no simple answer for everyone. However, compounded oral medications can help you use several approaches to manage your pain in the most effective way. Combining the right medications can work synergistically to target your pain and help you manage it successfully.
For many people, it can be difficult to take a range of oral medications each day, and some of them may even taste bad. While handfuls of pills and poor taste might not be a concern for everyone who takes medications for pain, it can be a real issue for others who are sensitive to the taste or have trouble swallowing pills and capsules. This can be a real barrier for chronic pain sufferers.
Compounding oral medications enables pharmacists to create liquid or other oral medications as an alternative to pills. Pharmacists can add or disguise flavors to fit your personal preference. In addition, multiple medications can be compounded into a single oral dose to reduce the number of pills you’ll need to swallow and ensure you stay on track with your pain medications.
Compounded Transdermal Patches and Pain Relief
Transdermal patches are another effective tool for chronic pain sufferers. This form of topical analgesic can be extremely effective with a simple application to the skin; the encapsulated medication compounds inside can cross into the bloodstream and provide full-body relief. Typically, transdermal patch medications like buprenorphine and fentanyl work by blocking the brain’s pain receptors or interfering with the way the brain experiences pain.
One of the primary benefits of transdermal patches is that they deliver the correct amount of medication over a longer period of time than oral pain relievers. These are typically placed on the skin for up to 12 hours a day, but during this time the pain medication will be delivered to the necessary area. In this way, they are both more effective and longer-lasting than most oral analgesics.
People who have difficulties with swallowing pills can benefit from this form of pain relief, as do people who may not always remember whether or not they’ve taken their medication. Pain relief is more consistent through this method than through oral routes. Additionally, the patches can be applied directly to the area that needs relief for a more targeted approach. Transdermal patches also reduce the risk of stomach issues that can come with oral analgesics, which can be incredibly beneficial for chronic pain sufferers.
This method is an excellent alternative to pills, but it’s important to also keep in mind a few precautions when using transdermal patches. Patches should only be used one at a time unless specifically instructed by a healthcare provider.
Transdermal patches should be applied to mucous membranes, such as the mouth. Be sure to wash your hands after applying a transdermal patch, as some of the medication can be transferred to other areas of the body if you touch them. This can irritate sensitive areas, like the eyes or other delicate skin. Finally, when you remove a transdermal patch, make sure that you fold the adhesive sides together so that any medication that may be left on the patch isn’t left for pets or children to touch.
Compounded Suppositories and Pain Management
Compounded suppositories can be an incredibly effective option for people who don’t wish to take oral medications. Suppositories don’t have to be an intimidating method for the administration of pain medication and can easily serve as an alternative to other routes. Suppositories can be inserted in the body through vaginal, rectal, or urethral openings and are made of a base substance that will melt at the body’s temperature. Once the base material melts, the compounded medication will be released for more targeted absorption.
Like topical analgesics and transdermal patches, compounded suppositories totally bypass the digestive system, eliminating the stomach issues that can arise with prolonged oral pain methods. They are also beneficial for those who frequently experience nausea and vomiting with their pain, as well as people who have trouble swallowing oral medications.
Suppositories are a frequent solution for people who suffer from IBD, constipation, hemorrhoids, or vaginal pain, as a suppository will target the specific areas where they are applied. Because they fully bypass the digestive system, they can be more effectively absorbed by those critical areas of the body. Suppositories can thus provide relief from inflammation and pain in targeted areas.
Like other compounded medication methods, compounded suppositories allow for customized formulations of ingredients that can best suit the needs of each individual patient. Suppositories can be especially helpful for specific populations, particularly the elderly and children, who often have difficulty with swallowing.
Compounded Sublingual and Buccal Preparations
These administration methods may be the least known of all compounded medications but are often the most effective. The term sublingual comes from Latin and means “under the tongue.” Subsequently, sublingual medications are placed under the tongue and allowed to dissolve before being absorbed directly into the bloodstream through the thin skin under the tongue. Buccal medications are administered between the cheek and gums. They’re a topical solution that is absorbed quickly, much like sublingual preparations.
One major benefit of sublingual and buccal administration methods is the way they’re absorbed directly into the bloodstream via thin skin and a rich network of capillaries. This means they can work very quickly and bypass the digestive system. For that reason, users can experience quick relief without the GI issues that can arise from orally administered medications. Also, because these methods bypass the digestive system, they also bypass first-pass metabolism in the liver. This prevents the medication from diminishing in concentration and becoming less effective.
Choosing the Right Compounding Medication
It can be difficult to know which method for chronic pain relief will be best for you. The best pain management solutions are different for everyone and typically depend on the type of pain you are experiencing, your sensitivity, underlying conditions, preferences, and other factors. If you have difficulty swallowing, suppositories, sublingual or buccal preparations may be the best option for you. These compounded medications allow you to get pain relief without having to swallow a pill.
For those who may need long-term relief or those who may not remember to take medication, transdermal patches can be incredibly helpful. These allow a person up to 12 hours of relief from pain and can be applied directly to the affected area, which is another major benefit. For those who need nearly immediate relief, sublingual and buccal methods are best. These medications can be absorbed directly into the bloodstream, and don’t lose potency like digested medications.
Compounding Medication for Pain FAQs
Still, have compounding pain medication questions? Browse these answers to our most frequently asked questions.
Compounding Medications for Chronic Pain
Each person’s chronic pain journey is different, and methods should be customized for each person to make sure that they’re receiving the best care possible to suit their needs. Personalized pain management is crucial to the quality of life for many patients. With the help of a compounding pharmacy, you can receive the precision compounded medications you need in the administration methods that suit you best.
Customized pain relief can be life-changing, and at Compounding Pharmacy of America, we want our patients to live the best lives they can. That’s why we strive to provide personalized compounded medications in any formulation necessary to provide effective pain relief. Contact us about our specialized compounding pharmacy services.
Sources:
Chief Operating Officer, The Compounding Pharmacy of America
Matthew Poteet, Pharm.D. graduated with Honors from Lee University with a Bachelors of Science in Biological Science. After his undergraduate training, he completed the Doctor of Pharmacy program at Mercer University Southern School of Pharmacy, graduating in 2004. Dr. Poteet has spent much of his pharmacy career on staff at two of the most prestigious academic teaching hospitals in the Southeast; Emory University in Atlanta and Vanderbilt University Medical Center in Nashville. At these institutions he received extensive experience and training in sterile products compounding.
He returned home to East Tennessee in 2010, where he has held the position of Pharmacy Director at two sterile products pharmacies in Knoxville. Matthew lives in Knoxville with his wife, Chris. Dr. Poteet is Tennessee’s first Board Certified Anti-Aging Pharmacist by the American Academy of Anti-Aging Medicine.
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