What About Pain Medications?
Do I wait until the pain is really bad before I take my pain medications?
No! Pain medications are an important part of treating your pain. It is important to treat your pain as early as possible. Controlling your pain early on helps prevent a cycle of stress and increased pain, and pain medications are more likely to work when your pain is less severe. Don’t wait till you cannot possibly bear it any longer before taking your medication.
What medications are available?
Mild pain can often be controlled with over-the-counter medication. Moderate to severe pain requires prescription medication. There are many different types of medication, including analgesics (pain medication) and medications which work well combined with analgesics. Talk with your doctor about the best choice for you. Discuss with your doctor and pharmacist what medications you are using to control your pain. It is important for them to monitor the combination of medications, including over-the-counter medications and herbal preparations.
Mild to moderate pain is often treated initially with acetaminophen and anti-inflammatories or NSAIDs such as ibuprofen, naproxen, and diclofenac, among others. Muscle relaxants combined with an analgesic, and topical analgesic creams and rubs may also be effective. Two other medications called meloxicam and celecoxib are often used because they are less likely to cause ulcers compared with NSAIDs. Although these medications are effective, they should be used cautiously in patients with cardiovascular disease such as angina, and in patients with risk factors for heart disease such as high cholesterol and smoking.
- Moderate to severe pain can be treated with tramadol, codeine and stronger opioids like oxycodone.
- Neuropathic pain is treated differently; medications like antidepressants and anti-seizure drugs, as well as analgesics such as tramadol, are frequently used. Talk to your doctor or nurse about these choices.
What about addiction?
Addiction to opioids used to treat chronic pain can occur but is actually uncommon. Chronic pain occurs over a long period of time, and therefore many people rely on opioid analgesics daily to help them manage their pain. A physical dependence on opioids for pain relief is not an addiction. Physical dependence occurs with many medications, not only ones for pain, and is addressed by slowly lowering your dose before stopping these medications completely. Your doctor will help you with this process.
Addiction to opioids is more likely to occur if you, or a parent or sibling, have had a previous history of addiction to another substance such as alcohol. Slow-release opioids taken once or twice daily are less likely to cause addiction than fastacting forms. Your doctor can help you switch over to the slow-release type of opioid if it seems you will require opioids for a long time.
If you are taking opioids you may also need to deal with constipation. If you have back pain it is important not to strain for your bowel movement. A good natural remedy is a mix of equal amounts of applesauce, prune juice and bran kept in the refrigerator; take 1 tablespoon per day. Talk to your doctor or pharmacist if your constipation does not improve or if it gets worse.