What is Ultram?

Ultram / Tramadol helps relieve pain in two important ways. While it’s not completely understood how Ultram works, studies suggest that it first acts directly on parts of the brain and spinal cord to reduce the amount of pain. Secondly, it reduces the pain signal passed from one nerve to another. Ultram works differently from an NSAID (nonsteroidal anti-inflammatory drug) such as ibuprofen. Ultram is also different from narcotic pain medications such as codeine or morphine, as it is less addictive.

What is Tramadol?

Tramadol (and Ultram) work quite differently from NSAIDs like ibuprofen, and pain relief narcotics like codeine and morphine. Although the exact mechanism is not known for sure, lab studies suggest Tramadol acts directly on parts of the brain and spinal cord to reduce the amount of pain. And it also reduces the size of the pain signal passed from one nerve to another.

Butalbital is a barbiturate class drug that acts as a muscle relaxant and is often prescribed for the treatment of headaches and other moderate level pain that may not respond to over-the-counter preparations. Butalbital is frequently formulated with other ingredients to enhance its effectiveness as a pain relief medication.

• Dizziness or lightheadedness
• Drowsiness
• Abdominal pain, nausea or vomiting
• Feelings of intoxication
• Shortness of breath
• Nervousness, anxiety or irritability

Other more serious side effects have been reported, though rarely. If you experience any of the following while taking Butalbital, seek immediate medical attention: rapid or irregular heartbeat, itchiness or rash, severe dizziness, swelling, or difficulty breathing.     Q: How can I tell if Butalbital is right for me? A: Only by consulting with a qualified physician can you determine whether Butalbital is right for you. It is essential that your doctor carefully reviews your symptoms and medical history, lifestyle, allergies, and any other medication you may be taking before prescribing Butalbital or any other pain relief product.     Q: What activities or other drugs should I avoid while taking Butalbital? A: To reduce the risk of intoxication and/or over sedation, you should avoid consuming alcohol while taking Butalbital. Since taking Butalbital can result in drowsiness or dizziness, you should exercise extreme caution while driving, operating machinery or heavy equipment, or engaging in other activities that require clear focus and alertness. Because Butalbital/APAP/CAFF contains caffeine, you should avoid drinking large quantities of caffeinated beverages, as this may increase the risk of irritability and/or nervousness. Since Butalbital/APAP/CAFF contains the pain relief ingredient acetaminophen (Tylenol), which can be harmful to the liver when taken in high doses, check with your doctor before taking any other drugs that contain acetaminophen.     Q: Is it OK to take Butalbital while pregnant? A: You must consult with your doctor if you are pregnant or plan to become pregnant and are taking or considering taking Butalbital. It is unknown whether Butalbital can affect a developing fetus. However, both acetaminophen and Butalbital appear in breast milk, so women who are breastfeeding should also discuss this with their physician.     Q: How do I take Butalbital for pain relief? A: Butalbital/APAP/CAFF is available as a capsule, and should be taken orally as prescribed by your physician. Generally, you should take Butalbital with a glass of water or with milk or food to avoid getting an upset stomach.     Q: What if I miss taking a dose of Butalbital? A: If you miss taking a dose of Butalbital, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, it is better to skip the missed dose entirely. You should never take a double dose of Butalbital/APAP/CAFF at once.         ]]> http://www.edrugstore.md/articles/pain-relief/butalbital-faqs/feed 0 http://www.edrugstore.md/articles/pain-relief/pain-management-quiz http://www.edrugstore.md/articles/pain-relief/pain-management-quiz#comments Thu, 21 Aug 2008 12:42:00 +0000 admin http://edrugstore.uat.com/articles/?p=207
Read the Rest >>]]> At one time or another, every one of us suffers from some sort of pain. But very few of us take the time to learn about the causes of our pain and the many different pain relief drugs and techniques to make it go away.

The following quiz is intended to test and improve your knowledge of pain and pain management (answers below). Good luck and good learning!

1. Pain is frequently categorized as being either acute or chronic. One of the key differences between acute pain and chronic pain is that:

    

   1. Acute pain is always more severe than chronic pain.
   2. Chronic pain typically has a longer duration than acute pain.
   3. Chronic pain usually responds better to pain management techniques than acute pain.
   4. Acute pain develops gradually over time, whereas chronic pain appears suddenly.
2. Another difference between acute pain and chronic pain is that the underlying cause of acute pain is often more easily identified than the cause of chronic pain. Which of the following is not a common cause of acute pain?

    

   1. Surgery or other invasive medical procedures.
   2. Broken bones or other trauma.
   3. Arthritis.
   4. Severe cuts or burns.
3. Since the cause of chronic pain may sometimes be difficult to identify, pain management specialists often focus on relieving their patients’ symptoms, rather than on fixing an underlying problem. Which of the following is generally not thought of as a common pain management technique?

    

   1. Physical therapy.
   2. Pain relief medication.
   3. Surgery.
   4. Activity changes.
4. Health professionals who deal with pain management encompass a wide range of disciplines. All of the following professions deal frequently with pain management, except:

    

   1. Physiatrists.
   2. Physical therapists.
   3. Psychiatrists.
   4. Neurologists.
   5. All of the above professions are concerned with pain management.
5. There are a variety of physical therapy or non-drug treatments that can be used as pain management techniques, including massage, hot and cold therapy, and TENS. TENS is an acronym for the pain management technique known as:

    

   1. Transcutaneous Electrical Nerve Stimulation.
   2. Total Energy Neural Saturation.
   3. Targeted and Elevated Nebulization Sensing.
   4. Triple Enzyme Neuro Statins.
6. Pain management specialists often recommend analgesics for pain relief. Analgesics are:

    

   1. Pain relief medications such as acetaminophen, NSAIDs (non-steroidal anti-inflammatory drugs) or narcotics.
   2. Holistic pain management treatments including acupuncture, acupressure, biofeedback and others.
   3. Physical therapy to reduce pain, including exercise, hot/cold therapy and massage.
   4. All of the above are analgesics.
7. Non-steroidal anti-inflammatory drugs (NSAIDs) are non-narcotic drugs used to treat pain and inflammation. The two most common NSAIDs prescribed by pain management professionals are:

    

   1. Acetaminophen and aspirin.
   2. Ibuprofen and aspirin.
   3. Ibuprofen and acetaminophen.
   4. Aspirin and Tylenol.
8. A small percentage of patients develop a physical dependency on or addiction to pain relief medicine, especially when they fail to follow their physicians’ instructions. Which of the following type of pain management drug is least likely to result in addiction?

    

   1. Narcotics.
   2. Muscle relaxants.
   3. Barbiturates.
   4. NSAIDs.
9. Psychogenic pain is pain that has a psychological or emotional cause, even though it is reported as physical pain by the patient. Which of the following pain management specialists is most qualified to treat psychogenic pain?

    

   1. Physiatrist.
   2. Psychiatrist.
   3. Anesthesiologist.
   4. Oncologist.
10. Pain management professionals sometimes recommend injection therapy for patients who suffer from chronic back or spinal pain. Which of the following is not a common injection therapy for back pain relief?

     

    1. Epidural injection.
    2. Sacroiliac joint injection.
    3. Opioidal injection.
    4. Nerve root block.
11. When dealing with chronic back pain, many health professionals recommend surgery only after non-surgical pain management treatments have proven inadequate. Which of the following statements about back surgery is untrue?

     

    1. Patients considering back surgery as a pain relief measure must carefully weigh the risks and potential benefits of the procedure.
    2. Back surgery nearly always has a more positive outcome for the patient than non-surgical pain management treatments.
    3. Spinal fusion is a common surgical procedure designed to treat degenerative disc disease and other spinal conditions.
    4. Back surgery is more likely to be recommended in cases where there are symptoms of a pinched or damaged nerve.

To learn more about pain management and to better understand the various pain management options available, browse our library of related pain relief articles on eDrugstore.md.

Answers:    1)B    2)C    3)C    4)E    5)A    6)A    7)B    8)D    9)B    10)C    11)B

Management of arthritis pain depends not only upon the specific condition, but also upon your age, lifestyle, and unique response to different treatment methods.

Osteoarthritis and Rheumatoid Arthritis

The two most common forms of arthritis are osteoarthritis and rheumatoid arthritis. Together these conditions affect approximately 40 million people in the United States alone.

• Osteoarthritis is a degenerative condition involving deterioration of the cartilage in the joints, resulting in joint pain or stiffness.
• Rheumatoid arthritis is an inflammatory disease affecting the lining of the joints. While osteoarthritis is far more common, rheumatoid arthritis is often a much more severe form of the disease.

Before assessing your arthritis pain relief options, it is important to consult with a physician to determine whether you have arthritis, and if so, which type since treatment options differ.

Common Causes of Arthritis Pain

The joint pain associated with arthritis may be caused by a variety of factors. Most commonly, arthritis pain originates from:

• Inflammation of the tendons, ligaments or lining of the joints. This inflammation may be accompanied by swelling or redness, which results in joint pain.
• Joint tissue damage, which may be related to an injury or excess pressure on the joints.
• Fatigue, which is sometimes a result of arthritis and can make the joint pain seem more intense and the condition more difficult to cope with.

Arthritis Pain Treatment Options

There are a variety of ways to treat arthritis pain and other joint pain. It’s essential to be aware that people respond differently to different treatments. An individual’s response to pain and pain relief treatments is affected by the particular disease or condition he/she suffers from, the severity of the pain, and a range of psychological and emotional factors.

Short Term Pain Relief

One of the most important considerations when evaluating arthritis pain relief treatment options is to be clear about whether you are focusing on short or long term pain relief.

For short term relief from arthritis pain, many people use hot or cold therapy, depending on the type of pain and the specific condition. Cold therapy in the form of an ice pack can sometimes provide pain relief by reducing swelling, but may not be a good option for patients with poor circulation. Heat therapy, either moist or dry, acts as a muscle relaxant, and can also provide short term pain relief.

Certain drugs can also give quick, short term relief from the joint pain associated with arthritis. Depending on the amount of inflammation, doctors will often recommend a pain relief medication such as acetaminophen or a non-steroidal anti-inflammatory drug (NSAID) like aspirin or ibuprofen.

Another non-drug alternative that provides some patients with short term relief from arthritis pain is TENS, or transcutaneous electrical nerve stimulation. A TENS unit delivers electrical pulses to nerves in the affected area. The pulses block pain messages that the nerves would normally deliver to the brain, thereby bringing pain relief to the patient.

TENS therapy may also raise the level of endorphins produced by the brain. Endorphins are substances that are produced naturally in the body and contribute to feelings of well-being and pain relief.

Long Term Pain Relief

Because both rheumatoid arthritis and osteoarthritis are chronic conditions, sufferers often need to look for long term options to deal with their joint pain.

Drugs such as NSAIDs provide some level of pain relief. In the case of rheumatoid arthritis, disease-modifying antirheumatic drugs (DMARDs) target the immune system and are helpful for some patients. Corticosteroids are hormones that are sometimes prescribed for treatment of the joint pain and inflammation that typically accompany arthritis.

For many people with arthritis pain, exercise and physical therapy can help reduce stiffness and joint pain. Depending on the severity of the condition, walking, swimming, and a variety of strengthening and/or aerobic activities may be helpful, not only in pain relief but also from the standpoint of improving patients’ self-confidence and psychological and emotional well-being.

Overweight people suffering from arthritis pain are frequently advised to lose weight, since additional weight places an added burden on the joints.

In a small minority of cases, medication and lifestyle changes do not provide the desired pain relief and doctors may recommend surgery. Surgical procedures can remove tissue within the joint, or else realign or replace the joint.

For more information on arthritis pain, joint pain, and pain relief treatment options, see these related pain relief articles on eDrugstore.md.

The short answer is this: Dilated blood vessels can cause or contribute to tension headaches. Caffeine is believed to shrink blood vessels, which helps relieve the pressure. Caffeine also facilitates the action of the other ingredients.

There are now several drugs on the market, both prescription and non prescription, in which caffeine is blended with one or more drugs to create effective "combination" pain relievers.

For example, in Butalbital, Acetaminophen and Caffeine (sold here as Butalbital / APAP / CAFF, but also called Fioricet) each of the three active ingredients plays a different role:

1. Butalbital is a powerful barbiturate sedative with muscle relaxing and anti-anxiety properties. It helps calm the brain.
2. Acetaminophen (Tylenol) relieves pain, eases inflammation and brings down fevers. It also boosts the potency of the Butalbital so less is needed.
3. Caffeine constricts swollen blood vessels to relieve pain and pressure.

That triple action is why Fioricet / Butalbital, Acetaminophen and Caffeine is often prescribed for people who suffer from tension headaches or migraines.

Here are some other common questions and answers about the effects of caffeine in pain relievers like Fioricet.

Q and A About Caffeine and Pain Relief

Q: If caffeine is a pain reliever, couldn’t I just drink coffee to get rid of my headaches?

A: It depends on what kind of headaches you get and how bad they are, but the caffeine in coffee may actually provide you with some pain relief.

A study of tension headache sufferers produced some fascinating results. Researchers at the Diamond Headache Clinic found that 200 mg of caffeine (the amount in 1-2 regular cups of coffee) gave the same level of pain relief as 400 mg of ibuprofen (Advil, Motrin, etc.) in their subjects. They also found the coffee gave faster relief than the ibuprofen.

But the best pain reliever in their study was caffeine in combination with ibuprofen, which gave fast and much longer lasting relief than either caffeine or ibuprofen alone.

Q: What is the caffeine content in pain relievers?

A: It differs depending on the product. Each Fioricet / Butalbital, Acetaminophen and Caffeine tablet that we sell contains 40 mg of caffeine. Other pain relievers may contain more or less caffeine than Fioricet. Check the product label for details.

Q: If I take a pain reliever that contains caffeine before bedtime, will it keep me awake?

A: It depends on your sensitivity to caffeine. Two Fioricet / Butalbital, Acetaminophen and Caffeine tablets contain a total of 80 mg of caffeine, which is about the same as one average cup of brewed coffee (there’s between 80 and 125 mg of caffeine in a cup of coffee, depending on how strong it is).

Q: If I drink coffee and take Butalbital containing caffeine at the same time, can I expect to have any side effects?

A: When taking Fioricet, check the caffeine content of beverages like coffee, tea and cola as well as all prescription and non-prescription drugs you take. Avoid taking too much caffeine as it could cause nervousness, shakiness and fast heartbeat.

However, drowsiness is actually a much more common side effect of the Butalbital, Acetaminophen and Caffeine combination.

Here are the possible side effects listed for Fioricet / Butalbital, Acetaminophen and Caffeine:

• drowsiness
• upset stomach, stomach pain
• nausea, vomiting, loss of appetite
• depression
• lightheadedness, dizziness, confusion
• tiredness, weakness
• shortness of breath
• dry mouth
• agitation, anxiety, irritability
• rash or itching
• headache
• constipation

More serious but rare side effects like difficulty breathing, low blood sugar or unusual bleeding are possible when taking Fioricet and should be reported to a doctor immediately.

Summary

Since caffeine has pain relieving properties and few if any known negative side effects, it has been added to the active ingredients of several different pain relievers. The effects of caffeine in these products is to lessen the pressure that contributes to headache pain and help the other ingredients work more effectively.

For more articles on pain and pain relievers, we invite you to browse our Pain Relief Library.

To help guide you to the most reliable information, we’ve assembled a handy list of useful Butalbital links along with a brief description of the material.

We start with some of the Butalbital-related pages hosted right here on eDrugstore.md, and then move on to explore some other online and offline resources worth considering.

Butalbital Links on eDrugstore.md

• eDrugstore.md Knowledge Base
  This page has a variety of information about pain relief, along with a feature that lets you submit a question to the eDrugstore.md physicians and pharmacists. As fully licensed professionals, they are available to address any questions you might have about health issues such as tension headache, back pain, and the specific drugs used to treat these conditions, including Butalbital.
  
• Butalbital and Pain Relief Articles
  This page links to articles and other reference material focusing specifically on pain relief issues, including tension headache and pain relief products like Butalbital. Articles include facts, quizzes and other information about pain relief and Butalbital, along with material on the most common side effects of Butalbital and other pain relief medications, drug interactions and what to expect when you order pain relief products online.

Other Useful Butalbital Links

• Butalbital Article: Mayo Clinic
  The world-renowned Mayo Clinic’s website gives consumers a complete library of health information. This article on Butalbital provides a great deal of information on the Butalbital formulations that combine Butalbital with acetaminophen, typically prescribed for treating tension headaches. It lists the potential risks of taking this pain relief medication for different individuals, including children, adults, elderly persons, and pregnant women. It also provides information on how to take Butalbital and possible drug interactions.
• Butalbital Link: Medline Plus (US National Library of Medicine)
  This page from the US National Library of Medicine and the National Institutes of Health is dedicated to drug formulations that combine Butalbital with acetaminophen and caffeine. It describes how to take Butalbital, and gives tips on how people who are prone to tension headaches can get the most out of the drug. In addition, it covers possible side effects and other frequently asked questions concerning this powerful pain relief medication.
• Butalbital Link: Wikipedia
  This Butalbital page on Wikipedia details the various formulations of the drug (and their trade names) along with some of the potential side effects and risks of taking Butalbital for tension headaches and other pain relief needs. Also included are links to other useful sites dealing with Butalbital.

Offline Butalbital Resources

• Your Physician or Pharmacist
  Always consult with your doctor or pharmacist before taking Butalbital as a pain relief or tension headache treatment. Because Butalbital is strong prescription medicine, you should take it only as directed by a qualified physician or pharmacist.
• Community Support and Outreach Groups
  Butalbital is a barbiturate-class drug which in rare cases can result in a patient developing a dependency or even an addiction. In such cases, some people turn to community support and outreach groups to help them overcome their addiction. Dependence on or addiction to Butalbital or other pain killers can be a serious issue if not dealt with properly, so these groups can be a vital resource for those experiencing addiction problems.

When taken as directed, Butalbital can be a highly effective pain relief remedy for your tension headaches. We encourage you to explore the links and resources above to ensure that you are well informed about Butalbital, including the risks of using it, and how to achieve maximum pain relief benefit.

But it may be possible to avoid some types of back pain by better understanding its causes and avoiding or preventing them in the first place.

And while over-the-counter pain relief medications can help lessen back pain once it occurs, exercise, improved posture, and good furniture can strengthen and heal your back and even prevent back pain from occurring in the first place.

This article will guide you in both ways: how to avoid back pain and how to find back relief.

Back Pain Causes

The back is a powerful structure comprising bone, muscle, and elastic discs. This marvel of efficiency allows you to bend, twist, and carry weight. However, its flexibility makes it susceptible to injury and pain. Not surprisingly, back pain often results from neglect or other lifestyle factors such as:

• Bad posture – A normal adult spine resembles a double ‘S’. When you slouch, the pelvis and the stomach thrust forward, the knees bend, and the back muscles are strained. This strain can easily lead to back pain.

• Sedentary lifestyle and stress – Lack of exercise tends to weaken the muscles in the body. At the same time, stress can lead to muscle tension, causing the unprepared muscles to spasm.

• Weak abdominal muscles – Back pain is often related to weak stomach muscles, which can place added stress on the back.

• Obesity - Overweight people may find it difficult to maintain proper posture, and the burden of additional weight puts pressure on the back.

• High heels – They push the body’s center of gravity forward. To offset this, people tend to bend their knees and move their torsos forward. This can exaggerate the spine’s inward curve, leading to back pain.

People can also experience back pain as a result of specific health conditions:

• Spondylosis - Arthritis of the spine occurs due to degenerative spinal changes, and is often characterized by back pain.

• Spondylolisthesis - This occurs when one spinal vertebra slips forward on top of another one, causing back pain.

• Spinal stenosis – When the space around the spinal column and nerve roots is reduced, nerves are pinched or pressed, resulting in back pain. Arthritis and bone overgrowth trigger this condition.

• Herniated disc – One of the most common causes of back pain, this condition occurs when a spinal disc presses on a nerve. It’s also referred to as slipped disc.

• Sciatica - Sharp, shooting pain that radiates through the lower back or buttocks to the back of the leg when a herniated disc presses the sciatic nerve.

• Spinal infection – When this occurs, back pain is often accompanied by fever and tenderness.

Back Pain Relief Options

Not every type of back pain is a condition you have to put up with. In addition to medication and home therapies, there are a variety of complementary and alternative therapies that can provide back pain relief.

Bed rest may help relieve acute, temporary back pain. But this may not work for chronic back pain, which may require long-term treatment.

Here are just some of the methods you can try to get back pain relief:

• Heat and ice treatment – For lower back pain relief, use an ice pack first to sooth the sore muscles. You can use a cold compress several times a day for up to 20 minutes per treatment. A warm compress or a heating pad loosens the muscles and increases blood flow, which can provide some back pain relief.

• Chiropractic care – Some research on pain relief has shown that chiropractic manipulation may be as effective as pain relief medication for certain patients.

• Acupuncture - In this alternative medicine procedure, the practitioner inserts sterilized stainless steel needles at specific points on the body. This may stimulate the brain to release natural endorphins, which can provide some level of back pain relief.

• Electrical stimulation – Transcutaneous electrical nerve stimulation (TENS) often works for acute back pain. In this procedure, weak electrical pulses sent to nerve pathways through specific points prevent pain signals from reaching the brain. This back pain relief procedure may be appropriate for those who prefer to avoid medication.

• Over-the-counter medication – Drugs such as aspirin and ibuprofen can help reduce inflammation and relieve back pain, while acetaminophen controls pain without addressing inflammation.

• Prescription medication – When over-the-counter drugs fail to provide pain relief, doctors may prescribe a nonsteroidal anti-inflammatory drug (other than aspirin or ibuprofen), a muscle relaxant, or other medication.

• Epidural injections – When other measures fail to relieve back pain, doctors may prescribe epidural injections of anti-inflammatory medication such as cortisone to provide pain relief.

Back Pain Don’ts

• Do not exercise while suffering from severe back pain.

• Do not sit for long periods when suffering from back pain. Sitting exerts more pressure on your nerves than standing or lying down. This can exacerbate back pain.

• Do not slouch or overarch your back, as this increases pressure on the lower back and may cause back pain to become more intense.

How To Avoid Back Pain

Many people who suffer from chronic back pain have found that a few lifestyle changes and healthy work habits can help them avoid recurrences of back pain:

• Exercise - Exercise not only helps to maintain proper weight, but also helps build and maintain strong muscles. However, if you already suffer from back pain, consult your doctor before starting an exercise routine.

• Good posture – A balanced posture allows the body to relax while maintaining an erect position. If you stand for long hours, avoid back pain by placing one foot on a stool or a box to avoid stressing the pelvis. While sitting, make sure that your lower back is supported and that your feet stay flat on the floor.

• Bend and lift properly – Improper bending is a common cause of back pain. When bending down, bend your knees, separate your feet about shoulder width apart, and keep your back straight. When lifting things, let your legs bear your weight, keep objects close to your body, and ask for help if the load is too heavy.

• Sleeping position – Sleep on your side, with your knees bent towards the chest. Place a pillow between the knees to reduce pressure on the back.

• Heel inserts – To reduce the risk of back pain, some doctors recommend heel inserts to alleviate stress on the lower back and provide shock absorption.

• Medium-firm mattresses – Sleep on a mattress that is firm enough to support your body but does not distort the body’s natural curves.

• Car seating position – Tilt your car seat back slightly, so that your knees are higher than your hips. Place the seat close enough to the wheel to let your arms bend.

Treating your back with respect is one key to avoiding back pain. However, if you already do have back pain, a variety of pain relief medications and treatments are available. To learn more about back pain and pain relief, visit the online knowledge base at eDrugstore.md.