Chronic Pain Health Center

Medication

There are literally hundreds of different medication options available to treat chronic pain, from simple over-the-counter (OTC) aspirin and ibuprofen to extremely potent opioid narcotics.

Most OTC medications are based on one of the following active ingredients, sometimes in combination:

• aspirin
• acetaminophen (Tylenol)
• naproxen sodium (Aleve)
• ibuprofen (Advil, Motrin)

Always read the label of any OTC medication to make sure the active ingredient is the correct medication for you. Many OTC medications have more than one of these ingredients or other additives such as caffeine or diphenhydramine (Benadryl).

Just because OTC medications are not restricted by prescription, it does not mean they are safe for everyone to take. Acetaminophen and aspirin can both cause serious liver damage if taken improperly. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can cause stomach and kidney diseases over time. Always discuss dosing and use of any OTC medication with your doctor before using such medications.

There are also several different NSAIDs that are prescription strength and sold in different formulations. Some are made specifically to protect the stomach, and others are in gel form to be applied directly to the skin or in an intravenous formulation to be infused directly into the bloodstream.

Opioid analgesics are potent pain relievers that can be extremely effective when used properly. For many patients, opioid analgesics can significantly improve functional ability, provide pain relief and reduce the depression and hopelessness that can come with constant pain. Unfortunately, long-term use of opioids can also lead to tolerance and addiction. Other side effects include decreased testosterone levels in men, decreased libido and sex drive, irregular menses, depression, impaired sleep patterns and suppression of the immune system. One should never take any opioid analgesics without consultation and direction from a physician. 

Most opioid analgesics contain one of the following active ingredients:

• morphine
• oxycodone
• hydrocodone
• tramadol
• methadone
• fenanyl
• hydromorphone
• oxymorphone

Many of these active ingredients are also mixed with non-opioid pain relievers in a combination pill. A widely used (and abused) example is hydrocodone with acetaminophen (commonly marketed as Vicodin).

There are dozens of different medication formulations that include some form of opioid analgesic. Do not take any of these medications without consulting a physician or pharmacist first.

Complementary and Alternative Medicine

Many individuals with chronic pain turn to alternative medical procedures and practices to supplement other conventional medical treatment. Massage, acupuncture, yoga and tai chi are a few methods that are used.

Complementary and alternative medicine (CAM) is commonly used for chronic pain relief. However, there is conflicting medical evidence on whether these treatments have been scientifically shown to be successful. Using these methods, many patients find relief that they were not able to get through medication. You should speak with your doctor about your treatment goals and ask what is best for you.

Forms of alternative treatment include the following:

• Acupuncture
• Massage
• Spinal Manipulation
• Progressive Relaxation
• Yoga
• Mineral Baths (Balneotherapy)
• Tai Chi
• Cognitive-Behavioral Therapy
• Exercise Therapy
• Herbal Remedies (including glucosamine, chondroitin and various herbs)
• Guided Imagery
• Hypnotherapy
• Meditation
• Relaxation Therapy

Reviews of research on acupuncture, massage and spinal manipulation have found that these therapies may be helpful for patients with low-back pain. Acupuncture, herbal remedies, mineral baths and tai chi may help patients of arthritis.

Some physicians use placebos (fake medication), which in some cases has reduced or eliminated pain. Scientists believe that advances in neuroscience will lead to more and better treatment options for patients with chronic pain.