Summary
The pharmacologic treatment of chronic pelvic pain requires knowledge about several classes of drugs. The standard approach is to use non-opioid drugs such as non-steroidal anti-inflammatory drugs or acetaminophen initially with or without non-opioid adjuvants (or adjuncts). Adjuvant therapy may include anticonvulsants, antidepressants, or a combination of both. Opioids are appropriate, safe, and effective in the treatment of non-cancer chronic pain. When initiating opioid therapy, patients should achieve a stable opioid dose with in a few months and thereafter be monitored regularly for pain relief, functionality, and side effects. Physicians who prescribe opioids should have an understanding of addiction, pseudoaddiction, tolerance, and dependence.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Marjoribanks J, Proctor ML, Farquhar C. Nonsteroidal anti-inflammatory drugs for primary dysmenorrhoea. Cochrane Database Syst Rev 2003;CD001751.
Allen C, Hopewell S, Prentice A. Non-steroidal anti-inflammatory drugs for pain in women with endometriosis. Cochrane Database Syst Rev 2005;CD004753.
Evans JA. Reflex sympathetic dystrophy: Report on 57 cases. Ann Intern Med 1947;26:417–26.
Chronic pain in America: Roadblocks to relief. Glenview, Il: American Pain Society. 2003.
Bennett GJ. Neuropathic pain: New insights, new interventions. Hosp Pract 1998;33:95–8.
Backonja MM, Serra J. Pharmacologic management part 1: Better-studied neuropathic pain diseases. Pain Med 2004;5:S28–47.
Backonja MM, Serra J. Pharmacologic management part 2: Lesser-studied neuropathic pain diseases. Pain Med 2004;5:S48–59.
Wiffen PJ, McQuay HJ, Moore RA. Carbamazepine for acute and chronic pain. Cochrane Database Syst Rev 2005;CD005451.
Serpell MG, Neuropathic pain group. Gabapentin in neuropathic pain syndromes: A randomized, double-blind, placebo-controlled trial. Pain 2002;99:557–66.
Rice ASC, Maton S. Postherpetic neuralgia study group. Gabapentin in postherpetic neuralgia: A randomized, double blind, placebo controlled study. Pain 2001;94:215–24.
Rowbotham M, Harden N, Stacey B, Bernstein P, Magnus-Miller L. Gabapentin postherpetic neuralgia study group. Gabapentin for the study of postherpetic neuralgia: A randomized controlled trial. JAMA 1998;260:1837–42.
Backonja M, Beydoun A, Edwards KR, Schwartz SL, Fonseca V, Hes M, LaMoreaux L, Garofalo E. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: A randomized controlled study. JAMA 1998;280:1831–6.
Morello CM, Leckband SG, Stoner CP, Moorhouse DF, Sahagian GA. Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathic pain. Arch Intern Med 1999;159:1931–7.
Sator-Katzenschlager SM, Scharbert G, Kress HG, Frickey N, Ellend A, Gleiss A, Kozek-Langenecker SA. Chronic pelvic pain treated with gabapentin and amitryptyline: A randomized controlled pilot study. Wien Klin Wochenschr. 2005;117:761–8.
Gorson KC, Schott C, Herman R, Ropper AH, Rand WM. Gabapentin in the treatment of painful diabetic neuropathy: A placebo controlled, double blind, crossover trial. J Neurol Neurosurg Psychiatry 1999;66:251–2.
Sindrup SH, Jensen TS. Efficacy of pharmacological treatments of neuropathic pain: An update and effect related to mechanism of drug action. Pain 1999;83:389–400.
McQuay H, Tramer M, Nye BA, Carroll D, Wiffen P, Moore RA. A systematic review of antidepressants in neuropathic pain. Pain 1996;68:217–27.
Wiffen PJ, McQuay HJ, Edwards JE, Moore RA. Gabapentin for acute and chronic pain. Cochrane Database Syst Rev 2005:CD005452.
Dworkin RH, Corbin AE, Young JP, Sharma U, LaMoreaux L, Bockbrader H, Garofalo EA, Poole RM. Pregabalin for the treatment of postherpetic neuralgia: A randomized, placebo controlled trial. Neurology 2003;60:1274–83.
Watson CPN, Chipman M, Reed K, Evans RJ, Birkett N. Amitryptyline versus maprotiline in postherpetic neuralgia: A randomized, double blind, crossover trial Pain 1992;48:29–36.
Watson CP, Evans RJ, Reed K, Merskey H, Goldsmith L, Warsh J. Amitriptyline versus placebo in postherpetic neuralgia. Neurology 1982;32:671–3.
Max MB, Schafer SC, Culnane M, Smoller B, Dubner R, Gracely RH. Amitryptyline, but not lorazepam, relieves postherpetic neuralgia. Neurology 1988;38:1427–32.
Saarto T, Wiffen PJ. Antidepressants for neuropathic pain. Cochrane Database Syst Rev 2005;CD005454.
Sindrup SH, Gram LF, Brosen K, Esoj O, Mogensen EF. The selective serotonin reuptake inhibitor paroxetine is effective in the treatment of diabetic neuropathy symptoms. Pain 1990;42:135–44.
Sindrup SH, Bjerre U, Dejgaard A, Brosen K, Aaes-Jorgensen T, Gram LF. The selective serotonin reuptake inhibitor citalopram relieves the symptoms of diabetic neuropathy. Clin Pharmacol Ther 1992;52:547–52.
Sindrup SH, Bach FW, Madsen C, Gram LF, Jensen TS. Venlafaxine versus imipramine in painful polyneuropathy: A randomized, controlled trial. Neurology 2003;60:1284–9.
Namaka M, Gramlich CR, Ruhlen D, Melanson M, Sutton I, Major J. A treatment algorithm for neuropathic pain. Clin Ther 2004;26:2163.
Haddox JD, Joranson DE, Angarola RT., et al. Consensus statement from the American Academy of Pain Management and American Pain Society. The use of opioids for the treatment of chronic pain. Clin J Pain 1997;13:6.
Eisenberg E, McNicol ED, Carr DB. Efficacy and safety of opioid agonists in the treatment of neuropathic pain of nonmalignant origin: Systematic review and meta-analysis of randomized controlled trials. JAMA 2005;293:3043–52.
Harati Y, Gooch C, Swenson M, et al. Double-blind randomized trial of tramadol for the treatment of the pain of diabetic neuropathy. Neurology 1998;50:1842–46.
Sindrup SH, Andersen G, Madsen C, Smith T, Brosen K, Jensen TS. Tramadol relieves pain and allodynia in polyneuropathy: A randomized, double-blind, controlled trial. Pain 1999;83:85–90.
Boureau F, Legallicier P, Kabir-Ahmadi M. Tramadol in post-herpetic neuralgia: A randomized, double-blind, placebo-controlled trial. Pain 2003;104:323–31.
Duhmke RM, Cornblath DD, Hollingshead JR. Tramadol for neuropathic pain. Cochrane Database Syst Rev 2004;CD003726.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Humana Press
About this chapter
Cite this chapter
Sharp, H.T. (2008). Pharmacological Treatment of Pelvic Pain. In: Potts, J.M. (eds) Genitourinary Pain And Inflammation. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-126-4_21
Download citation
DOI: https://doi.org/10.1007/978-1-60327-126-4_21
Publisher Name: Humana Press
Print ISBN: 978-1-58829-816-4
Online ISBN: 978-1-60327-126-4
eBook Packages: MedicineMedicine (R0)