While it might seem that there are a large number of medications available for the treatment of pain, there are unfortunately only a few types. Each type of analgesic might however be available as several brands making it appear that there are many options.
The principal types of analgesics (‘pain-killers’) are:
- Non-steroidal anti-inflammatory drugs or NSAIDs e.g. ibuprofen, diclofenac, meloxicam.
- Opioids (Opiates or Narcotics) eg codeine, morphine, tramadol.
Paracetamol is usually safe if taken as prescribed. It can be dangerous however if excessive amounts are taken.
Non-steroidal anti-inflammatory drugs are useful for acute pain when they are taken for short periods of time. They are less useful when taken for prolonged periods of time, and can result in serious side-effects potentially affecting the stomach and gastrointestinal tract, the kidneys, aggravating asthma and affecting blood clotting. The use of these drugs must be discussed with your doctor.
Opioids are also potentially useful for acute pain for short periods of time. Unfortunately the continuous use of opioids often results in loss of effect. If the dose is increased this loss of effect recurs. Opioids have significant side-effects and it can be difficult to stop them. Dependency and addiction are possible, even with weak opioids such as codeine. The long term use of opioids is generally not recommended for treatment of chronic non-cancer pain.
Pain due to nerve damage might respond to some drugs also used to treat other conditions such as epilepsy and depression. Medications used for nerve pain (neuropathic pain) include certain:
- Anticonvulsants (anti-epilepsy drugs) e.g. pregabalin, gabapentin.
- Antidepressants eg amitriptyline, nortriptyline, duloxetine.
- Local anaesthetics e.g. lignocaine.
- Infrequently, opioids might also be used for neuropathic pain treatment although the comments above still apply.
We will discuss with you the best medications for your pain condition. For more information, QPain is here to help and can be contacted on (07) 3391 7111.