The classical pain therapy still works with medication. Before successful therapy, an accurate diagnosis must be made. The patient must be thoroughly examined, but most importantly, the pain must be attributed to the original trigger – this may go back years. The doctor determines whether the pain has a physical cause, for example a tumor, whether it is a malfunction of the nerves or the pain receptors in the brain, or whether there is a completely different cause.
The doctor also includes psychological and social aspects in the diagnosis. If the chronic pain is particularly intense, it makes sense to see the pain therapist.
- The first stage consists of weak analgesics. Here are drug agents such as acetylsalicylic acid, paracetamol or diclofenac represented.
- On the second stage, one sets medium-strength morphine-like agents, so-called weak opiates. These include the active ingredients tramadol, tilidine and naloxone.
- In the third stage, morphine and other morphine-like analgesics are administered. These are agents such as morphine sulfate, buprenorphine or fentanyl.
So it is not surprising that painkillers are the best sellers in pharmacies. Their annual turnover in Germany is about 500 million euros. The main active ingredients are called acetylsalicylic acid, ibuprofen and paracetamol. Hippocrates successfully treated pain and fever with the bitter extract of willow bark around 2,500 years ago. This extract contained a high proportion of salicylic acid, the original form of today’s aspirin. Since then, salicylates and later the more advanced acetysalicylic acid have been used successfully in pain therapy.
