Pain Meds

Pain Meds

When used as directed, pain meds can be an effective add-on to your treatment plan. If your chronic pain doesn't respond to self-care, talk to your doctor about them. Make it a goal to know your options first.

Conditions:  Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain, aching, tenderness, throbbing pain

Triggers:

Treatments:

Categories: Meds

Duration

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Safe and Slow

Pain meds -- even over-the-counter ones -- are potent drugs, so it's important to use them with care. Pain meds are processed mainly by the liver and kidneys and may have far-reaching effects in the body. For this reason, doctors will start with the safest drugs at the lowest effective dose for the shortest amount of time and work up from there as needed. This process can be frustrating when you are in pain, so be sure to tell doctor about any side effects and how meds affect your pain.

Prompt: Start safely.

CTA: Be patient during pain med selection.

Conditions: Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain, aching, tenderness, throbbing pain

Triggers: craning neck, heavy lifting, pushing or pulling, repetitive motions, sports injury, twisting, injury, carrying or lifting, excess activity, holding a child

Treatments: ibuprofen, Advil, naproxen sodium, Aleve, Anaprox, Naprosyn, aspirin, Bayer, Bufferin, aspirin, Motrin IB, Nuprin, Icy Hot, Bengay, capsaicin, Methyl salicylate/menthol, menthol, Metholatum Deep Heat, acetaminophen, Tylenol, Anacin, Panadol, Tempra

Categories: Meds

Avoid Interactions

Many people take pain meds without problems, but certain meds may not be safe for everyone. Some meds may cause significant side effects. Often side effects can be managed or go away after a short time. But sometimes side effects can be serious. Because of the risk for interactions, tell your doctor about any supplements and prescription and OTC meds you take. Tell your doctor about any alcohol or illicit drug use as well. Being open can help your doctor choose the best treatment for you.

Prompt:  Side effect precautions.

CTA: Tell all drugs you take.

Conditions: Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: ibuprofen, Advil, naproxen sodium, Aleve, Anaprox, Naprosyn, aspirin, Bayer, Bufferin, aspirin, Motrin IB, Nuprin, Icy Hot, Bengay, capsaicin, Methyl salicylate/menthol, menthol, Metholatum Deep Heat, acetaminophen, Tylenol, Anacin, Panadol, Tempra, gabapentin, Neurontin Cymbalta, duloxetine

Categories: Meds

When to Use NSAIDs

Over-the-counter pain relievers are a good place to start. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be good options when you have osteoarthritis or back or neck pain because they reduce inflammation and ease pain.

OTC NSAIDs include Advil, Motrin IB, Nuprin (ibuprofen), Aleve, Anaprox, Naprosyn (naproxen sodium), and Bayer, Bufferin, and Fasprin (aspirin). Always discuss any new meds you take with your doctor -- even OTC ones.

Prompt:  When to use NSAIDs.

CTA: Ease pain and inflammation.

Conditions: Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: ibuprofen, Advil, naproxen sodium, Aleve, Anaprox, Naprosyn, aspirin, Bayer, Bufferin, aspirin, Motrin IB, Nuprin

Categories: Meds

Acetaminophen: When?

Acetaminophen treats pain and fever but doesn't reduce inflammation. Examples include Panadol, Tempra, and Tylenol. Acetaminophen is less likely than NSAIDs to cause stomach upset. However, taking more than recommended may lead to liver or kidney problems, so never take more than the recommended dose. Also, you should also not take this pain reliever if you drink 3 or more alcoholic drinks a day due to increased risk of liver problems. Remember to discuss any new medications you take with your doctor.

Prompt:  When to pick acetaminophen.

CTA: Fight fever and pain.

Conditions: Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: acetaminophen, Tylenol, Anacin, Panadol, Tempra

Categories: Meds

OTC Dose Limits

If 1 is good, is 3 better? No. A lot of research goes into finding a safe and effective dose of meds. OTC pain relievers like NSAIDs and acetaminophen have what's called a "ceiling effect." This means after a certain dose, taking more of them won't give you more pain relief.

Plus, even OTC meds can have significant side effects, so always use the label's dosage instructions.  If OTC pain meds aren't helping manage pain, don't just take more, talk with your doctor about how to get safe relief.

Prompt: OTC dose limits?

CTA: More isn't better.

Conditions: Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: ibuprofen, Advil, naproxen sodium, Aleve, Anaprox, Naprosyn, aspirin, Bayer, Bufferin, aspirin, Motrin IB, Nuprin, acetaminophen, Tylenol, Anacin, Panadol, Tempra

Categories: Meds

Topical Pain Relief

OTC topical pain relievers include creams, gels, sprays, patches, and rubs. You apply topical meds to the skin over a painful muscle or joint.  Some can help decrease pain and inflammation. Others, called counterirritants, create a sensation of heat or cold, which distracts you so you feel less severe pain. Examples include Bengay, Deep Heat Mentholatum, or Icy Hot (methyl salicylate/menthol) and capsaicin. Ask your doctor how effective these may be for you and which one to try first.

Prompt:  Explore topicals.

CTA: Consider rub-on relief.

Conditions: Osteoarthritis, Rheumatoid arthritis, Back Pain, Neck Pain, Nerve Pain

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: Icy Hot, Bengay, capsaicin, Methyl salicylate/menthol, menthol, Metholatum Deep Heat

Categories: Meds

Prepare for Opioids

If other pain relievers don't work, prescribed opioids may be an option. Opioids reduce pain by acting on pain receptors in the brain and nerves. They are a very powerful pain reliever.

When taken as prescribed, these drugs can be very effective. However, opioids may be habit-forming and can have serious side effects. You should only take opioid meds under the direct supervision of your doctor.

If your doctor is considering opioids for you, ask about their benefits and risks.

Prompt: Opioid prep.

CTA: Ensure safety with powerful relief.

Conditions: Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: oxycodone, hydrocodone, Vicodin, Percocet, codeine, morphine, fentanyl, duragesic, Norco, Dilaudid, Exalgo, hydromorphone, Astramorph, Avinza, OxyContin

Categories: Meds

Off-Label Facts

Drugs often treat a few conditions. Doctors prescribe some meds for conditions other than what they have been approved for by the FDA. This is called off-label use, and it's an accepted and legal practice.

For example, to treat chronic pain, doctors often prescribe antiseizure or antidepressant meds, even though they were originally developed to treat other conditions. Don't be surprised if your doctor suggests one. But always ask your questions about why a med is being suggested for you.

Prompt: Off-label meds?

CTA: Safe, legal, helpful.

Conditions: Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments:

Categories: Meds

Pain Treatment

Many antidepressants effectively treat certain types of pain. They work because some brain chemicals related to depression are also involved in pain.  If your doctor prescribes an antidepressant to treat your pain, it doesn't necessarily mean you've been diagnosed with depression. However, many people with chronic pain also deal with depression, so the one medication can often help treat both conditions.

Prompt: Anti-pain!

CTA: Explore antidepressants.

Conditions: Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: Anafranil, Adapin, Aventyl, elavil, Norpramin, Pamelor, Pertofran, Sinequan, Surmontil, Tofranil, Vivactil, Parnate, Nardil, Marplan, Celexa, Luvox, Paxil, Prozac, Zoloft, Effexor, Remeron, Cymbalta, duloxetine, paroxetine, fluoxetine, Lexapro, venlafaxine, citalopram, escitalopram, Sarafem, sertraline

Categories: Meds

Anti-Seizure Drugs

Anticonvulsants were developed to help control seizures in people with epilepsy. They have also been found to help improve certain types of pain, so your doctor may consider one for you.

Doctors aren't sure exactly how they work, but they are thought to block pain signals in nerves. Examples of anticonvulsants used for pain include Fanatrex, Gabarone, Gralise, Horizant, Neurontin (gabapentin), Carbitrol, Epitol, Equetro, and Tegretol (carbamazepine), and Lyrica (pregabalin).  

Prompt: Anticonvulsants.

CTA: Epilepsy drugs for pain.

Conditions: Migraine, Back Pain, Fibromyalgia, Nerve Pain

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: gabapentin, Fanatrex, Gabarone, Gralise, Horizant, Neurontin, Carbitrol, Epitol, Equetro, Tegretol, carbamazepine, Lyrica, pregabalin

Categories: Meds

Ease Muscle Tension

Muscle relaxers work by depressing the central nervous system, helping to relieve muscle tension and spasm and often causing drowsiness. There are several reasons your doctor may prescribe them.

* They can be effective for short-term use for acute flare-ups of back pain and nerve pain.

* They can also help treat nighttime muscle pain from fibromyalgia.

Some examples include Flexeril (cyclobenzaprine), Norflex (orphenadrine), and Soma (carisoprodol).

Prompt: Relax away pain.

CTA: Explore muscle relaxers.

Conditions: Back Pain, Neck Pain, Fibromyalgia, Nerve Pain

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: cyclobenzaprine, Flexeril, Soma, carisoprodol, Norflex, orphenadrine

Categories: Meds

A Good Night's Sleep

Good sleep is critical for people dealing with chronic pain, and it can be hard to get. Your doctors may prescribe a sedative for a few days to help you get good, restorative sleep, which may help improve pain. Some sedatives can become habit forming and may have side effects such as memory loss and dizziness, and they should be used with extreme caution in people with liver problems. If pain is keeping you from a good night's sleep, discuss the benefits and risks of a sedative.

Prompt: Not enough sleep?

CTA: Explore sedatives.

Conditions: Osteoarthritis, Rheumatoid arthritis, Migraine, Back Pain, Neck Pain, Fibromyalgia, Nerve Pain, Undiagnosed

Symptoms:  burning, headache, pain, pain with movement, lower back pain, upper back pain, sharp pain, shocking pain, extreme sensitivity, deep pain, electric pain, abdomen pain, ankle pain, arm pain, buttock pain, chest pain, face pain, foot pain, hand pain, head pain, hip pain, knee pain, leg pain, neck pain, scalp pain, shoulder pain, spine pain, shooting pain, stabbing pain

Triggers:

Treatments: Lunesta, eszopiclone, Ativan, lorazepam, Serax, oxazepam, Restoril, temazepam, Sonata, zaleplon, Ambien, zolpidem, Halcion, triazolam, Xanax, alprazolam, Valium, diazepam

Categories: Meds

WebMD Medical Reference Reviewed by David Zelman, MD on October 01, 2016

Sources

SOURCES:

American Chronic Pain Association: "Resource Guide 2012."

International Association for the Study of Pain: "IASP Taxonomy."

Agency for Healthcare Research and Quality: "Navigating the Health Care System."

Consumer Reports: "Best Buy Drugs. Shopper’s Guide to Prescription Drugs, No. 6."

National Institute of Drug Abuse. "Research Reports:  Prescription Drugs: Abuse and Addiction. How do opioids affect the brain and body?"

Beth Israel Medical Center: "About Opioids."

Pain Treatment Topics: "Glossary."

Chronic Pain Network.

Fibromyalgia Network: "Treatment Studies."

Arthritis Foundation: "Fibromyalgia: Treatment Options."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Fast Facts about Fibromyalgia."

McIlwain, H. and Bruce, D. The Fibromyalgia Handbook, Holt, 2007.

FDA: “Acetaminophen and Liver Injury: Q & A for Consumers,” “A Guide to Safe Use of Pain Medicine.”

Family Doctor: “Pain Relievers: Understanding Your OTC Options.”

American Heart Association: “Use of Nonsteroidal Anti-inflammatory Drugs: An Update for Clinicians: A Scientific Statement From the American Heart Association.”

California State Board of Pharmacy: “What's the deal with double dosing?”

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