If Pain Doesn't Subside Even with Tramadol, a Narcotic Analgesic | Incheon Chronic Pain
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Hello, I am Choi Yeon-seung, a Korean medicine doctor at Baekrokdam Korean Medicine Clinic.
“There's pain that doesn't respond to painkillers”
Quite a lot of people say this in the examination room. They've tried changing medications multiple times, received physical therapy, and even tried the injection treatments recommended by hospitals...
Yet they still say it hurts. Not just a little pain, but “it doesn't get better at all—is there something stronger?” When they say that, exhaustion is already visible in their expressions, and signs that their body's rhythm has collapsed are showing externally.
These patients have already tried NSAIDs (non-steroidal anti-inflammatory drugs), and sometimes have been taking central-acting analgesics like tramadol. But what's surprising is hearing them say even those strong medications “seemed to help at first, but quickly became ineffective.”
The Complexity of Pain
In such cases, it's not simply that the pain intensity is higher, but that the pain circuit within the body has shifted into a more complex direction.
But here's an important point: pain never occurs simply at one spot. Especially with chronic pain, it's not a 'wound' but a 'condition.'
“Instead of asking what disease it is, I want to know why this pain keeps lingering in my body.”
How Tramadol Works
Tramadol is a bit different from regular painkillers. This medication doesn't just reduce inflammation or act only on peripheral nerves—it directly affects the central nervous system, meaning the brain and spinal cord.
It blocks pain signals from reaching the brain, or regulates them so the brain doesn't perceive pain in the first place. Additionally, tramadol has a dual action: it suppresses the reuptake of neurotransmitters like serotonin and norepinephrine, simultaneously calming mood and sensation.
“Tramadol is a pretty strong medication—why doesn't it work?”
Distortion of Pain
However, if pain persists even after taking such medication, it means not just that the pain is intense, but that the entire nervous system's way of accepting pain has already become distorted.
Simply put, it's like pressing the 'off' switch for pain, but the switch itself is broken and won't work. This cannot be solved simply by increasing the strength or dosage of medication.
Sensory Errors
“Is it a nerve problem? Or a sensory error?” Many people wonder this.
Of course, those cases do exist. If peripheral nerves are compressed or inflammatory responses occur, neuropathic pain can develop, and in those cases, injections at precise locations or using neurotransmitter inhibitors can provide solutions. But when it comes to chronic pain, especially pain that doesn't respond even to tramadol, it's a different story.
The Memory of Pain
This is closer to 'sensory habituation' or 'sensory fixation' than a nerve problem. It's a kind of repetitive sensory loop. And this loop cannot be broken simply by willpower alone.
This is because the body's sensory processing system, emotions, sleep, and immune responses are all connected. What's needed in such cases isn't treating damaged tissue, but an approach that recalibrates the distorted sensory circuit.
Korean Medicine Approach
In Korean medicine, this state is interpreted as stagnated qi (氣), phlegm (痰) accumulation, or deficiency (虛) fixation—energy that cannot move and has become stagnant. In such cases, rather than simply applying medication to the painful area, treatment that changes the overall flow and sensory patterns of the body is more necessary.
Clinic Information
- Clinic Hours-
- Monday–Friday 10:00 AM – 7:00 PM
- Lunch break 1:00 PM – 2:00 PM
※ Individual consultations via blog are not available. For reservation and clinic inquiries, please check Naver Place or the official website.
Baekrokdam Korean Medicine Clinic Incheon Yeonsu-gu, Conventionna-ro 81, Songdo Dream City
3rd Floor
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