Often one of the complications of medical negligence is long term, or chronic, pain. Some patients we have represented suffer pain from arachnoiditis, phantom pain following amputations, or debilitating migraines, to name just a few. An issue many have to deal with is managing this pain, sometimes for the rest of their life. And managing chronic pain for victims of medical malpractice comes with its own set of risks.

Different pain medications reduce pain in different ways. We have heard a lot about opioids or opiates, which are often used interchangeably, but do in fact mean different things. Opiates refers specifically to natural opioids such as heroin, morphine, and codeine. Opioid is the more general term to describe natural and synthetic opioids. Still with me?

There are a multitude of ways to treat chronic pain, including physical therapy, acupuncture, massage therapy, nerve blocks or injections, and medications. Not all pain medications are opioids, and some come in handy when a patient has breakthrough or acute pain flares. Some medications you might have heard of in recent years include hydrocodone, oxycodone, and codeine. You may have read something about the controversy revolving around these medications.

Tramadol is a powerful synthetic opioid, increasingly prescribed for chronic non-cancer pain. An evaluation of over one million patients prescribed either codeine or tramadol found tramadol was significantly associated with an increased risk of all cause mortality, cardiovascular events, and fractures (such as from falling). Tramadol is also associated with severe rebound headaches.

Toradol is an NSAID; it works, like other NSAIDS such as ibuprofren, by inhibiting enzymes that create inflammation. These enzymes, though, also protect the stomach lining and help maintain kidney function. So, NSAID use can contribute to GI complaints and kidney disease. For example, patients with chronic kidney disease should not be taking NAIDs. Toradol is recommended only for short term use (up to five days), so recommended only for acute pain rather than chronic pain. In addition, it creates an increased risk of bleeding, because it inhibits platelet function (platelets help your body form clots).

Gabapentin was developed as an anti-epileptic, but is also often prescribed for nerve pain. Many patients have to undergo a sleep study to evaluate whether gabapentin is appropriate, as it has been connected to deaths in patients with sleep apnea.

For many victims of medical malpractice, the very therapies they are relying on to help them overcome their injuries can significantly, and negatively, affect them.