Acute & Chronic Pain

here are many painkiller medications available, for both acute and chronic pain. These include non-steroidal anti-inflammatory drugs [NSAIDs - aspirin, ibuprofin, Arcoxia ,Atopen], opiates [tramadol, codin, oxycodone, morphine] and skeletal muscle relaxants [SMRs]. In addition, there are also non-drug treatment options such as physiotherapy, acupuncture, massage, exercise and more. The preferred treatment method is determined after an accurate diagnosis that includes, among other things, the duration of the pain, location of the pain, whether the pain is radiating or not, the patient's age, background diseases and other medications that the patient is taking.

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Most of the abovementioned drugs have demonstrated efficacy, but their side effects can be, in some cases, severe and may even cause addiction and death following regular and prolonged use. A study from Denmark published in 2017 in the European Heart Journal involving 29,000 patients found that the use of over-the-counter NSAIDs, such as Neurofen, Advil and Diclofenac, increased the risk of cardiac arrest by 31-50% (3). A Canadian study published in the British Medical Journal involving 446,763 patients showed similar results with short-term use of these drugs of only 7 days (4). At the same time, the use of opiate drugs has made headlines since over 400,000 Americans have died from the use of these drugs in the last decade and, according to authorities, every 3 minutes a woman is admitted to ER for misuse of such drugs (5).

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Following these developments, the US Food and Drug Administration (FDA) issued new guidelines for physicians treating chronic pain, to consider recommending non-drug alternatives such as acupuncture and chiropractic methods as first line of treatment (6). In Israel, too, due to the significant increase in the use of addictive narcotics, the Ministry of Health changed its prescription guidelines for pain management (7).