Pain Management

There are no drugs specifically for phantom limb pain. But medicines for other conditions, from depression to epilepsy, may help:

Other painkillers. A few other types may help with phantom limb pain, including:

• Tricyclic antidepressants
• Anticonvulsants
• Opioids

• NMDA receptor antagonists, such asketamine and dextromethorphan
• Over-the-counter medicine, such as aspirin and acetaminophen
• A shot of a pain-blocking drug where you got the amputation

Many types of arthritis can affect your elbow, but the main ones are rheumatoid arthritis and osteoarthritis. Rheumatoid arthritis is the most common type of arthritis in the elbow. When you have it, your immune system attacks your body’s healthy tissue and causes swelling in your joints. You get osteoarthritis when your elbow cartilage breaks down over time, which means the bones rub together and cause pain and stiffness.

A sudden, severe chest pain following vomiting or a procedure involving the esophagus coul signal a rupture or tear in the esophagus.

Myofascial pain symptoms usually involve muscle pain with specific “trigger” or “tender” points. The pain can be made worse with activity or stress. In addition to the local or regional pain associated with myofascial pain syndrome, people with the disorder also can suffer from depression, fatigue and behavioral disturbances.

Topical pain killers, or analgesics, are sprayed on or rubbed into the skin over painful muscles or joints. All are designed to relieve pain, but different products use different ingredients.

A spinal headache can occur as a result of a procedure such as a spinal tap (lumbar puncture) or epidural block (such as that performed during a woman’s labor and delivery). During a spinal tap, a needle is placed within the fluid-filled space surrounding the spinal cord. This creates a passage for the spinal fluid to leak out, changing the fluid pressure around the brain and spinal cord. If enough of the fluid leaks out, a spinal headache may develop.

Causes of neck pain include:

• Abnormalities in the bone or joints
• Trauma
• Poor posture
• Degenerative diseases
• Tumors
• Muscle strain

The treatment of soft tissue neck pain often includes the use of anti-inflammatory medication such as ibuprofen (Advil or Motrin) or naproxen (Aleve or Naprosyn). Pain relievers such as acetaminophen (Tylenol) may also be recommended. Depending on the source of pain, drugs like muscle relaxers and even antidepressants might be helpful. Pain also may be treated with a local application of moist heat or ice. Local corticosteroid injections are often helpful for arthritis of the shoulder. For neck pain movement, exercises may help. For cases in which nerve roots or the spinal cord are involved, surgical procedures may be necessary. Your doctor can tell you which is the best course of treatment for you.

Researchers don’t know exactly what causes phantom limb pain. One possible reason is that nerves in parts of your spinal cord and brain “rewire” when they lose signals from the missing arm or leg. So they send pain signals, a typical response when your body senses something is wrong.

Another example of this rewiring: When you touch one body part — say, your hip or your forearm — your brain might sense it on your missing limb.

Other possible causes of phantom limb pain include damaged nerve endings and scar tissue from the amputation surgery.

The shoulder is a ball and socket joint with a large range of movement. Such a mobile joint tends to be more susceptible to injury. Shoulder pain can stem from one or more of the following causes:

• Strains from overexertion
• Tendonitis from overuse
• Shoulder joint instability
• Dislocation
• Collar or upper arm bone fractures
• Frozen shoulder
• Pinched nerves (also called radiculopathy)

The treatment of soft tissue shoulder pain often includes the use of anti-inflammatory medication such as ibuprofen (Advil or Motrin) or naproxen (Aleve or Naprosyn). Pain relievers such as acetaminophen (Tylenol) may also be recommended. Depending on the source of pain, drugs like muscle relaxers and even antidepressants might be helpful. Pain also may be treated with a local application of moist heat or ice. Local corticosteroid injections are often helpful for arthritis of the shoulder. For shoulder pain movement, exercises may help. For cases in which nerve roots or the spinal cord are involved, surgical procedures may be necessary. Your doctor can tell you which is the best course of treatment for you.

Some kinds of chronic, or on-going, pain have many causes. One of them might be diseases, such as rheumatoid arthritis, osteoarthritis, and fibromyalgia. Other sources of constant pain can include cancer, multiple sclerosis, stomach ulcers, AIDS, and gallbladder disease.

But it’s often hard or even impossible to untangle all thee causes behind chronic pain. It may start with a physical cause, and then turn into a more complex problem involving your mind, mood, and lifestyle. That’s why doctors many times have to try different therapies to find the one that works for you.