Do You Suffer From Chronic Pain?
You are not alone, many people suffer needlessly with chronic pain, such as arthritis, fibromyalgia, migraine headaches, or nerve and muscle pain. Uncontrolled or unrelieved chronic pain interferes with all aspects of a person’s life, from your ability to concentrate on a project, while at work, exercising or playing sports, or interfering with your interpersonal relationships with family and friends. You can’t forget the pain. The management of pain often presents a major challenge, not only to the patient, but also the prescriber and the pharmacist. The good news is that chronic pain can be managed.
The Solution to Chronic Pain
Compounding often affords the best solution for the effective management of chronic pain. Working closely with you and your Prescriber, the Pharmacist can develop a compounded medication, formulated to personally take into account the location and type of pain and your tolerance for pain, providing you with the best possible strength and dosage form for maximum pain relief.
Examples Of Chronic Pain Solutions
Compounding pharmacies formulate solutions that are especially suited to meet the diverse needs of chronic pain associated with the following:
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Migraines Headaches– By formulating pain medication to be administered through nasal sprays, transdermal pain gels, flavored troches or lozenges, that provide fast relief, while bypassing the gastrointestinal tract, with optimal results without stomach irritation.
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Arthritis– By formulating pain medications that eliminate the problems of stomach irritation and other unwanted side effects by combining oral medications into topical gels, creams, or sprays that can be directly applied to the area of pain
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Nerve and Muscle Pain– By formulating topical anti-inflammatory medications that are incorporated into a variety of transdermal gels, including pluronic lecithin organogels (PLO), that allow for the absorption of the drug through the skin, avoiding gastric side effects.
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Fibromyalgia– By formulating the sometimes multiple medications needed to treat the syndrome, into a single topical gel, ready to be applied directly to an affected area, or they can be combined into a single capsule, resulting in better compliance.
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Sports Related Injuries– By formulating specialized topical anti-inflammatory creams and gels that can include anesthetic agents and muscle relaxants, at the same time avoiding the systemic side effects of oral medications
Non-Steroidal Anti-inflammatory Drugs (NSAIDs)
The most commonly prescribed medications for pain are Non-Steroidal Anti-inflammatory Drugs or (NSAIDs). They are used by prescriber to relieve pain in the majority of patients. These drugs have side effects, such as stomach upset, gastritis, and ulcers, with long term oral use. However, Compounding pharmacists have developed a therapeutic alternative to oral NSAIDs, a variety of NSAID transdermal gels. These gels require a prescription specifically written for a patient by a licensed Prescriber. Each product is individually formulated for that patient.
Facts about NSAID transdermal creams:
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There is less concern about upset stomach and gastritis with NSAID gels, since less then 3% of the drug reaches systemic levels in the body, reducing the potential for any side effects.
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The amount of gels needed to treat pain and inflammation is small, usually about 1/4 teaspoon, or enough to cover the affected area. Application is generally three time daily to achieve sufficient relief of pain and reduce inflammation.
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Most NSAIDs are available in a transdermal gel. The most commonly prescribed NSAID creams are Ketoprofen, Naproxen, Ibuprofen, Piroxicam, Indomethacin, and Diclofenac.
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Other drugs can be added to the NSAID gel to solve secondary problems. For example:
Muscle relaxants for muscle strain
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Neuroleptics for nerve pain
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Other analgesics for increased pain relief
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Local aesthetic agents
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NSAID transdermal creams cost on an average less than $1.00 per day.
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NSAIDs may be covered by your insurance company. In general, Worker’s Compensation Insurance will pay the entire cost of the creams.
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NSAID transdermal gels are not commercially available from drug manufacturers because the drugs are what is termed off patent, and there is no motivation for drug manufacturers to invest millions of dollars to develop a product without patent and profit protection.
Sports Medicine
Have you ever suffered from a sports injury like tennis elbow, sprained wrist or ankle, swimmer’s ear, fungal infections, sore back, swelling , or leg cramps? Have you ever wondered by the Pros seem to recover faster from the aches and pains than you do? The answer is that their trainers and physicians are advocates of compounding. Compounding has solutions for all your sports related injuries. Athletes of every type, whether professional, amateur, or just an exercise junky, who suffer from acute or chronic injures that may result from repetitive sports, can benefit from compounding.
The compounding pharmacist in association with your trainer and prescriber will formulate a medication designed for your body type and level of activity. Products that are available commercially are limited in dosage strengths and forms. This individualized compounded formula with the appropriate dosage strengths, potency and method of delivery may be just what you need to put you back into the game.
Compounding Areas for Sports Injuries:
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Blisters– Flexible collodion preparations
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Fever Blisters– Lip balms with or without sunblock
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Rehydration– Sports drink formulas
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Athlete’s Foot– Topical antifungals
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Muscle Cramps– Speed gels, topicals
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Wounds– Polyox bandages, tissue-regenerating gels, protective ointments
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Calluses– Creams
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Carpal Tunnel– Transdermal pain gels
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Dry Skin– Moisturizing creams, lotions
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Nail Fungus– Antifungal formulations
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Hemorrhoids– Rectal rocket suppositories
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Sprains– Transdermal pain gels
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Trigger Point– Transdermal pain gels
Fibromyalgia
Fibromyalgia, Fibrositis, or Myofascial Pain syndrome is defined by the American College of Rheumatology as a chronic pain syndrome in combination with hyperalgesia. Most health care professionals consider this syndrome to be a minor rheumatism. This clinical syndrome affects millions of Americans, mostly middle-aged women usually beginning between the ages of 20 and 30. It comes and goes in cycles and is characterized by generalized musculoskeletal pain, stiffness, chronic aching, sleep disturbance and fatigue. Certain tender points are important in it’s diagnosis. These are described as specific anatomical sites with reproducible tenderness upon touch. The syndrome is aggravated by such factors as emotional stress, fatigue, unaccustomed exertion and damp or cold weather. There is no clearly defined cause, some feel very strongly that it may be caused by an inflammatory reaction. There is also some evidence that the syndrome is hereditary, passed on from generation to generation.
Medications, physical therapy, massage and other forms of treatment are used to provide relief, these are not generally adequate in the long run. One logical class of drugs, nonsteroidal anti-inflammatory drugs, seems to show more promise in providing relief, and are being employed in the treatment of fibromyalgia.
Ketoprofen, one of the most studied nonsteroidal anti-inflammatory drugs, has been shown to be effective in the treatment of fibromyalgia, when administered topically. This application provides several advantages, it delivers the drug directly to the pain site, it produces a high local drug concentration, and without high systemic concentration of the drug. The use of a transdermal nonsteroidal anti-inflammatory drug, such as ketoprofen, as part of a logical drug therapy regimen, could lead to reduced inflammation that may ease stiffness, aching, and fatigue, thereby greatly improving the fibromyalgia patient’s overall quality of life.
Lifestyle changes that may help the patient with their symptoms:
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Stress reduction - Develop a plan to deal with daily stress
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Regular Mild Exercise
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Adequate Sleep
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Education
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Medications
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Other techniques - Some people obtain relief from massages, hot baths and relaxation techniques
