Neuropathic Chronic Pain Management

Written By: Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II Date: April 30th, 2009. Topic: Member Blogs.

One of the more challenging types of chronic pain involves neuropathic (burning, tingling, shooting, etc, nerve pain) symptoms that opiates do NOT adequately address. A report came out in October 2007 published by Science Daily that discussed why painkillers don’t work for neuropathic pain from fibromyalgia and states in part: “When the painkillers cannot bind to the receptors, they cannot alleviate the patient’s pain as effectively, Harris says. The reduced availability of the receptors could result from a reduced number of opioid receptors, enhanced release of endogenous opioids (opioids, such as endorphins, that are produced naturally by the body), or both, Harris says.” To read the complete report, please Click Here.

Neuropathic pain is frequent for diabetics, fibromyalgia, and shingles. Many pain management providers have tried alternative (“off-label”) medications such as Neurontin (Gabapentin) with varying degrees of success. Unfortunately, this medication sometimes causes significant side effects for many people. Fortunately, there are other medication choices such as pregabalin (Lyrica).

For example, the report presented at the American Society of Anesthesiologists (ASA) 2008 Annual Meeting regarding the Perioperative (the time period surrounding a patient’s surgical procedure; this commonly includes ward admission, anesthesia, surgery, and recovery) administration of pregabalin significantly decreases the incidence of neuropathic pain at 3 and 6 months after total knee arthroplasty (TKA), according to research. The report concluded that this procedure significantly reduced the patients’ pain. To see the entire report please Click Here.

In June of 2008 the Food and Drug Administration (FDA) approved duloxetine HCl delayed-release capsules (Cymbalta) for the management of fibromyalgia. Previously, only pregabalin (Lyrica; Pfizer, Inc) was approved to treat this painful condition. Some see this as a major victory in validating fibromyalgia as a legitimate diagnosis while others see this as a greed-driven pharmaceutical ploy. Having worked with many patients who were diagnosed and living with the pain and problems of fibromyalgia I am firmly in the first camp.

To read more about this topic please go to our 2008 Research Archive and scroll down to the Cymbalta posting. Also, near the end of the page is a posting titled Neuropathic Pain Management.

If you would like to be skill trained in a collaborative treatment smodel we have two Addiction-Free Pain Management®Trainings scheduled this Spring — one in Sacramento California in May and the one at Valley Forge Medical Center and Hospital in June. It’s not to late for people to sign up and in fact by mentioning this Blog I will make sure you get a $20 discount for either training. To get this discount you must call Ellen at (916) 575-9961 and ask her for the discount. Also, for these and other upcoming trainings you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are living with chronic pain, especially if you’re in recovery or believe you may have a medication or other mental health problem and want to learn how to develop a plan for managing your pain and medication effectively, please go to our Publications page and check out my book the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

To listen to a radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.