Pharmacotherapy
Different oral treatments and medications can be used to treat wrist pain. The most common aids to obtain acute pain relief are oral anti-inflammatory agents such as diclofenac, ibuprofen, indomethacin, and naproxen. All of these are over-the-counter medications but should be consumed according to your doctor’s indications. They are nonsteroidal anti-inflammatory drugs or NSAIDs.
NSAIDs work by inhibiting enzymes and reducing the formation of substances called cytokines. They are responsible for triggering inflammation in the tissues. By reducing cytokines, swelling and inflammation are controlled, and the intensity of pain diminishes. But sometimes, pain is not triggered by inflammation or can be very severe, and oral medications are not enough. In such cases, we still have some injected NSAIDs. If those are still not effective, doctors can also use injectable corticosteroids.
The most common injectable corticosteroid to control wrist pain is known as methylprednisolone. Other injected medications doctors can use include anesthetics, which are mostly used to reduce acute pain after receiving surgery. One of these anesthetics is bupivacaine, and they are always administered under the strict vigilance of a healthcare professional.
In some cases, wrist pain can be due to an infection of the articulation. In case of infections, patients have something called septic arthritis, which can be very painful and causes acute wrist pain. Patients with infection should receive antibiotics and painkillers to achieve long-term pain relief. The type of antibiotic and the dose highly depend on the bacteria and the severity of the infection.
In some cases, patients should receive pharmacotherapy aimed at the central nervous system to address nerve-related pain. For example, the antidepressant duloxetine can be used for musculoskeletal pain and to reverse vasospasms in Raynaud’s phenomenon. It also has an antinociceptive effect, especially in patients with a psychogenic element. Antiepileptics and other antidepressants can also be used in chronic pain due to nerve entrapment syndromes and other nerve-related diseases. They change the concentration and activation of neurotransmitters and ion channels in neurons and provide lasting analgesic effects in such cases.
Pharmacotherapy also includes opioid analgesics but should always be used with extreme care. Patients receiving this type of analgesic treatment are prone to tolerance and addiction. They also cause agitation, tremors, and hallucinations if they are given in a high dose. Thus, this type of treatment should always be administered following the exact recommendations of your doctor.