Pain Management is essential because even when the underlying process is stable,


uncontrolled pain prevents patients from working productively or enjoying the normal rhythm of life. Pain disruption can affect sleep, concentration, induce drowsiness, and much more. Chronic pain may have a range of causative factors and therefore can be much more difficult to manage than acute pain, requiring multiple approaches and customized treatment protocols to meet the specific needs of each patient.

Optimal treatment may involve the use of medications that possess pain-relieving properties, including antidepressants, anticonvulsants, antiarrhythmics, anesthetics, antiviral agents, and NMDA (N-methyl-D-aspartate) antagonists. NMDA antagonists, such as Amantadine and Ketamine, can block pain transmission in dorsal horn spinal neurons, reduce nociception, and may decrease the need for opioids.

By combining various agents which utilize different mechanisms to alter the sensation of pain, commonly smaller concentrations of each medication can be used. Topical and transdermal creams and gels can be compounded and formulated to provide high local concentrations at the site of application. Side effects associated with oral administration can often be avoided when medications are used topically. These side effects from oral pain medications may include: GI irritation, liver damage, kidney problems, drowsiness, constipation, and more. Over 56,000 emergency room visits are made each year just from over-the-counter oral pain remedies. Studies suggest that there are no great restrictions on the type of drug that can be incorporated into a properly compounded product.

When medications are administered transdermally, they are not absorbed through the gastrointestinal system and do not undergo first-pass hepatic metabolism, which can greatly reduce certain drug interactions and negative side effects. Using a topical makes application easy and controllable as well as onset of relief may be seen faster than oral preparations. Formulations penetrate through the skin to produce effects in the tissues underneath while avoiding many systemic side effects.