Pain Management

USC School of PharmacyMaya Shehayeb & Angela Shen

January 8, 2015

Background

100 million in the U.S. have Chronic Pain.

The pain lasts for weeks, months, or years.

It can be severe enough to cause difficulty

sleeping or depression.

12 million peopleCancer

23 million peopleHeart Attack & Stroke

25 million peopleDiabetes

100 million peoplePain

How much pain are you feeling?

Over-the-Counter Pain Medications

• Tylenol

• Advil/Motrin

• Aleve

• Aspirin

Tylenol (acetaminophen)

325 mg 500 mg 650 mg

Take 2 tablets

every 4-6 hours

Take 2 tablets

every 6 hours

Take 2 tablets

every 8 hours

Relieves pain and headache, lowers fever.

Do not take Tylenol if you have liver damage.

Tylenol (acetaminophen)

Acetaminophen can cause liver damage

if taken inappropriately.

Do not take more than 2000-3000 mg/day

Avoid other products containing acetaminophen

when taking Tylenol:

Advil or Motrin (ibuprofen)

• To relieve pain and inflammation such as

headache, backache, and arthritis.

• Stop taking 1 or 2 days before surgery.

200 mgTake 1 tablet every 4-6 hours

• Very similar to Ibuprofen but lasts longer

(relieves pain up to 12 hours)

• Can be too strong for 65 years and older

Ibuprofen may be a better choice

Aleve (naproxen)

220 mg

Take 1 tablet every 8-12 hours

• Always take these medications with food.

• They may bother the stomach (or cause

stomach bleeding if you already have an

ulcer).

• Be careful if you have asthma, kidney

problems, or high blood pressure.

Advil, Motrin, or Aleve

(ibuprofen or naproxen)

Bayer (aspirin)

325 mg, pain81 mg, heart protection

only if Dr. recommends it

• Relieves headache or muscle pain.

• Can cause stomach bleeding. Avoid if you have

an ulcer. Stop taking a week before surgery.

•Avoid if you have asthma, kidney problems, or

gout. For adults only.

Common Pain Conditions

1. Headache

2. Back/Neck Pain

3. Arthritis

4. Nerve Pain

Types of Headache

• Tension

• Migraine

• Sinus

• Medication Overuse*Do not use headache medications

for more than 3 times a week or

longer than 3 months.

Tension Headache

• Squeezing of forehead and back of head

• Caused by stress or emotional anxiety

Migraine

• Throbbing pain on one side of face

• Can see flashing lights, hallucinations and have

difficulty speaking

• See your doctor, if undiagnosed

Sinus Headache

• Pressure behind the forehead and cheeks.

• Congested sinuses.

• Pain is worse when awaken, lean forward, or

blow nose.

Humidifier Elevate Head

Types of Arthritis

• Rheumatoid Arthritis

• Osteoarthritis

Rheumatoid Arthritis

• Stiff hands and feet in the morning for more than 45 minutes

• Swollen joints (can be on one side of the body only)

• Fever and fatigue

See your Doctor

Osteoarthritis

• Bones rub against each other and wear down the cartilage between them.

• Knees, hips, and lower back are stiff in morning for < 30 minutes. Pain gets better with movement.

Protruding Bones Stiff Joints

Osteoarthritis Treatment

Low-impact exercises: walk, bike, swim

Cushioned shoes Tylenol

Glucosamine Chondroitin

Use with caution if you have a shellfish allergy or diabetes.

1500 mg daily 1200 mg daily

• Can prevent loss of and rebuild cartilage

• Start with Glucosamine alone (add Chondroitin after 3-5 months, if working)

Osteoarthritis Treatment

• Capsaicin

• Menthol: causes cooling

• Methyl Salicylate: causes warmth, do

not use right after a bath or with a

heating pad. For adults only.

Topical Products: for local pain relief

Lower Back Pain

Prevent Back Pain

Do not lift with your back. Lift with your knees.

Hold the load close to your body.

Prevent Back Pain

Good Posture

Sleep on a Firm Surface

Treat Back Pain

Ibuprofen

Ibuprofen

Naproxen

For pain and

inflammation

Right after an injury…

At the start, Cold pack

20 minutes, 2-3 times a day

After 2-3 days, Heat pack

20 minutes, 3-4 times a day

Rest for 2-3 days

Nerve Pain

Tingling, shooting pain and numbness

Can try Capsaicin, but should go see your doctor

Capsaicin

• For nerve and muscle pain

• Apply a thin layer 3-4 times a day. Causes a

warmth and burning that will go away 3 days

later, if regularly applied.

• Maximum relief after 14 days of regular use.

See your doctor if you have:

fever > 104˚F or >1 day

sore throat

swelling

loss of movement

severe pain

abdominal pain, nausea, or vomiting

Use over-the-counter medications for

LESS than 7 days

If you need more help or have questions,call the American Chronic Pain Association

(800) 533-3231