Although there are many types and brands of medications, what medication we will prescribe depends entirely on your pain level, the treatment goals, and your medical conditions.
Some medications have serious side effects. If you notice any new symptoms, tell us immediately. But don’t stop taking your medication unless your doctor tells you to do so.
Please take all the medicines prescribed to you exactly as directed for us. Do not stop taking your medicines because you feel better. If you still do not feel good enough, do not take more medicines than those indicated, an overdose can be very dangerous.
Also, you should tell us about everything you are taking, including herbal remedies and supplements, because of possible drug interactions or side effects.
The most important thing to remember when taking medications to treat your chronic pain is that you need to be an active participant in your own treatment plan. Don’t be afraid to ask questions—you have to be your own advocate.
Over time, you may need to increase or decrease your dose of medication or even to change the medications. Again, it is very important to carefully follow your doctor’s directions.
Non-steroidal anti-inflammatory drugs (NSAIDs)
They also lower fevers and reduce inflammation. This anti-inflammatory effect makes these medicines useful when inflammation is part of the problem, as usually happens in joints diseases. Then, osteoarthritis, rheumatoid arthritis, and headaches are common conditions that NSAIDs treat.
NSAIDs use can lead to gastrointestinal upset and bleeding and may increase the risk of heart disease and stroke.
There are 2 categories of anti-depressants that work well with pain:
- Tricyclic antidepressants (TCAs), Examples of TCAs are amitriptyline hydrochloride (Elavil) and nortriptyline (Pamelor).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs are duloxetine (eg, Cymbalta) and venlafaxine (Effexor).
Anti-epileptic (anti seizure) drugs
Examples of anti-seizure medications are pregabalin (Lyrica) and gabapentin (eg, Gabarone).
Steroids have certain side effects (eg, weight gain, raising blood glucose, weight gain). You can’t just stop taking them—your dose must be slowly decreased.
In the most extreme pain cases, we could prescribe you an opioid. Due to potent side effects and the risks of tolerance or abuse, you’ll need to be under your doctor’s careful supervision when taking this medication.
Opioids—also called narcotics—are potent painkillers. They provide immediate relief to intense pain by changing your brain’s perception of the pain message. However, opioids are typically prescribed only if other medication options aren’t successful. They may be prescribed for low back pain, neuropathic pain, or arthritis pain, for example. Examples of opioids are oxycodone (Endocet), tramadol (Ultram), and morphine.
The use of opiate analgesics or narcotics is not the answer to the treatment of chronic pain. They can be addicting and can decrease the patient’s ability to cope with pain. When we prescribe opioids, we attach to the highest ethical and medical standards.