Category Description Common Medications



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Additional file 2: General pain categories

Category

Description

Common Medications

Joint Pain (Arthritis/

Rheumatism)

OsteoArthritis – inflammation of joints – osteoarthritis is commonly associated with older populations.

Rheumatoid Arthritis – has a younger age of onset than Osteoarthritis; the body’s immune system starts to attack tissues, including joint tissues, which causes inflammation and pain.



  • Analgesics (pain relievers), from Paracetamol to opiates.

  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen & ibuprofen (Nurofen), ketoprofen (Orudis)

  • Corticosteroids (taken by tablet or injection) (prednisolone, cortisone injection)

  • Disease-modifying anti-rheumatic drugs (DMARDS) – suppress the immune system (biological DMARDS block substances that cause inflammation). Halting the inflammation reduces pain (Orencia, Humira) (Arthritis Information Sheet: Medicines and arthritis, 2012)

Chronic back or neck problems

Commonly pain in the lower back but can be in the neck.

  • Analgesics, including opioids

  • NSAIDs

  • Muscle Relaxants (benzodiazepines such as Valium or Xanax)

  • Antidepressants (Bogduk, 2004)

Frequent or severe headaches

Most common form of chronic headache pain is Migraine – chronic, moderate-severe headache & nausea.

Nerve Pain (Neuralgias) can also occur as a headache.



  • NSAIDS, including Naproxen or ketorolac injections

  • Triptan (Seratonin antagonist) such as Sumatriptan

  • Antidepressants (Tricyclic or SSRI’s) may help prevent migraines

  • Corticosteroid injection

  • Ergot alkaloid - Ergotamine (vasoconstrictor alkaloid often combined with caffeine for treatment of migraines, i.e. Cafergot)

  • Combination of paracetamol, codeine and antihistamine doxylamine (Dolased or Mersyndol) (Duckro, 1999) (Consumer Medicine Information: Mersyndol, 2007) (Consumer Medicine Informaiton: Dolased Analgesic, 2004)

Generalised Pain

Common chronic generalised pain conditions (pain throughout the body) include:

  • Complex Regional Pain Syndrome (CRPS) – intense, burning chronic pain caused by nerve damage

  1. Reflex Sympathetic Dystrophy (CRPS1) – chronic nerve disorder occurs most often in arms or legs after a minor injury

  2. Causalgia (CRPS2) - caused by injury to the nerve

  • Fibromyalgia – chronic widespread pain, fatigue and heightened and painful response to pressure.

  • Chronic fatigue syndrome – chronic muscle pain, joint pain, or headaches are some of the symptoms of this disorder.

  • Analgesics (including opioids)

  • NSAIDS

  • Antidepressants such as Duloxetine used for control of neuropathic pain conditions like Fibromyalgia.

  • Anticonvulsants such as Lyrica are also used for neuropathic pain conditions Fibromyalgia (Consumer Medicine Information: Lyrica, 2011) (Eustice, 2008)




Visceral Pain

Pain that is felt inside the body. Pain from the organs. Some common conditions involving visceral pain include:

  • Endometriosis – a condition affecting women caused by an excess of cells in the uterine cavity. Major symptom of this condition is recurring pelvic pain

  • Chronic Pancreatis - inflammation of the pancreas

Opioids are a common treatment for visceral pain (Giamberardino, 2005).

Other Neuropathic Pain Conditions

Neuropathic pain is caused by damaged or malfunctioning nerves. It is often described as different from other forms of pain and is often described as: electric shocks, burning, or “heavy” sensations. It can occur by itself or along with other forms of pain in many conditions. Some examples include:

  • Alcohol dependence and Diabetes can contribute to peripheral neuropathy (pain at extremities such as hands and feet)

  • Phantom pain – pain from a part of the body that has been lost, common experience of amputees and can become chronic.

  • Operations such as mastectomies or thorocotomy or amputations can leave ongoing chronic neuropathic pain at the affected site.

Neuropathic pain is difficult to treat compared to somatic pain. A combination of treatments can be used:

  • Antidepressants of the Tricyclic type

  • Anticonvulsants (Gabapentin)

  • Analgesics like opioids (may be ineffective but pain that does not respond to other treatments may respond to opioids)

  • Local anaesthetics

  • Ketamine (Helme, 2006)








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