A panel from the US Food and Drug Administration met this week to discuss pain medications, particularly those containing acetaminophen. The dangers of taking too much acetaminophen have been in the news lately, as the medication can be lethal if the recommended daily dose is exceeded. Because many of these medications are available over-the-counter, many unsuspecting people looking for pain relief may get much more than they bargained for: severe, potentially deadly liver damage.

The panel recommended the maximum dose of over-the-counter acetaminophen be restricted to 650 mg, even though products with nearly double that amount are currently available for purchase in any drug store. They hope this might reduce some of the yearly acetaminophen-associated deaths.

Many people who suffer from chronic pain rely on over-the-counter painkillers such as NSAIDs and acetaminophen to manage their pain, or to control breakthrough pain. Though the dangers of overdosing on acetaminophen are clear, making the strongest version available by prescription could make the drug harder for some to access, and possibly more expensive. There is a big difference between walking into a convenience store and having to pay a copay at the doctor to get a prescription.

How many of you take acetaminophen regularly for your chronic pain? If the FDA panel's recommendations go into effect, how will it impact your pain control?

When you think of a drug overdose, you may think of a rock star strung out on heroin or a celebrity found unresponsive amidst multiple prescription bottles. However, recently the FDA has begun to consider drug overdoses that come from a more unlikely source: over-the-counter pain relief.

A recent Time Magazine article detailed the FDA's scrutiny of over-the-counter medication labels of drugs such as acetaminophen, commonly used both for fever reduction and pain relief. One of the potential risks of chronic acetaminophen use is liver damage, however there may be a risk with occasional use as well. Acetaminophen is sometimes taken with other over-the-counter or prescription drugs that contain more acetaminophen, boosting the daily intake over four grams, the maximum amount considered to be safe per day. Any more than that, the FDA points out, can lead to potentially fatal liver damage.

Many other over-the-counter pain relievers have also been under scrutiny lately, particularly NSAIDs, for their potentially serious gastrointestinal effects. Acetaminophen and NSAIDs are some of the most commonly used medications for pain control, including both acute pain and chronic pain.

By bringing these issues to the public's attention, I hope the FDA succeeds in preventing some potentially deadly over-the-counter drug interactions. We are so used to just taking a pill when we get a headache or a backache, that we often don't stop to consider the consequences of long-term use. Or, we don't think about the potential interaction with other medications we take regularly. Based on these recent findings, it's time we pay closer attention!

Everywhere you turn, there is another theory about the pop icon Michael Jackson's death. One of the most recent, and most chilling to me, is that he suffered a fatal Demerol overdose. While it is purely speculation at this point, it does touch a nerve with me as the Guide to chronic pain.

Demerol is a narcotic pain reliever, available only by doctor's prescription. It is classified as an opioid analgesic, and is similar in strength and effect to morphine. Like other opioids, it has potentially deadly side effects if used inappropriately. For people with certain conditions, such as sickle cell anemia and respiratory problems, Demerol use can have serious complications. It can also cause respiratory distress or even death when combined with alcohol or other sedatives.

There is no doubt that Demerol is serious stuff. But why does it bother me so much that Demerol complications might have potentially led to the death of such a prominent celebrity? Well, it seems that every time I turn around, another celebrity is in the news talking about their addiction to painkillers. In the past few years, we have lost both Anna Nicole Smith and Heath Ledger to prescription medication overdoses. Each was reportedly taking multiple medications with potentially deadly effects when mixed together. It just makes me wonder, why were their physicians prescribing such potentially lethal combinations? It also makes me wonder how many ordinary people out there die of accidental overdoses and receive no press at all.

It seems to me that the greatest risk for deadly prescription combinations happens when you see multiple specialty doctors. You may assume that each doctor knows what the other is prescribing, but having worked in the health industry for over fifteen years I can assure you that this is not always the case. To protect yourself, you must keep good records of your medications. If you keep a pain journal, you can detail your daily doses there. Bring your journal to every doctor's appointment to ensure each has your current medication list, both prescription and over-the-counter. It might even be wise to carry a list of your prescriptions with you at all times, in case of emergency.

If you take Demerol for chronic pain, don't panic. But please, do go over your medications with your doctor and discuss any concerns you may have. It could very well save your life.

Are you considering using an alternative treatment for chronic pain? With many choices available these days to treat our pain, we no longer have to rely solely on medication for relief. However, there are a few things you should consider before you take the plunge.

First, what kind of relief are you looking for? Do you want something you can do in addition to your usual medication? Or, are you looking for something to replace your medication completely? Complimentary medicine is non-medical treament that is used in addition to your normal treatment regime. Alternative medicine, on the other hand, replaces your former medical pain control methods. If you are on the fence, you should talk to your doctor. Read this article for more information about making the decision to switch to alternative medicine.

Next, what do you want to try? There are plenty of options available, from yoga to acupuncture to herbal remedies. Figuring out where to start can be overwheming. Ask your friends, read chronic pain forums and do a little research online. Be sure to ask questions about safety and success rates of the treatments you are considering.

Finally, ask yourself what you will do if the treatment does not work. Are you willing to try something different? Would you just go back to your old regime? Having a loose plan in place can help you take the next step without getting as frustrated. Keep in mind that, much like pain medication, it may take time and a little experimentation to find a complimentary or alternative treatment that works for you.

It isn't news that chronic pain and depression are often closely related. However, a new study found that the risk for having chronic pain and depression at the same time is greatest in middle aged women. There was also a significant correlation between the two diagnoses for African Americans. According to the study, depression was not significantly associated with any chronic pain diagnosis in particular.

I think this is a very interesting finding, and I have to admit I was not completely surprised. After all, women are more likely to suffer from chronic pain than men. Women are also more likely than men to have depression. It seems almost logical that this finding would follow.

It does present some potential challenges for physicians when they diagnose chronic pain. Will they be more likely to ask a woman than a man if they are also experiencing signs of depression? Will they ask African Americans more frequently than Caucasians, or other races? On the contrary, will the consider that a younger man might be suffering not from one of the two diagnoses, but both?

I would love to hear some reader opinions on the matter.

Even if you have had a chronic pain condition for years, it is still good to get a check-up every now and then. Your doctor is one of your best resources in the fight against chronic pain. In fact, here are four good reasons to see your chronic pain doctor regularly.

Before you head out for your next doctor's appointment, make a plan by asking yourself a few questions. Has anything about your condition changed since your last visit? Are your medications still effective? Are you having breakthrough pain? Take a few minutes to make notes in your pain journal, and be sure to bring them with you.

Regular check-ups with your pain doctor can make the difference between simply living with chronic pain, and actually coping with chronic pain.

Pain is meant to serve a purpose. When you have acute pain, your body is telling you something is wrong. Even after a minor injury, your body has a routine in place which determines how you feel pain. Your nerves, brain and spinal cord begin a complex set of interactions that happen almost instantly, causing your hand to jerk away from a hot burner or your foot to recoil from a sharp tack.

When pain becomes chronic, however, this system is not always working the same way. Some chronic pain conditions, such as arthritis, cause permanent or continual damage, keeping your pain response system active all of the time. Other conditions may persist long after the injury has healed, such as some cases of chronic back pain. Because of this, acute pain and chronic pain may be felt differently.

Regardless of how or why we feel pain, living with chronic pain is not easy. Chronic pain can interfere with your work as well as your home life. This is why I wrote a section on coping with chronic pain. In it, you can find information about the physical and psychological effects of chronic pain, as well as some tips for getting on with your life. If you have any other suggestions for your fellow chronic pain sufferers, please leave them here!

We have a long history of headaches in my family. My father gets sinus headaches. My nephew gets migraines. I get tension headaches. The interesting thing, however, is that until I began to guide this site, I didn't truly understand the cause and treatment of chronic headaches. Considering how long my family has been dealing with them, this came as a bit of a shock.

When I first began receiving treatment for my tension headaches, it was commonly thought that they were caused by muscle tension. I felt I was under a lot of pressure at the time, and my doctor attributed them to stress. I got a prescription for a strong NSAID, and another for a muscle relaxer. The medications helped relieve my headache pain, but they did nothing to prevent them. Since living stress-free at the time was not really an option (I was working hard to get accepted into my occupational therapy program), I thought I would have chronic tension headaches for the rest of my life.

Today, however, newer research indicates that what we used to think caused certain types of headaches is not necessarily accurate. In fact, I detailed many of these new findings in one of my headache articles. Interestingly, while stress may be a trigger of tension headaches, other more likely triggers are caffiene, fatigue and eye strain. You know, I was a college student at the time I was diagnosed. That trigger list sounds like one of my typical school days! It's funny how things change with a little research.

If you suffer from chronic neck pain, I have some good news for you. The National Center for Complimentary and Alternative Medicine has found evidence that therapeutic massage can decrease chronic neck pain.

While this may not seem like news to you, it is one of the first studies that has shown a significant association between massage and pain control. Many people who have been seeing a massage therapist all along may know that it helps their pain, but having a study to back it up confirms that there are therapeutic benefits to this type of treatment. If you never felt like you had a reason to get a massage, well here's your chance!

If you have never had a massage for your chronic pain, here are a few things to consider:

Be sure your massage therapist is an LMT, or a licensed massage therapist. LMT's have extensive anatomical training, and are licensed and certified only after passing a board exam.

Before your appointment, tell your LMT about your medical history. A good LMT will ask if you have any medical conditions, so be sure to include your chronic neck pain, even if you do not have a concerete diagnosis.

Don't be afraid to speak up! If the pressure is too intense, tell your LMT. She will lighten up to make you more comfortable. Most LMT's will ask how you are doing during your massage, but don't be afraid to volunteer this information as needed.

Finally, relax and enjoy yourself. Sure, this is therapy for your neck. But it's also a spa treatment! Why not enjoy the pampering?

Like many complimentary medical treatments, many health insurance providers do not cover massage under your medical plan. But, sometimes the benefits outweigh the cost of treatment. The way I see it, getting a massage is a wonderful way to relax, which can help you cope with chronic pain. Now we know neck massage can actually help reduce your neck pain. Plus, you are doing something enjoyable for yourself. To me, that's a win-win situation.

A new report from the American Geriatrics Society (AGS) states that opiods may be better than NSAIDs for controlling chronic pain in seniors. Opioids, such as codeine, differ from NSAIDs, such as ibuprofen, in that they available by prescription only. They act on the nervous and musculoskeletal system in different ways, though both are effective in controlling chronic pain. So why is one better for seniors?

According the the AGS, NSAIDs have a higher probability for medication interactions, particularly with meds that control blood pressure and heart disease. Seniors who take NSAIDs regularly are also at a higher risk for gastrointestinal disorders, such as stomach and liver damage. The AGS feel that NSAIDs have too high a risk to be used to control chronic pain long-term in seniors.

Dont's worry: the AGS is not suggesting all seniors with chronic pain go out and get presciptions for morphine. Rather, they propose the use of low doses of opioids for long-term pain control. I wonder if it will change the ease of seniors managing their pain medication?