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Medication Management


 

What are the different types of pain medication options?

Patients suffering from painful conditions need options to help treat their symptoms. The best pain control can be achieved by trying to target appropriate medications for the underlying problem, and trying to minimize pain with different medication and non-pharmaceutical treatments. Learn about different types of medications used to control pain.


Acetaminophen:

Tylenol (Acetaminophen) is used to treat pain. Unlike some medications for pain, Tylenol does not have anti-inflammatory effects. Often, however, in cases of chronic pain, no inflammation is at the site of the pain, and thus Tylenol may be an appropriate treatment choice. Tylenol is safe when used appropriately, but can be dangerous when used excessively. Patients should be aware of Tylenol that is mixed in with prescriptions such as Percocet or Darvocet, and not take these medications as well as regular Tylenol.


Non-Steroidal Anti-Inflammatory Medications (NSAIDs):

The NSAIDs (such as Ibuprofen, Motrin, Aleve, etc.) are most beneficial in cases of acute pain, or flare-ups in patients with chronic pain. NSAIDs are excellent at treating inflammatory conditions including tendonitis, bursitis, and arthritis. In general, NSAID use is limited for patients with chronic pain because of concerns about the development to stomach problems. While the newer, so-called COX-2 inhibitors, such as Celebrex, were designed to avoid this complication, caution should still be used when using these medications for long periods of time.


Corticosteroids:

As with NSAIDs, corticosteroids are powerful anti-inflammatory medications, and best used for acute pain or for flare-ups of a chronic inflammatory problem. Corticosteroids can either be taken orally (such as Medrol, Prednisone), or injected into the soft tissues or joints (cortisone injections).


Narcotics:

Narcotics should be considered if pain cannot be otherwise controlled. Although these medications can be dangerous and addicting, they can also be extremely effective. While narcotic medications are useful for acute pain, they also have significant side effects. The short-acting types of these medications can lead to overuse and the development of tolerance. Long-acting options have fewer side effects, and better control of chronic pain. Narcotics can become addictive when they are used for lengthy times without gradual reduction in the dose, or if the medications are taken for reasons other than pain.


Anti-Convulsants:

Anti-convulsant medications are the category of medications that work to relieve nerve pain. These medications alter the function of the nerve and the signals that are sent to the brain. The most commonly prescribed anticonvulsant medication for nerve pain is called Neurontin (Gabapentin). Another option that has more recently emerged, specifically for the treatment of fibromyalgia, is called Lyrica (Pregabalin).


Local Anesthetics:

Local anesthetics can provide temporary pain relief to an area. When used in the setting of chronic pain, local anesthetics are often applied as a topical patch to the area of pain. Lidoderm comes in a patch that is applied to the skin and decreases the sensitivity of this area.


Bottom Line:

Chronic pain is a problem that is seldom resolved quickly, or with one treatment. The best way to treat chronic pain is by working with your doctor and trying to attack the pain with different types of treatments. Other treatments effective for chronic pain include acupuncture, ice and heat application, massage, and other alternative treatments.


Sources:
• Marcus, DA “Treatment of Nonmalignant Chronic Pain” Amer. Family Physician. 2000. 61(5) Pages 1331-8.
• Katz, WA “The Needs of a Patient in Pain” Amer. J. Med. 1998. 105(1B) Pages 2S-7S.
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