Best Practice for using NSAIDs and other OTC Pain Meds
It is best to use NSAIDs continuously for several days in a row to build up a base level of anti-inflammatory in the circulatory system. The efficacy is lower if taken only one day a week. Taking the drug regularly in the recommended dose lets the drug build up over time and maximizes the effect. It is generally accepted that eliminating inflammation from an injury can also contribute to promote a rapid healing environment for injured tissue.
NSAIDs and the pain relief medication acetaminophen (brand name Tylenol) have different mechanisms of action. Sometimes doctors recommend taking the two medications at the same time. Some people report feeling more effective pain relief when they take both an NSAID and acetaminophen for their pain. Again for Carpal Tunnel Symptoms, this combined medication approach tends only to take the edge off the most intense symptoms and not provide any long-term relief. It will not relieve the pressure on the Median Nerve.
NSAIDs are generally considered to be non-habit forming pain medication.
No one should use NSAIDs for chronic pain medication for more than two weeks, without a physician’s directive and regular monitoring for possible complications.
NSAIDs Potential Risks and Common Complications
NSAIDs are cleared from the blood stream by the kidney, so it is very important that patients over 65 years of age or patients with kidney disease consult a physician prior to taking the medication. If patients take an NSAID for an extended period of time (six months or more), a blood test needs to be performed regularly to check for early signs of kidney damage. Kidney damage is a real possibility with long-term exposure to oral pain medication.
NSAIDs may also cause stomach upset or possibly ulcers. Patients with stomach ulcers or a history of stomach ulcers should first consult with their physician. Signs of stomach ulceration and intestinal bleeding typically include one or a combination of the following symptoms: abdominal pain, black tarry stools, weakness, or dizziness upon standing.
Most types of NSAIDs have a variety of other potential risks and complications associated with them. While most side effects are rare, it is important for patients to remain aware of them and under supervision by a health professional. As a general rule, patients with any of the following factors should meet with their doctor before taking any type of NSAID:
- If you have Diabetes
- If you have Heart disease
- If you have High blood pressure
- If you have had an Allergic reaction to any pain reliever medication
- If you are Pregnant, about to become pregnant, or breast feeding
- If Regularly Consume three or more alcoholic beverages a day
- If you have any Thyroid Problems
- If you are about to have any type of surgery
In order to ensure that NSAIDs are used safely, patients should meet with a physician to evaluate their individual risk factors and to determine the most appropriate dosages and treatment options.
As with all medications, patients should discuss with their doctor all other medical conditions and allergies before pain medications are taken. Patients should strictly follow label directions for all pain medications.
Oral Prednisone Medication
Often Doctors will prescribe Oral Prednisone Caplets for short-term relief of Carpal Tunnel Pain. Prednisone is a powerful steroidal medication that can have some effect on Carpal Tunnel Syndrome Pain in the short run. However, it is a poor choice for the Treatment of any chronic condition like, Carpal Tunnel Syndrome, because the side effects are extremely dangerous and life changing with routine exposure to this steroid treatment. Some of the side effects will make Carpal Tunnel Worse in the long run and lead to life threatening conditions with long-term usage. We urge extreme caution in any treatment of Carpal Tunnel Syndrome with steroidal treatments.
Common side effects of long-term steroid treatment are well studied and well understood they include:
- Increases in appetite, weight gain (bad for Carpal Tunnel Syndrome and your overall health)
- Nervousness, restlessness
- Irritability and Sudden unexplainable mood swings
- Relationship with loved ones and friends often suffer creating more anxiety and unhappiness.
- Distance from Normal Social Circles
- Muscle weakness and loss of desire to exercise
- Declining Physical Fitness
- Blurred vision – Cataracts or glaucoma
- Increased growth of body hair
- Lower Immunity to disease
- Lower resistance to infection
- Swollen, “puffy” face or round face syndrome
- Acne and skin disorders
- Increased Incidence of Osteoporosis – weakening bones & joints – loss of mobility – more difficult to exercise
- Aggravation of diabetes – deadly consequences
- Increased Blood Pressure Measurements – deadly consequences
- Upset Stomach
- Bloating Digestive System
- Sleep interruption – irregular sleep patterns
- Difficulty getting sufficient REM sleep – leading to more anxiety and irritability
- Water retention, swelling – worse for Carpal Tunnel Pressure
- Easy Bruising and Skin Wounds
- Deterioration of important organs and body tissue with long-term use – examples include loss of Esophagus, deep skin wounds with ordinary bumps and contact with the outside environment.
Narcotic Pain Medication – represent the most powerful and most dangerous class of oral pain medication. Narcotics are only available through a doctor’s prescription. Doctors are very careful about providing these oral pain medications because they are habit forming. Though narcotics are the most powerful way to deal with pain, they are a poor choice for chronic pain conditions like Carpal Tunnel Syndrome, because they are extremely addictive. No one wants to add an addiction to Narcotics to their Carpal Tunnel challenges.
Occasionally, a doctor will prescribe Narcotics for Carpal Tunnel for short-term relief in extreme cases. The emphasis is on short-term relief. However, in most cases, Narcotics are reported to only take the edge off the most intense symptoms and will not relieve the overall symptoms of this chronic condition. Narcotics, like NSAIDs, will not relieve the pressure on the Median Nerve. This is why most doctors believe that the risks of narcotic medications are not worth the very limited short-term symptom relief for CTS.
Gabapentin for Carpal Tunnel?
There is a new class of oral pain medication now being prescribed by many Doctors for Carpal Tunnel Syndrome and other forms of nerve related pain. It is called Gabapentin and it is prescribed as an “off-label prescription treatment for Carpal Tunnel Syndrome Treatment”. Pharmaceutical representatives encourage Doctors to prescribe this medication for Carpal Tunnel Syndrome and for nerve pain “off-label”. “Off-label” means that Gabapentin was approved by the FDA for treating epilepsy to prevent epileptic seizures, but it was not approved for treating nerve pain or for treating Carpal Tunnel Syndrome. An “Off-label prescription” means the FDA has not evaluated the medication for the suggested use. It also means that it is not an FDA approved application of the medication. So, Gabapentin is not approved by the FDA for treating Carpal Tunnel Syndrome.
Some Doctors are prescribing Gabapentin in combination with Opioid Narcotics in an effort to lower the exposure of the patient to the narcotic. This is a very dangerous practice. Gabapentin and opioids when used together can seriously depress respiration of the patient. Since respiration (breathing) is key to staying alive, any combination of drugs that seriously depresses respiration should only be used in extreme circumstances in a clinical setting where the patient can be monitored continuously and with intubation available as an option by trained experienced medical professionals like anesthesiologist or emergency medical doctors.
The combined use of these medications has led to a significantly increased rate of death in patients using both pain medications at the same time. Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case–control study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626029/
You can learn more about Gabapentin and its side effects and why the Doctors at First Hand Medical see no reason to justify the use of narcotics, opioids or Gabapentin for the treatment of Carpal Tunnel Syndrome. There is no therapeutic benefit – just pain relief – and the side effects are too risky to justify its use for Carpal Tunnel Syndrome.
here are too many safer options for the effective treatment of Carpal Tunnel Syndrome to expose patients to the risks of Gabapentin or Narcotic Medication, like opioids.