Medical Management

Like in other chronic conditions, treatment of chronic pain usually involves medicines in combination with nonpharmacological therapies. However, the efficacy of medications varies from patient to patient; hence, medication management involves assessing the patient’s need for treatment, providing prescriptions, and monitoring patients to improve the therapeutic outcome and safety of the medications. Health care providers also review prescribed drugs and their possible side effects when creating individualized treatment plans.

The most common chronic pain medications include:

  • Acetaminophen (Tylenol), also found in over-the-counter and prescription pain medications, may be used as first-line treatment for patients with chronic pain. However, too much acetaminophen can damage your liver, especially if you drink alcohol.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Motrin, Advil), and naproxen (Aleve) are also found in over-the-counter medications. Side effects from NSAIDs include increased bruising, bleeding in the stomach, kidney damage, high blood pressure, and interference with blood pressure medications.
  • Antidepressants can provide chronic pain relief and can be used to treat nerve damage, arthritis, fibromyalgia, headache, low back pain, and pelvic pain. Possible side effects of antidepressants include nausea, trouble sleeping, dry mouth, constipation, weight gain, dizziness, and heart disease
  • A health care provider may also prescribe anticonvulsant medications for some patients. Side effects of the anticonvulsants include drowsiness, nausea or vomiting, restlessness, dizziness, loss of appetite, weight gain, itching, or swelling.
  • On rare occasions, health care providers prescribe narcotics or opioids to treat chronic pain, but they are highly addictive. Although opioid use, abuse, and adverse consequences, including death, have escalated, surveys conducted in 2017 showed that 92% of physicians and patients believed that opioids reduce pain, and 57% of the patients reported improved quality of life. Hence, there are regulations and guidelines for responsible opioid prescribing to allow access for patients who need it and reduce the harmful effects of addiction, depression, and deaths. Once the pain has eased, physicians may help patients decrease the amount of opioid medication slowly and safely to reduce withdrawal symptoms. They may also change the prescription to another drug or stop the medication completely.