How is pain treated? What are the pros and cons of such treatment?

If pain is a natural defence mechanism of the body, why treat it?!

Simply put, while chronic pain leads to lower quality of life and, consequent, drop in productivity, severe pain can lead to neurogenic shock and even death. Imagine going through a surgery without anaesthesia! So, pain, in many situations, must be treated.

Unlike Anaesthetics, which temporarily and completely eliminate the sensation of pain and are used during surgery, Analgesics (Paracetamol, Ibuprofen, Lidocaine, Morphine etc.) work in different ways, depending on their classification. What’s important is to understand is that while analgesics can be used over a long period of time, anaesthetics are meant for temporary and short term, specific pain relief only.

One of the most popular family of analgesics used for treatment of pain, especially chronic pain, is what is known as Opioids. However, the use of opioids in treatment of pain is extremely controversial. The controversy stems from the following key points:

1. The body develops a tolerance for the drug. Therefore, over time a higher dosage is required for the same effect, leading to a loss in efficacy and increased risk of overdose mortality.
2. Patients exhibit physical dependence, such that cessation of use of the drug leads to withdrawal symptoms.
3. Opioids are addictive due to its euphoric and reinforcing effects.
4. Opioids are resold illegally.

In general, available analgesics (both opioids and non-opioids), are simply not effective enough to treat chronic and neuropathic pain. According to Dr. Clifford Woolf, a professor at Harvard Medical School, nearly 60% of patients with neuropathic pain in the US report no improvement with available analgesics.