Adjunct pain treatment

Adjunct pain treatment

In situations of chronic pain, adjunctive therapy is often added to optimize analgesic therapy, to reduce side effects of the primary agent, or in situations where the therapeutic value of the primary agent is in question (i.e. neuropathic pain).

NSAIDs and corticosteroids are thought to decrease pain by providing anti-inflammatory action and decreasing edema that causes pressure around nerves.

Tricyclic antidepressants (TCA’s) are thought to be pain modulating agents (by

NE and 5HT inhibition), local anesthetics (by inhibiting Na channels) and cause sleep and reduce anxiety (H1 antagonism).Anticonvulsants have been used in various types of neuropathic pain as they are thought to exert local anesthetic activity (by blocking Na channels) and decrease neuronal transmission.

Lastly, adjunctive pain management can be tissue specific, such as in the case of adding a bisphosphonate to a patient with metastases in bone.