Advances in Pain Treatment

Recent advances in pain management focus on safer, more effective non-steroidal anti-inflammatory medicines (NSAIDs), and on tamper-resistant versions of mainstay opioid drugs. New agents are being studied to treat specific kinds of pain, such as pain associated with joint disease and cancer. Antidepressants are also proving valuable to manage some types of pain. 

Newer pain therapies include tapentadol, the first topical and intravenous NSAIDS, and treatment for cancer pain. Tapentadol, a new chemical agent, treats moderate to severe pain and is especially useful for lower back and joint pain. Topical NSAIDS are now available in patch and gel formulations, which are expected to have less harmful effects on the stomach and liver, and the first intravenous form of acetaminophen (Ofirmev) was approved to control post-surgical pain. BEMA fentanyl relieves cancer pain that “breaks through” traditional pain medications. 

A number of tamper-resistant opioid medications aimed at discouraging drug abuse are entering medical practice. The first, Embeda, was introduced in 2009, followed by tamper-resistant formulations of Oxycontin in 2010 and Opana in 2011. Several years of observational studies are needed to learn whether these and other tamper-resistant opioids succeed in reducing abuse-related hospitalizations. 

Duloxetine (the antidepressant Cymbalta) has been approved for chronic lower back pain and osteoarthritis. Pregabalin (the antidepressant Lyrica) was approved in 2012 to treat neuropathic pain in diabetes, post-herpetic neuralgia, and spinal cord injury. 

In 2011, an innovative spinal cord stimulator (SCS) reached U.S. patients. SCS systems use implanted devices that send electronic pulses to block pain signals, a treatment used to control severe chronic pain. 

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