Dr. Charles Orth D.O.

Orthopedic Surgeon
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The Treatment of Pain
The Treatment of Pain

There are various ways to treat pain whether it is from surgery, broken bones, sprains, strains, swelling or nerve related pain.

We shall cover some of the common medications and other things to consider, as one or more may be needed in your care,
and combinations of these may be beneficial. We find it easier to start with the simplest of medicines and work our way up if needed, as if a surgery is upcoming then stronger medicines tend to work better when you really need them. If you are on stronger medicines prior to an injury we will have a harder time managing your pain because of the prior tolerance to those medications, and we will have to work closely with you in this regard.

Common Non-Nacotic Medications:
  Acetometaphin (Tylenol):is a non-opiate, non-salicylate(ASA) pain reliever.
 Celebrex: is a nonsteroidal medicine that inhibits cyclooxygenase-2 & reduces prostaglandin synthesis(COX-2) inhibitor.
 Motrin: is a nonsteroidal medicine that is a cyclooxygenase inhibitor and reduces prostaglandin & thromboxane synthesis.
 Lidoderm Patch: is an amide type local anesthetic topical agent that stabilises neuronal membranes.
 Aspirin: inhibits production of prostaglandins especially those involved with inflammation.
 Lyrica: binds with alpha2-delta sites in CNS that work with Ca Channels.
 Cymbalta: is a (SRI) serotonin reuptake inhibitor involved in the CNS

Narcotic Pain Medications:



 Hydrocodone(vicodin, norco,): these are believed to work at the CNS  opioid receptor level.

 Oxycondone: opioid agaonist mediated by receptors U & K in CNS

 Oxycontin: opioid receptor binding

 Nucynta:mu opioid receptor binding action.

 Ultram: mu opioid receptor binding action and weakly inhibits norepi/serotonin reuptake.

Dilaudid: CNS opioid receptor binding, exact mechanism unknown.