Parenteral Pain Management

Pain control is one of the most challenging tasks that family physicians face when providing care for patients.

Despite recent advances in the understanding of pain management, pain is often untreated or undertreated. Consequently, a significant number of patients needlessly suffer physical pain and mental distress.

The challenge for physicians is to provide aggressive pain management and implement strategies to alleviate suffering in patients with pain that is difficult to control.

Pain Syndromes and Management

Pain syndromes can be nociceptive (somatic or visceral pain) or neuropathic (continuous dysesthesias or chronic lancinating or paroxysmal pain).

With correct identification of the pain syndrome, physicians can provide better pain control using appropriate adjuvant therapies and interventions. It is still important to apply basic pain management principles.

Nociceptive Pain

Nociceptive pain is the result of actual or potential tissue damage and includes somatic and visceral pain.

Somatic pain presents as an aching, throbbing, stabbing and/or pressure sensation, and its source is skin, muscle or bone.

Visceral pain presents as a gnawing, cramping, aching, sharp and/or stabbing sensation, and it comes from internal organs.

Somatic Pain. Skin or musculoskeletal pain usually responds to nonsteroidal anti-inflammatory drugs (NSAIDs). Patients who cannot tolerate NSAIDs because of gastrointestinal side effects may be able to tolerate choline magnesium trisalicylate (Trilisate).