Pain Medications

• For what conditions are pain medications used?
• What are the differences among the types of pain medications?
• What are the side effects of pain medications?
• What are the warnings/precautions with pain medications?
• What are some examples of pain medications?

Pain medications are drugs used to relieve discomfort associated with disease, injury, or surgery. Because the pain process is complex, there are many types of pain drugs that provide relief by acting through a variety of physiological mechanisms.

• Nonsteroidal anti-inflammatory drugs (NSAIDs) act on substances in the body that can cause inflammation, pain, and fever.
• Corticosteroids are often administered at the site of musculoskeletal injuries. They exert powerful anti-inflammatory effects.
• Acetaminophen increases the body's pain threshold, but it has little effect on inflammation.
• Opioids, also known as narcotic analgesics, modify pain messages in the brain.
• Muscle relaxants reduce pain from tense muscle groups, most likely through sedative action in the central nervous system.
• Anti-anxiety drugs work on pain in three ways: they reduce anxiety, they relax muscles, and they help patients cope with discomfort.
• Some antidepressants, particularly the tricyclics, may reduce pain transmission through the spinal cord.
• Some anticonvulsant drugs also relieve the pain of neuropathies, possibly by stabilizing nerve cells.

For what conditions are pain medications used?

Virtually any disease as well as most injuries and surgical procedures involve some degree of pain. It's not surprising, then, that pain medications, also known as analgesics, are among the most commonly used drugs in the U.S. Pain can range from minor, acute complaints, such as a muscle sprain, to chronic, severe pain, such as that sometimes experienced by cancer patients. Some drugs used for other conditions also are effective at relieving certain types of pain. These drugs include certain drugs used for depression, epilepsy, and anxiety.

What are the differences among the types of pain medications?

Pain medications can be broadly classified into two categories: prescription and nonprescription. In the latter category are several mild anti-inflammatory drugs (ibuprofen, naproxen), as well as acetaminophen. These are mainly meant for use with short-term, acute pain -- menstrual cramps, tension headaches, minor sprains -- what are known colloquially as "everyday aches and pains."These drugs also lower fever and are often used for that purpose.

The prescription arsenal against pain is extensive. It also includes some NSAIDS more powerful than their over-the-counter cousins as well as opioid analgesics. These medications can be used in virtually any type of pain situation but are usually reserved for severe pain of either an acute or chronic nature.

One major difference between anti-inflammatories and opioid analgesics is that the former have a "ceiling effect"-- that is, continuous dose escalation does not provide concomitant escalation in pain relief. Of course, increasing the dose of an opioid may achieve relief, but it can also increase the likelihood of side effects, some of which are dangerous.