"It’s hard to describe the pain it’s so painful." This statement sounds contradictory, but pain, whether acute or chronic, can be so belligerent or intimidating that descriptive words fail us. Pain is part of the body’s defense system, instructing neurons in the spinal cord to release glutamate, a neurotransmitter that relays signals from one neuron to another.

The signals go to the thalmus, where pain perception occurs. From there, the signal goes to the somatosensory cortex in the brain, where pain is identified, and the individual responds to the pain. When acute pain occurs, the response takes seconds. In episodes of chronic pain, the sensation may be constant.

Ever wonder how aspirin works? When pain pays a visit, cells in damaged tissues make chemicals called prostaglandins that work with an enzyme, cyclooxygenase, or COX-2, to signal pain. Aspirin stops cells from making prostaglandins by sticking to the COX-2 enzymes. Aspirin "lowers the intensity" of the pain signals, and works only where prostaglandins are being made.

Much stronger pain control agents, whether oral, dermal or intradermal, are used by Bay’s Pain Center specialists to manage debilitating pain.

Used to relieve signs and symptoms of osteoarthritis and rheumatoid arthritis in adults. Tablet form in 7.5 mg., 15 mg., 7.5 mg/5mL. Examples of other non-steroidal anti-inflammatory agents include: ibuprofen, naproxen, diclofenac, nabumetone, and ketoprofen. Mobic is not advised for those with asthma, hives, or allergic reactions to aspirin or other non-steroidal anti-inflammatory agents. Side effects can include: indigestion, upper respiratory tract infection, diarrhea, joint or stomach pain, and nausea.

Another non-steroidal anti-inflammatory agent. One of the more common brand names is Aleve or Motrin. Naproxen works by managing mild to moderate pain, fever and inflammation by reducing prostaglandin levels. Naproxen often prescribed in 250mg, 375mg or 500mg tablets. Naproxen may increase the levels of lithium and reduce blood pressure. Those taking blood thinners should avoid Naproxen because it also thins the blood, with excess bleeding leading to thinning. Common side effects: rash, headaches, dizziness, drowsiness, abdominal pain, nausea, diarrhea, constipation, fluid retention and shortness of breath.

This is yet another anti-inflammatory agent, similar to ibuprofen and naproxen. This medication works by inhibiting the production of prostaglandins. Prostaglandins promote inflammation, pain and fever, supporting the function of platelets to stop blood clots, and protecting acid damage to the stomach lining. Usually prescribed in 50 mg/µg or 75/200µg. Used to treat rheumatoid arthritis and osteoarthritis in patients at risk for developing ulcers. Arthrotec should be used with caution in patients taking Coumadin, lithium, or methotrexate, and it can reduce the effect of hypertensive medications.

Neurotinin affects chemicals and nerves in the body associated with seizures or some types pain, or May cause dizziness or drowsiness. Discuss with your doctor if you have kidney, level or heart disease before beginning this medication. Side effects can include: difficulty breathing, lip, tongue or face swelling, dizziness, poor coordination, blurred or double vision, anxiety, thought disorders, amnesia, depression, or hyperactivity.

Lyrica affects chemicals and nerves in the body associated with seizures and some types of neuropathic pain (particularly diabetic peripheral neuropathy), or postheptic neuralgia. This is expressed as severe pain along the course of a nerve, or when toxins or inflammation are present. Side effects can include blurry vision, excessive tiredness, fever, weight gain, swelling of hands or feet, muscle pain weakness or soreness.

Elavil is a tricyclic antidepressant, affecting brain chemicals that can cause depression. Elavil is also used to treat chronic pain and prevent migraines. Side effects: drowsiness, dizziness, difficulty breathing, fast, irregular heartbeat, high blood pressure, difficulty urinating, dry mouth and eyes, sweating, nausea, loss of weight or appetite.

Used to relieve moderate to moderately severe pain. Its effect is similar to narcotics, but with significantly less potential for abuse or addiction. Can also be used to treat pain caused by surgery, and chronic conditions, such as cancer or joint pain. Tramadol decreases the body’s sense of pain. Can be habit-forming. Side effects can include: nervousness, panic, sweating, difficulty getting or staying asleep, numbness, pain, burning, and tingling in hands or feet.

This patch provides a continuous delivery of an opoid pain reliever through the skin. The patches are helpful after surgery, and are used to manage cancer pain. The transdermal delivery system has proven to be an excellent means of pain relief delivery. It is a narcotic, and reaches peak level in 24 hours. Some patients also require a "breakthrough" medication to relieve pain. The most potentially serious side effect is respiratory complications.

Used as a topical treatment for relief of pain associated with postherpes neuralgia, or post-shingles pain. Allergic reactions are rare.

Vicodin (related to codeine) is a narcotic analgesic for pain relief. Taken with acetominophen, it can increase the effects of Vicodin. Used to relieve moderate-to-severe pain. Side effects: may increase impact of other drugs that cause drowsiness, and can cause constipation, dry mouth, nausea, vomiting or decreased appetite.

A strong narcotic analgesic used to relieve pain, particularly from cancer, heart attacks, or sickle cell anemia. Kadian depresses the central nervous system, and can cause drowsiness, dizziness, lightheadedness, or feeling a false sense of well-being.

A morphine sulfate, Avinza treats moderate-severe chronic pain in patients requiring continuous 24/7 therapy for an extended time period. Side effects: constipation, nausea, somnolence, vomiting and headache.

A minimally-invasive surgery procedure to treat progressive vertebral body fracture. The cause can include osteoporosis or a tumor spread to the vertebral body. The procedure uses a balloon to restore the vertebral body and shape. Bone cement is used for strengthening. Prior to implanting the cement, the balloon is withdrawn. A single stitch can usually close the incision. Kyphoplasty can prevent more fractures by keeping the spine lined up in its upright position.

The injection of a local anesthetic or neurolytic agents into or near a peripheral nerve, nerve plexus or pain-sensitive trigger point. Nerve blocks relieve pain by interrupting pain sensory pathways and preventing communication with the brain. Used to treat neck and low back pain, sciatica from herniated discs, lumbar canal stenosis, pain for peripheral vascular disease, shingles, myofascial pain syndrome and cancer pain. Nerve blocks can include: trigger point injections, epidural steroid injections, facet joint injections, stellate ganglion block (nerves in neck area), lumbar sympathetic block, and intercostal nerve block (local anesthetic between the ribs).