Medication Options to Treat Acute and Chronic Pain

Acute vs. chronic pain

Acute pain is short-term pain that develops suddenly. It is caused by tissue damage, inflammation, or other disease processes. It tends to be sharp or intense before slowly calming. Acute pain can last for a few seconds to several months. The purpose of acute pain is to protect the body from serious injury or further injury.

Chronic pain is any pain that continues for three to six months or after healing would have normally occurred. Pain signals can remain active in the body for months or years. Chronic pain ranges from mild to severe. It can be caused from an injury, a disease, or an unknown origin.

Medication options to treat acute and chronic pain

Pain-relieving medication can reduce or relieve various aches and pains. There are advantages and risks to all pain medicines. Additionally, each person may respond differently to the same pain reliever. Pain medications may be over-the-counter or prescription and can come in various forms.

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are available in over-the-counter and prescription strength. NSAIDs belong to the drug class used as an analgesic (pain reliever), anti-inflammatory, and antipyretic (fever reducer). The most common over-the-counter NSAIDs include ibuprofen, naproxen, ketoprofen, and high-dose aspirin. Prescription strength NSAIDs include nabumetone, etodolac, naproxen, diclofenac, etc.

NSAIDs are proven to have fewer side effects compared to corticosteroids, which are also anti-inflammatory drugs. They should not be taken longer than recommended as serious side effects can occur.

Acetaminophen

Acetaminophen is an active ingredient that relieves pain and reduces fever. It is available in over-the-counter and prescription medications. Acetaminophen is also combined with other ingredients in medicine that treats the flu, coughs and colds. It is believed to block the production of an enzyme in the brain that is related to pain. Similarly, it is thought to work on the brain mechanism that elevates body temperature.

COX-2 inhibitors

COX-2 inhibitors are a type of NSAID developed to reduce common side effects of traditional NSAIDs. They work by blocking the COX-2 enzyme that is most likely to cause pain and inflammation. The COX-1 enzymes continue to function, which protects the lining of the stomach. Older individuals are at an increased risk for side effects compared to younger adults.

Antidepressants

Antidepressants are typically prescribed to treat depression. However, they have also become a mainstay in treating certain chronic pain conditions. Some antidepressants present analgesic properties, while others only treat depression, anxiety disorders, and obsessive compulsive disorder (OCD). Antidepressants for pain management are usually prescribed at a lower dosage than those to treat depression alone, and are gradually increased as necessary.

Anticonvulsants

Anticonvulsants are prescription medicines that calm brain hyperactivity and treat seizure disorders. They have also been known to reduce chronic pain. Anticonvulsants relieve pain by interfering with damaged or overly sensitive nerve signals. They reduce or control abnormal increases in brain electrical activity.

Anticonvulsants are used to alter or control excitability of neurons. Anticonvulsant medicine may relieve chronic pain for some people, but not for others. They have nerve-calming qualities that can help soothe burning, stabbing or shooting pain resulting from nerve damage.

Opioids

An opioid, or narcotic, is a medication prescribed to relieve moderate to severe pain by weakening pain signals from nerves to the brain. Opioids have been a standard of care in pain management for decades. They can be made synthetically or derived from the opium poppy plant. They block pain signals by attaching to opioid receptors in the central nervous system and peripheral nervous system. As pain messages are modified, less pain is experienced.

Topical pain relievers

Topical pain relievers (analgesics) are applied to the skin over painful muscles or joints. They may include: creams, ointments, sprays and patches. They distract the mind from pain, block enzymes (cox-2), or decrease bodily substances (P) that pass pain signals to the brain. Lidocaine is the most common local anesthetic. Topical local anesthetics are typically available in a gel, spray or patch.

Muscle Relaxants

A muscle relaxant is a medication that is prescribed to treat muscle pain and discomfort, such as spasms. They work through the brain and spinal cord to help muscles relax, reduce pain, and improve movement. Muscle relaxers are typically prescribed for acute pain, rather than chronic pain. Since they cause drowsiness, they can also improve sleep.

Steroids

Steroids are chemical hormones produced naturally by the body, and can be lab-made to reduce inflammation. Corticosteroids are strong NSAIDs that help prevent the immune system from producing substances that cause inflammation. Anabolic steroids build muscle mass depleted by conditions such as cancer.