Encyclopedia of Health and Medicine

366 Pain and Pain Management
Massage Therapy
Therapeutic massage relaxes stiff muscles and
increases the flow of BLOOD. These effects improve
flexibility and movement, and bring pain-relieving
chemicals (the body’s own substances or medications
in the blood circulation) to the area. Massage
therapy is effective for many types of pain and
helps relieve the emotional stress that often
accompanies conditions of chronic pain.
Herbal and Botanical Remedies
Numerous herbal and botanical remedies have
pain-relieving actions. Some are effective for specific
discomfort, such as DONG QUAI for dysmenorrhea
(menstrual cramps) and FEVERFEW for
migraine headaches. These herbs appear to block
the release of PROSTAGLANDINS, substances the body
produces that cause INFLAMMATION. Research studies
also support the effectiveness of CHONDROITIN
and GLUCOSAMINE, chemical compounds that occur
naturally in the body. These compounds block the
actions of enzymes that destroy connective tissue.
Taken as nutritional supplements, chondroitin and
glucosamine may be as effective as NSAIDs for
relieving the inflammation of osteoarthritis that
causes pain. Herbal and botanical products for
pain relief may interact with OVER-THE-COUNTER
(OTC) DRUGS and prescription medications, notably
NSAIDS.
Benefits and Risks of
Alternative Pain Relief Methods
Some alternative pain methods can interact or
interfere with conventional therapies the doctor
prescribes or recommends. It is important to discuss
alternative methods with the doctor to effectively
integrate them with other therapeutic
approaches and to minimize the risk for complications,
including worsening of the condition or
interactions with other methods.
See also CRANIOSACRAL MASSAGE; MEDICINAL HERBS
AND BOTANICALS; MIND–BODY INTERACTIONS; OSTEO-
PATHIC MANIPULATIVE TREATMENT (OMT); REFLEXOLOGY;
REIKI; SAME; YOGA.
analgesic medications Drugs, products, and
preparations that relieve PAIN, often called pain
relievers. Some kinds of analgesic medications,
such as OPIATES and other NARCOTICS, solely relieve
pain by acting on neuroreceptors in the brain.
Other analgesics have multiple effects, such as
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS),
which also relieve INFLAMMATION and FEVER, and
acetaminophen, which also relieves fever. Other
kinds of medications primarily prescribed for other
therapeutic uses are effective for pain relief in certain
pain syndromes. Some ANTIDEPRESSANT MEDICA-
TIONS, antiseizure medications, beta-antagonist
medications (beta-blockers), and calcium channel
antagonists (calcium channel blockers) can provide
relief from and often can prevent NEUROGENIC
PAIN (pain arising from injury to nerves) and
migraine HEADACHE.
Routes of Administration
Analgesic medications are available in numerous
formulations for several different ROUTES OF ADMIN-
ISTRATION. The most common route of administration
for analgesics is oral—pills, tablets, capsules,
and liquids taken by mouth. Some medications
absorb poorly through the gastrointestinal tract so
are far more effective in other forms such as transdermal
patch, suppository, and injection. Topical
medications applied to the SKIN may relieve MUSCLE
and JOINT pain. The choice of both the analgesic
medication and its route of administration affects
how rapidly and how completely the medication
relieves pain.
Oral The processes of digestion—how much
and what kinds of food are in the STOMACH and
gastrointestinal tract as well as individual variations
in the digestive process—affect how rapidly
oral medications enter the BLOOD circulation. Most
oral analgesics begin to have an effect within 20 to
45 minutes and stay in the bloodstream at a therapeutic
level for two to six hours. Some long-acting
formulations are effective for 12 to 24 hours.
Transdermal patch Some products are available
in transdermal patches, small adhesive
patches placed on the surface of the skin, which
get the medication rapidly into the blood circulation
via absorption through the skin. The transdermal
patch is also effective for delivering
sustained-release medication (medication that
slowly absorbs over a planned period of time,
often 48 to 72 hours).
Topical Topical medications are also applied to
the surface of the skin though are not absorbed