Managing Chronic Pain: Medications

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 medication for you, and to use it 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:

  • To help break the pain cycle.

  • At times when pain is more intense than usual.

  • For daily relief.

  • Before activities that tend to trigger pain.

  • To decrease sensitivity to pain and help you sleep.

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

Non-opiods. 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. They 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 and ulcers. None is addictive.

Opiods. This includes drugs such as morphine, oxycodone, codeine, and others. They may be used to treat breakthrough pain or severe chronic pain. Opiods are available only by prescription. These medications are effective for managing chronic pain but do have side effects and 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 This group includes medications that were originally made to treat other conditions but were also found to have pain-relieving properties.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 pain. Examples include amitriptyline (Elavil), desipramine (Norpramin). Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and paroxetine (Paxil) 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, help certain pain conditions, particularly nerve pain. Examples include gabapentin (Neurontin) and pregabalin (Lyrica).

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 (Flexeril) work similarly to tricyclic antidepressants and can be sedating.

Taking Medication Safely

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

  • 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 or make your pain worse.