I was curious about what role narcotic pain medications play in your overall pain management? I was going to put this on the pain medication board, but since I'm interested in how you guys integrate your medication use with adjuvant pain management techniques I thought it was more appropriate here.
From what I gather there are two main ways, with variations, to approach narcotics for chronic pain management:
1) PRN (as needed) approach: There seem to be a few ways to manage meds on a prn basis. The main ones that come to mind are taking the narcotic for pain spikes when the pain is intolerable, or taking a narcotic before activities that are known to provoke pain. I think the overall theme with this is that the drug is taken with respect to pain levels- either an actual pain spike, or the prediction of a pain spike. This method seems to give narcotics a relatively small role in overall pain management, with the emphasis being that other techniques are used just as much or more than medication.
2) Around the clock approach: Narcotics are taken at regular time intervals irrespective of pain levels. This method seems to put narcotics more as a cornerstone of treatment, with other techniques being used to supplement the narcotic pain control as needed (which of course they are needed since narcotics certainly don't give 100% relief).
I'm not sure which way is better. Each has its benefits and drawbacks, so I was just curious how you guys manage and which method you prefer.