Each class of medication has their own unique activity for pain treatment as well as their own set of considerations.

Opioid Analgesics

Opioid analgesics, also known as narcotics or simply “opioids”, work by affecting certain systems in your body that not only control pain but also your body’s perception of pleasure, which can lead to addiction. Opioid receptors are more abundant in the brain and spinal cord but are also located elsewhere in the body such as the stomach and the lungs.

Examples: oxycodone, hydrocodone, morphine, fentanyl, methadone, codeine, dihydrocodeine, tramadol

Commonly used to treat: acute pain, chronic pain, cancer pain, breakthrough pain, neuropathic pain etc.

Opioid Analgesics

Opioid analgesics, also known as narcotics or simply “opioids”, work by affecting certain systems in your body that not only control pain but also your body’s perception of pleasure, which can lead to addiction. Opioid receptors are more abundant in the brain and spinal cord but are also located elsewhere in the body such as the stomach and the lungs.

Examples: oxycodone, hydrocodone, morphine, fentanyl, methadone, codeine, dihydrocodeine, tramadol

Commonly used to treat: acute pain, chronic pain, cancer pain, breakthrough pain, neuropathic pain etc.

NSAIDs

Nonsteroidal anti-inflammatory agents, usually abbreviated as NSAIDs, are a group of medications that lower fever, reduce inflammation (swelling), and provide pain relief. There are nearly two dozen different NSAIDs available, but they all work in the same way.

Examples: ibuprofen, naproxen, aspirin, celecoxib, diclofenac, meloxicam, diflunisal, etodolac

Commonly used to treat: acute and chronic inflammatory-associated pain, migraine, tension headaches, rheumatoid arthritis, osteoarthritis, sprains/strains, toothache, etc.

Skeletal Muscle Relaxants

Skeletal muscle relaxants are used to reduce muscle tension and treat pain due to musculoskeletal conditions such as lower back pain. There are two categories of skeletal muscle relaxants: antispasmodics and antispasticity agents – depending on the condition, your doctor may choose one category over another.

EXAMPLES:
Antispasmodics:
carisoprodol, cyclobenzaprine, orphenadrine, methocarbamol,
Antispasticity agents: baclofen, dantrolene

COMMONLY USED TO TREAT:
Antispasmodics:
lower back pain, tension headaches, muscle spasms, muscle strains, ligament sprains, tendon injuries (e.g., tendonitis), stress fractures, etc.
Antispasticity agents: post-stroke syndrome, cerebral palsy, multiple sclerosis, spinal cord injuries, etc.

Acetaminophen

Acetaminophen is a medicine that provides mild-to-moderate pain relief and reduces fevers. While the exact mechanism is unknown, it is believed to inhibit an important process involved in pain modulation. It is found in many products, including combination cold products, OTC pain relievers, and prescription drugs.

Commonly used to treat: arthritis, backaches, headaches, menstrual cramps, fever, inflammatory pain, acute pain, chronic pain, etc.

Corticosteroids

Corticosteroids are a broad category of medications used to reduce inflammation and as well as affect the immune system. Corticosteroids can be classified into two categories – glucocorticoids and mineralocorticoids, which play various roles in the body.

Examples: dexamethasone, prednisone, prednisolone, methylprednisolone

Commonly used to treat: arthritis, inflammatory conditions, autoimmune disorders, pain, infection, rheumatic diseases, asthma, COPD, allergic rhinitis, atopic dermatitis, etc.

Biologics

Biologics refer to a broad classification of drugs that are synthesized or derived from living organisms such as animals or microorganisms. Compared to most conventional medications, biologics are large, complex molecules that are typically administered by injection. Common examples of biologics include insulin, botox and monoclonal antibody therapies.

BIOLOGICS FOR INFLAMMATORY CONDITIONS
Examples:
rituximab, abatacept, tocilizumab, etanercept, adalimumab, secukinumab, certolizumab pegol, ustekinumab
Commonly used to treat: cancer, inflammatory autoimmune diseases (e.g., Crohn’s disease, psoriatic arthritis, rheumatoid arthritis), organ transplant, etc.

Biologics for migraine
Examples:
erenumab, fremanezumab, galcanezumab, vedolizumab, tocilizumab, rilonacept
Commonly used to treat: migraine headache and cluster headache

Analgesic Adjuvants / Additional Medications

ANTIDEPRESSANTS
Antidepressants work by altering levels of natural chemicals in the brain to reduce restlessness and anxiety, improve sleep, and aid in treating mood disorders. Antidepressants are most commonly used to treat depression but are also used alone or alongside other agents for a wide range of nervous system disorders. Antidepressants have been broadly used in the treatment of many chronic pain syndromes, although they are typically reserved for specific types of pain.
Examples include: duloxetine, venlafaxine, amitriptyline
Commonly used to treat: depression, anxiety disorders, insomnia, neuropathic pain, fibromyalgia, sciatica, etc.

ANTICONVULSANTS
Anticonvulsants are most commonly used to treat seizures, however, they may also be used in pain management. Anticonvulsants can aid in the treatment of chronic pain by interfering with damaged or overly sensitive nerve signals.
Examples include: carbamazepine, gabapentin, pregabalin, phenytoin, lamotrigine, topiramate
Commonly used to treat: seizures, mental health disorders, neuropathic pain, migraine headaches, restless leg syndrome, etc.

CAFFEINE
Despite caffeine being the most commonly known psychoactive stimulant, little attention is paid to the benefits it can have outside of kick starting your day. Caffeine appears to block the effects of certain hormones that affect pain signaling. On its own, caffeine does not provide pain relief but it has been found to help with pain management when combined with other medications. For this reason, caffeine is commonly combined with other agents to further reduce pain.
Commonly used to treat: tension headaches, general pain relief, musculoskeletal pain.

A DIVERSE TREATMENT

What is a Multimodal Approach?

The multimodal approach to pain management seeks to decrease the emphasis on opioid analgesics by combining several therapies to effectively improve patient health and provide pain relief. For various conditions, including chronic pain, acute pain, and even lower back pain, a multimodal approach has been found to:

  • Lower pain scale scores
  • Decrease opioid use
  • Result in fewer opioid-related adverse effects
  • Decrease length of post-surgery hospital stays

TREAT THE SOURCE

Are You Tired of Living With Pain?

Answer a few basic questions to help determine the type of pain you are suffering from. Based on your results, you will have the option to connect with a physician who can help determine a treatment plan.

TAKE PAIN QUIZ

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