Join our community

Facebook/avncharityuk  @avncharityuk

Add EasyFundraising to your bookmarks and use each time you shop on-line

Add EasySearch to your bookmarks and use each time you search on-line

Members' feedback

"I'm finding it shocking and surprising the number of new people joining the community. Let me explain. I was diagnosed with AVN first in both knees back in 2005, over the next few years it was found in both hips and shoulders. I had never come across AVN before and felt like I was the only person with it, I was always having to explain to people what it was."
 
"Thankfully I found this website and community over a year ago and realised I was not the only one suffering with AVN, it has been such a help talking to fellow sufferers who understand what I am going through."
 
Text taken from a recent post in our community forum.

Join us

If you are suffering from avascular necrosis AVN Osteonecrosis ON, or are close to someone that is, please consider joining our AVN Charity UK community. You will find many shared experiences about AVN and how it affects each of us differently, importantly there are also excellent success stories about the road to "Pain Free".
 
We also welcome any health professionals who are involved in any way with Avascular Necrosis AVN, please let us know how you think you can help.
Article Index
Pain from AVN
Pain - Page 2
Pain - Page 3
Pain - Page 4
All Pages

..../Cont. Pain and pain management. Page 2 of 4

There are many ways to manage persistent pain. Hew we try to summarise.

Pain relief - Drugs

Analgesics

Pain reliefPain relief

i) Non-steroidal anti-inflammatory drugs (NSAIDs) have been used for 150 years in Europe, and probably for a great deal longer in the East, in the form of willow bark extract. Useful when given appropriately, examination of the chronic pain population indicates that a very high number of patients are intolerant to these drugs because of gastrointestinal or other side-effects. There are two possible hypotheses for this. Firstly, chronic pain sufferers tend to be somewhat hypochondriacal and intolerant of body symptoms in general and thus less tolerant of real or perceived side-effects when taking medication. The second is that there may be a sub-group of patients whose pain is not managed well early on. NSAIDs may produce side-effects, limiting their use. With no pain relief, the patient fails to exercise. This hampering of their rehabilitation because of inadequate analgesia may contribute significantly towards the chronicity.

i) The use of opioid drugs for the management of chronic non-malignant pain is fraught with difficulties, some real and some perceived. Morphine itself has tended not to be prescribed for chronic pain, because of a fear or stigma concerning Morphine. Physicians may fear dependence, tolerance and side-effects. There is a wide difference of opinion, which is still to be resolved; however, some patients can have their pain adequately controlled with opioids, without an unacceptable level of addiction problems. The potential risk of addiction remains a very real problem for a minority. Also, a significant number of patients with chronic pain complain of bothersome side-effects from medication. Mobility and distress must be monitored and benefits must accrue in both these parameters, as well as in reduction of pain.

ii) In the UK and in the USA, traditionally most patients with chronic pain receive an opioid derivative such as Codeine, Dihydrocodeine or Dextropropoxyphene. In the past Pentazocine and Buprenorphine enjoyed a passing vogue but are now little used. Pentazocine proved to have unacceptable side-effects, and Buprenorphine, originally thought to be non-addictive, was shown to have addictive potential and since being classified as a controlled drug has enjoyed little popularity. Nefopam has limited efficacy and popularity, and Meptazinol is short-acting, and often associated with an unacceptable level of side-effects.
From - The Pain Web



Last Updated on Thursday, 19 March 2015 22:02