Let’s look at the common classes of medication used to treat chronic pain, along with some of the most widely used medications in each class. Please remember that this list is for informational purposes; you should always speak with your doctor before making decisions that could affect your health.
Opioids work by attaching to opioid receptors in the brain and spinal cord. There are three types of opioid receptors, called mu, delta, and kappa. Opioid medications attach to all three, but the primary pain-relief effects come from binding to mu receptors and blocking the pain signals that would normally travel through your body.
The use of opioids to treat chronic pain is becoming more common, and many patients report positive results. Opioids may be administered orally, rectally or intravenously, depending on the patient’s needs. The most common side-effects include nausea, vomiting and constipation.
Opioids do carry some risk of addiction and physical dependence, so it’s very important to take these medications exactly as prescribed.
Sometimes referred to as muscle “relaxers,” these medications affect the nervous system in the spine and brain, rather than the muscles themselves. Muscle relaxants that affect the nervous system are termed “centrally acting,” and work by inhibiting the signals that cause muscle spasms. These types of muscle relaxants are known clinically as spasmolytics.
Muscle relaxants are most often used to treat chronic back pain, and some doctors also use muscle relaxants as part of a larger overall treatment plan for fibromyalgia. The sedative effect of muscle relaxants may cause drowsiness and can be habit-forming, so always follow your doctor’s instructions. Other side-effects include dizziness, dry mouth and nausea.
Corticosteroids work by reducing inflammation, which may help reduce pain caused by certain conditions. The human body produces naturally occurring steroids, which are required for normal body function. When your body is not producing enough natural steroids, corticosteroids may be prescribed to restore the correct balance.
These strong medications are also used to treat allergic reactions because of their anti-inflammatory properties. The potential side-effects of corticosteroids can be significant and include mood changes, insomnia, heartburn and headache.
Non-steroidal Anti-inflammatory Drugs (NSAIDs)
NSAIDs are some of the most widely used medications in the world, and many are available without a prescription. In low dosage, NSAIDs can provide relief of minor pain, while higher dosage may be necessary if reducing inflammation is the goal. They work by inhibiting the production of prostaglandins (which cause swelling) by blocking the enzymes that produce them.
While NSAIDs are available over the counter, they may still cause serious side-effects, including possible increased risk of heart attack or stroke from non-aspirin NSAIDs. Other side-effects include constipation, gas or bloating, and dizziness.
Anticonvulsants and Anti-Epileptics
These classes of medication, developed to treat epileptic seizures, also have applications in the management of chronic pain. Since these medications work on the nervous system, they are most often used to treat neuropathic (nerve-based) pain from conditions like fibromyalgia. Anticonvulsants diminish abnormal brain excitement and can reduce pain signals from damaged nerves, which is why they are helpful in treating some types of chronic pain. Side-effects include anxiety, weight gain, dizziness, nausea and constipation.
Like many of the items on our list, antidepressants were not originally developed to treat chronic pain. However, antidepressants are an increasingly common part of pain management. Tricyclic antidepressants, the most common type prescribed for chronic pain, increase the chemicals that your body uses to regulate pain and mood.
Anti-depressants may cause serious side-effects including changes in mood, weight gain or loss and extreme tiredness.
Speak with Your Doctor
When working to address your chronic pain, it pays to understand all of your options. The medications listed above won’t be right for everyone, and it’s important to consider potential risks as well as potential benefits. Speak with your doctor to learn more about the medications available to treat chronic pain, and develop a plan that’s right for you.