Overview
Pain relief is very crucial to be managed especially in a benign or malignant disease that produces chronic pain. There are several types of chronic pain, which are nociceptive pain, neuropathic/neurogenic pain, and psychogenic pain. Nociceptive pain may occur from musculoskeletal disorders or prolonged ischaemic and inflammation process such as pancreatitis and malignancy. Neuropathic/neurogenic pain is dysfunction in the peripheral or central nerves due to noxious stimulation causing burning, shooting or stabbing type of pain. It is less responsive to opioids and example of conditions are trigeminal neuralgia and diabetic neuropathy. Psychogenic pain is in relation to depressive causing chronic illness. Common drugs used in chronic-non-malignant pain are paracetamol, NSAIDs, TCA, and opioid analgesic. Pain control in malignant disease can be started with simple analgesics like paracetamol followed by higher-level drugs such as opioids; codeine and tramadol and strongest opioids can be considered if pain still cannot be controlled using morphine.
