Pharmacological Pain Management: For Better or for Worse?

Although taking advantage of the synergistic effect of non-pharmacological and pharmacological approaches for the treatment of pain is always recommended, drugs remain the first and sometimes the only line of available treatment. Analgesics as well as pain itself do have an impact on cognitive and emotional processes. The cognitive/affective central effect of analgesics prescribed for chronic pain treatment is well documented in the literature, but the causal relationship of pain to cognitive and emotional disorders remains to be explored. In order to provide satisfactory pain alleviation, analgesic treatment in frail patients and in patients with preexisting cognitive/affective impairment is particularly difficult. Considering the large array of adverse events of orally administered analgesics, topical analgesics may be an interesting option for pain treatment. Non-pharmacological therapies should always be included in a comprehensive pain management plan.