PAIN MANAGEMENT COMPOUNDING
Pain Management Compounding
Pain management is essential because, even when the underlying disease process is stable, uncontrolled pain prevents patients from working productively, enjoying recreation, or taking pleasure in their usual roles in the family and society.
Chronic pain may have many contributing factors, and therefore can be much more difficult to manage than acute pain, requiring customized protocols to meet the specific needs of each patient.
What is Pain?
Pain is the most frequent reason people seek medical attention. It is one of the most common symptoms of disease and can significantly interfere with a person’s quality of life.
It includes a nociceptive (sensory) component, caused by stimulation of nerve fibers and an affective (emotional) component. Pain is usually transitory, but some painful conditions may persist for years. Sometimes pain arises in the absence of any detectable stimulus, damage, or disease.
Pain Pathways
Nociceptive Pain (tissue damage)
- Nociceptors are the nerves which sense and respond to parts of the body which suffer from damage. They signal tissue irritation, impending injury, or actual injury. When activated, they transmit pain signals (via the peripheral nerves as well as the spinal cord) to the brain.
- Somatic and visceral causes
- The pain is typically localized, constant, and often with an aching or throbbing quality.
- This type of pain tends to respond well to opioids.
Neuropathic Pain (nerve damage)
- Pain caused by damage or dysfunction to neural pathway of the peripheral or central nervous system. Pain signals continue to be generated in the injured/damaged area long after it has healed.
- The pain can be continuous or intermittent burning, shooting, or electrical shock qualities.
- The pain may persist for months or years beyond the apparent healing of any damaged tissues.
- This type of pain is frequently chronic, and tends to have a lesser response to assisting with opioids, but may respond well to other drugs.
Importance of Targeting Different Pathways
Transdermal Creams
Optimal assistance may involve the use of medications that possess pain-relieving properties, including some antidepressants, anticonvulsants, antiarrhythmics, anesthetics, antiviral agents, and NMDA antagonists. By combining various agents that utilize different mechanisms to alter the sensation of pain, physicians have found that smaller concentrations of each medication can be used.
Arthritis
Ankle Pain
Back Pain
Burning Foot Syndrome
Carpal Tunnel Syndrome
CRPS (Chronic Regional Pain Syndrome)
Diabetic Neuropathy
Fibromyalgia
Foot Pain
Gout
Head, Neck, and Facial Pain
Knee Pain
Migraines
Muscle Spasms
Myofacial pain
Neuropathic Pain
Post Herpetic Neuralgia
Shingles
Shoulder Pain
Tennis Elbow
TMJ/TMD
(Temporomandibular Disorders)
We work together with the prescribing physician and the patient to solve problems by customizing medications that meet the specific needs of each individual. Please contact our compounding pharmacist to discuss the appropriate dosage form, strength, and medication.
Low Dose Naltrexone & Pain Management
An Excerpt from The use of low-dose naltrexone (LDN) as a novel anti-inflammatory option for chronic pain by Younger, Partkitny, and Mclain
“Low-dose naltrexone (LDN) has been demonstrated to reduce symptom severity in conditions such as fibromyalgia, Crohn’s disease, multiple sclerosis, and complex regional pain syndrome. We review the evidence that LDN may operate as a novel anti-inflammatory agent in the central nervous system, via action on microglial cells. These effects may be unique to low dosages of naltrexone and appear to be entirely independent from naltrexone’s better-known activity on opioid receptors.”
As the off-label use of LDN has gained popularity, it has been widely accepted as an alternative medicine option and is used for various medical conditions. These off-label conditions include:
Multiple Sclerosis
Complex Regional Pain Syndrome
Fibromyalgia
Crohn’s Disease
Gastrointestinal Disorders
Cancer
Skin Conditions
Autism
Inflammatory Bowel Disease
…and more.