Killing pain. Is popping pills the answer?
Non steroid anti-inflammatory drugs (NSAIDs) are the front line pain relief for a large percentage of the population in the developed world and they are the daily bread and butter of the pharmaceutical industry. Awareness amongst the general public of side effects varies from high awareness of gastrointestinal problems to low awareness of medicine related photosensitivity. NSAIDs have all had their good and bad days. Aspirin is currently on an up, it is on the WHO list of essential medicines and approximately 40,000 tons of it are consumed each year. Yet aspirin is associated with stomach bleeding, bronchospasm and hemlytic anemia. Paracetamol is going through a new phase of being attacked for its liver toxicity and serious questions are being raised about its efficacy. Some reports question whether it is any better than placebo.
Pills are not the only way to kill pain. A new report calls on Neurologists to become aware of Complementary Alternative medicine and therapies to treat pain and to work with trained therapists and coordinate their treatments. An Italian study group followed up on recent data that showed use of CAM for pain and chronic conditions in pediatric patients had increased substantially in Europe and the USA. The group looked at CAM use in children aged 4-16 yrs who suffered from headaches which could be tension headaches, migraines with aura or migraines without aura. They found that 76% of patients used CAM for headaches for the following reasons 1. Reduce long term use of drugs and their side effects 2.Preference for an integrated approach 3. More suitable for children than taking pharmacological medicine. 80% of CAM users also used their preferred remedy as a preventative measure. Highest use of CAM was in the herbal remedies sector, followed by vitamins/mineral supplements, then homeopathy and physical treatments such as massage, osteopathy, yoga and acupuncture. Only 24% of the treatments were prescribed by a general practitioner and most of the treating doctors did not know that their patients were using or being given CAM. The study concludes that general practitioners and neurologists should be more receptive to learning about CAM and have direct contact with CAM practitioners in order to provide the safest and best integrated treatments for patients.
Libera et al. Complementary and alternative medicine (CAM) use in an Italian cohort of pediatric headache patients: the tip of the iceberg. Neurol Sci May 2014.