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    Pain Management

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    There are different types of pain. The same is true for pain medication. This page provides more information on this topic.

    There are different types of pain and thus also different types of painkillers. This category contains medicines for a migraine headache and NSAIDs (painkillers, rheumatism, etc.).

    1. Migraine and cluster headache: Migraine is a type of headache that comes in the form of recurrent attacks, often accompanied by nausea, vomiting and aura symptoms. Migraine symptoms include a pulsing pain, often felt on one side of the head, which is aggravated by physical exertion. As a result, migraine headaches can keep sufferers from being able to accomplish even the smallest daily tasks. Patients can also become oversensitive to sound and light. Migraine is often triggered by hormonal changes, fatigue, stress, weather changes and, in some cases, drug use.

    Migraine sufferers often feel an attack coming on. Some people perceive an aura, a transient visual or other disturbance which signals that the headache will soon occur.

    Cluster headache also has a neurovascular origin, which means that the symptoms are associated with both the central nervous system and the blood vessels. This type of headache also comes in episodes that involve severe pain localized to one side of the head, followed by symptom-free periods.

    Treatment (non-specific): Although lifestyle changes may help to relieve the symptoms, medication is usually required. When a patient feels an attack coming on, these products can be used to prevent the attack or stop a migraine attack after the attack begins. Mild attacks can be treated with paracetamol or other simple painkillers (NSAIDs).

    Triptans, specific medication for migraine: Triptans are selective serotonin receptor buffers, meaning that triptans inhibit the transmission of signals in certain nerve sections and cause blood vessels in the head to contract. There are currently seven different triptans available. They all work in a slightly different way and have different side effects. Most patients use the tablets, although injections work the fastest.
    Some triptans are available as fast-melt tablets that melt in your mouth. A convenient option as many patients have difficulty swallowing during an attack. The side effects of triptans are mild and not very common. See the package leaflet for more information. If you are a heart patient and are taking this medication for the first time, make sure you do so under medical supervision. Together with your doctor you can decide which triptan suits you best.

    2. Antipyretic analgesics: Antipyretic analgesics are used to relieve mild to moderate pain or fever symptoms. They have a wide range of applications: arthritis, the flu, headache, toothache, menstrual pain, migraine, rheumatic symptoms, muscle ache and swellings.
    The most well known painkillers in this group are paracetamol and acetylsalicylic acid (Aspirin).
    Paracetamol 500 mg (tablet form) is the cheapest over-the-counter pain reliever.
    We recommend that you consult a doctor if the pain persists for longer than a few days.

    Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are also considered antipyretic analgesics. NSAIDs are mainly used for rheumatic symptoms and other infections, but also for the pain symptoms referred to above. The most well known NSAIDs are diclofenac and ibuprofen. Low doses of ibuprofen are available over the counter. However, because of the side effects that may occur we recommend that you consult a doctor before taking ibuprofen.

    3. Pain: Opioids, substances often derived from morphine, are used to reduce moderate to severe pain.
    Codeine is the most widely used, usually in combination with paracetamol (Paracod). Paracod is available on prescription in various strengths.
    Codeine is also used to relieve dry cough.

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