Treatment for Pain

Treatment of pain includes both medications and non-drug approaches. The doctor recommends treatment based on many factors including the type and duration of pain. In addition to specific medications given for pain, pain is relieved or at least reduced when its cause is treated effectively such as if there is pain because of infection, taking antibiotics controls the infection and  eliminates the pain as well or if the pain is caused because of fracture, it is reduced by applying a cast. Even if the treatment of underlying problem relieves pain, you may still need analgesics (pain relievers).

Medications for pain

Analgesics can be classified as opioid (narcotic) analgesics, non-opioid analgesics and adjuvant analgesics (drugs that are basically prescribed for reasons other than pain, but in some cases, relieve pain).

Non-opioid Analgesics: Acetaminophen and non-steroidal anti-inflammatory medications (NSAIDs) are non-opioid analgesics. They are generally used for treatment of mild to moderate pain. The advantage of this group includes that they are not addictive and their pain-relieving effect does not decrease significantly over time.

• Acetaminophen: Acetaminophen is available over-the-counter and is most often used to treat acute pain. It has no anti-inflammatory effects, but is equal to aspirin in its potential to relieve pain and lower fever. Unlike NSAIDs, it has no adverse effects on the stomach and blood's ability to clot. It is a safe drug when used appropriately, but can have serious adverse effects such as liver damage and kidney damage when used excessively.
• Non-Steroidal Anti-Inflammatory Medications (NSAIDs): The NSAIDs (such as ibuprofen, naproxen, diclofenac, and aspirin) are very effective in relieving pain (both acute pain and in some cases, flare-ups in patients with chronic pain). The NSAIDs have good anti-inflammatory effect and therefore, are effective in relieving pain associated with inflammation such as pain of arthritis, tendonitis, and bursitis. Prolonged use or use of NSAIDs at high dose can cause side-effects such as digestive upset, ulcers and gastrointestinal bleeding. Other side-effects of NSAIDs include increase of blood pressure, worsening of asthma and decrease in the blood’s ability to clot. COX-2 inhibitors such as Celecoxib are as effective as the traditional NSAIDs in relieving pain and inflammation, but they are less likely to cause side-effects such as digestive upset, nausea, bloating, heartburn, bleeding, peptic ulcers and interfere with clotting (as compared with standard NSAIDs).

Opioid Analgesics

Opioid analgesics or narcotic analgesics (such as morphine, codeine, oxycodone, meperidine, hydromorphone, pentazocine) are part of some of the very effective pain relieving medications. They are most often prescribed for relief of pain associated with surgery, cancer, broken bones and burns. Although, they are very effective pain relievers, prolonged use of narcotic analgesics is avoided as they can cause several side-effects including dependence and tolerance (decrease in pain relieving effect).

Adjuvant Analgesics

Adjuvant analgesics are drugs that are basically used for some other condition and not as pain relieving medication. They may be effective in relieving pain in some circumstances such as neuropathic pain. They are mostly used in combination with other analgesics or non-drug pain treatments.  Some of the adjuvant analgesics currently used for treatment of pain include antidepressants (such as amitriptyline, bupropion, desipramine, fluoxetine, and venlafaxine), anticonvulsants (such as gabapentin and pregabalin) and oral and topical local anaesthetic.

Nondrug pain treatment

Besides medications, many other treatments can also help to relieve pain. Some of the commonly used non-drug pain treatments include applying cold or warm compresses directly to a painful area, ultrasonography that provides deep heat (diathermy), transcutaneous electrical nerve stimulation (TENS) and acupuncture.