Chronic Pain: OTC or Prescription Medicine?
Prescription Drugs: Not Always the Next Step
If OTC drugs are not effective in relieving your pain, moving to a prescription drug is not always necessarily the next step. In many cases, drugs may not always be the best course of treatment.
"Pain management doesn’t have to involve a drug," Minzter tells WebMD. Non-medication approaches include avoiding certain activities, exercising, heat or cold applications, weight management, bioelectric currents, complementary and alternative medicine, and surgical procedures.
But if you and your doctor decide that prescription medications are the way to go, there are plenty of options.
Many prescription drugs are designed to treat chronic pain, including back and neck pain, headaches, nerve pain, fibromyalgia, rheumatoid arthritis, and osteoarthritis. The following are a few examples:
Over the years, doctors have discovered that antidepressants actually help with certain types of pain, such as:
- Nerve damage caused by diabetes or shingles
- Tension headache and migraine
- Back pain
Doctors have found that tricyclic antidepressants are helpful in easing pain and may also improve sleep. While researchers aren’t exactly sure how they reduce pain, studies suggest that tricyclic antidepressants boost chemicals in the brain that help diminish pain signals.
Some examples of tricyclic antidepressants that may relieve pain include:
- Desipramine (Norpramin)
- Imipramine (Tofranil)
- Nortriptyline (Aventyl, Pamelor)
Other types of antidepressants called SNRIs (serotonin and norepinephrine reuptake inhibitors) that may help relieve pain include:
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Milnacipran (Savella)
- Venlafaxine (Effexor)
Other antidepressants known as SSRIs (selective serotonin reuptake inhibitors) may be used to treat the depression that often accompanies chronic pain. This, in turn, also may help relieve pain.
Possible side effects of certain antidepressants include dry mouth, blurred vision, constipation, weight gain, and/or sexual problems, such as the inability to achieve orgasm.
Another class of drugs used for pain relief is antispasmodics. Antispasmodics work by relaxing the smooth muscle of the gut. These drugs are used to treat irritable bowel syndrome, diverticular disease, and other digestive conditions, as well as menstrual pain and interstitial cystitis.
Antispasmodic drugs include:
- Chlordiazepoxidem/clindium (Librax)
- Dicyclomine (Bentyl)
- Glycopyrrolate (Robinul)
- Hyoscyamine (Levsin)
- Propantheline (Pro-Banthine)