Medications

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to manage pain

Medication can help manage your chronic pain condition, especially when the pain doesn't respond to other treatments. Medication works best when used with alternative therapies like heat, ice, and gentle exercise.

Medication guidelines

Follow these guidelines when taking pain medication to get the safest, most effective pain relief possible:

  • Always take your medication as prescribed. No more, no less. Talk with your doctor before changing how you take your medication.
  • Chronic pain is often treated by using around-the-clock medication. Take your medication on schedule, even if you feel like you don't need it right at that moment, to stay ahead of pain.
  • Before using any new medication (including over-the-counter drugs, herbs, or supplements) talk to your doctor or pharmacist about its safety, side effects, and how it will interact with other medications you are taking.
  • Use a medication schedule to keep track of when to take each medication, and write down any problems or side effects to tell your doctor about.

Anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are usually the first type of medication used to treat mild to moderate pain because they have the fewest side effects.

Some NSAIDs are available without a prescription, including:

  • ibuprofen (Advil, Motrin)
  • naproxen (Aleve)
  • aspirin (Do not give aspirin to anyone younger than 20 unless directed by a doctor.)

NSAIDs at higher doses may be prescribed by your doctor.

Arthritis treatments

Arthritis pain and stiffness may improve with pills, as well as site injections.

Osteoarthritis

Acetaminophen (Tylenol) can help with mild osteoarthritis pain. Acetaminophen is often a good choice because it is gentle on the stomach and controls pain better than some prescription medications.

Many other pain relievers include acetaminophen, so check the label carefully before taking these drugs. Too much acetaminophen can cause damage to your liver. Learn more about the risks of taking too much acetaminophen.

Your doctor may recommend shots of medication into your stiff joints if you have osteoarthritis. Corticosteroid injection (such as cortisone) is a powerful anti-inflammatory. While the shots can be helpful, they may have serious side effects — including osteoporosis — if used too often. Talk to your doctor about the risks and benefits.

Hyaluronic acid is naturally found in joint fluid and is used to improve lubrication. Hyaluronic acid can be injected only in the knee, although researchers are studying its use in other joints.

Rheumatoid arthritis

Disease-modifying antirheumatic drugs (DMARDs) can slow or sometimes prevent joint damage in rheumatoid arthritis. It may take up to 6 months for DMARDs to help you feel better.

Corticosteroids (cortisone, prednisone, Medrol) may be used to control symptoms of rheumatoid arthritis until your DMARD is effective.

Migraine treatments

There are 2 types of medication for migraine pain:

  • medications to prevent migraines
  • medications to stop migraines when they happen

You can get over-the-counter or prescription medications to stop a migraine. To prevent them, talk to your doctor about prescription options.

Some medications designed for other medical conditions can also be effective for migraines. These include:

  • beta blockers
  • calcium channel blockers
  • antidepressants
  • anti-seizure medications

Use the migraine medication decision tool to learn more about your options.

Opioids

Opioids (Vicodin, OxyContin) are generally used for more severe pain, and are only available by prescription.

There are 2 main types of opioids:

  • short-acting for pain that comes and goes
  • long-acting for pain that is constant

Your doctor will talk with you about the risks and side effects related to opioids, along with opioid safety guidelines.

Learn about opioid use and safety.

Steroids

Steroid medications are sometimes used for flare-ups of chronic painful conditions. You may also hear them called "corticosteroids."

They are often prescribed as a 1-week or 2-week "burst" (a large dose followed by smaller and smaller doses until finished). Steroids may be prescribed for long-term use, but this is rare.

Common steroids include:

Antidepressants used for pain

Antidepressant medications for pain are often used for conditions involving nerves, such as complications from shingles.

Taking antidepressants does not necessarily mean that you are depressed. Some antidepressants work directly on pain. Antidepressant prescriptions for pain are usually a much lower dosage than those used to treat depression.

Common antidepressant medications used for pain include:

Some antidepressants can help improve sleep, too — and a good night's sleep is key to managing pain.

Anti-seizure medications

Like antidepressants, anti-seizure medications are sometimes used for pain involving the nerves.

Some evidence suggests that anti-seizure medications can be especially helpful for fibromyalgia, migraine, and facial pain.

Common anti-seizure medications used for pain include:

Reviewed by: Andrew Bertagnolli, PhD, November, 2015

Additional Kaiser Permanente reviewers

©2015 Kaiser Permanente

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