Other drugs besides anti-depressants have this dual use. Anti-convulsants such as Neurontin are now known to block the firing of nerves that have grown new sprouts in response to injury. Anti-anxiety medications such as Valium, Ativan and Klonopin also block transmission of signals along pain nerves. Researchers are also finding better ways to deliver painkillers in patients who can't swallow or don't want injections. Fentanyl, for instance, comes in patches that deliver a steady dose over several days.
Some patches now come with buttons that a patient pushes when relief is needed.
There's even a lozenge of fentanyl on a stick, so the drug can be absorbed directly through mucus membranes in the mouth. At a few clinics, including the Advanced Pain Management Center in Stoneham, doctors are trying to shrink damaged spinal discs with heat. A wire is inserted into the disc through a tube and then heated to 194 degrees Fahrenheit. This seems to shrink collagen in the disc and reduce pain, says Dr. Anil Kumar, who has performed the procedure on a dozen patients so far. In other patients with back pain, steroids injected near the spinal cord sometimes work, as can injections of local anesthetics into nerve ganglia in the neck or lower back.