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Managing Chronic Pain: Medications

Medications can help you live better with chronic pain. You may use over-the-counter or prescription medications. It can take some time and trial and error to work out the best treatment plan for you. Work with your doctor to find the best medications for you, and to use them safely and effectively.

Tell your health care professional about all medications you`re taking, including herbs and vitamins.

A Part of Your Treatment Plan

Depending on your situation and the type of pain, you may take medications:

  • At times when pain is more intense than usual.

  • For pain relief throughout the day.

  • Before activities that tend to trigger pain, such as going shopping or doing physical therapy. 

  • To decrease sensitivity to pain and help you sleep.

There are 4 major groupings of medications for the treatment of chronic pain:

Non-opioids. These include the commonly used medicine acetaminophen as well as the non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, naproxen sodium, and ketoprofen. These all help control pain but NSAIDs also help relieve inflammation. These drugs are available over-the-counter. Some NSAIDS are available by prescription only.

Acetaminophen can cause liver damage if taken above the recommended dose. NSAIDs may cause stomach problems like bleeding ulcers. Using them over the long-term can cause heart problems and stroke in a very small number of people. None of these drugs is addictive.

Opioids. This includes drugs such as morphine, oxycodone, codeine, fentanyl, and methadone. Opioids may be used to treat breakthrough pain or severe chronic pain. Opioids are available only by prescription. These medications may be effective for managing chronic pain. But they are controversial because of their side effects and because they can be addictive.  

Adjuvants. This group includes medications that were originally made to treat other conditions but were also found to have pain-relieving properties. Examples of adjuvant drugs include antidepressants and anticonvulsants.

Antidepressants help pain by working on the same brain chemicals that play a role in depression. They also help improve sleep. Tricyclic antidepressants are one group of antidepressants used for treating chronic pain caused by nerve injury (neuropathic pain). Examples include amitriptyline, nortriptyline, and desipramine. Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine and milnacipran, are also used.

Some types of antidepressants are used in low doses for sleep problems. They may also be prescribed if you have heightened sensitivity to pain or some kinds of nerve pain.

Anticonvulsants, developed to prevent seizures, can help certain pain conditions, particularly nerve (neuropathic) pain. Examples include gabapentin and pregabalin.

Other Pain Medications

  • Topical. These medications, such as lidocaine or capsaicin, are applied to the skin to treat pain in one location.

  • Muscle relaxants. These may be used to stop painful muscle spasms. Drugs such as cyclobenzaprine work similarly to tricyclic antidepressants and can be sedating.

Taking Medication Safely

  • Take your medication on time and in the right dose as prescribed.

  • Tell your health care professional if your medication doesn't relieve your pain or work for a long enough time, or if you have side effects.

  • Don't take other people's medications. They may not be safe for you.

  • Avoid alcohol, tobacco, and illegal drugs. These may interact with your medications causing you harm.

© 2000-2015 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.