In some cases, treating the underlying disorder eliminates or minimizes the pain. For example, setting a broken bone in a cast or giving antibiotics for an infected joint helps reduce pain. However, even if the underlying disorder can be treated, pain relievers may still be needed to quickly manage the pain. Show Drugs used to relieve pain fall into three categories:
A variety of nonopioid pain relievers are available. They are often effective for mild to moderate pain and sometimes for severe pain. These drugs are often preferred for treating pain. People do not become physically dependent on these drugs or tolerant of their pain-relieving effects. Aspirin and acetaminophen are available without a prescription (over-the-counter, or OTC). Several other nonopioid analgesics (such as ibuprofen, ketoprofen, and naproxen) are available OTC, but higher doses may require a prescription. OTC pain relievers are reasonably safe to take for short periods of time. People should follow the instructions on the label for the maximum dose, frequency, and length of time the drug should be taken. A doctor should be consulted if symptoms worsen or do not go away. Many of the most commonly used nonopioid pain relievers are classified as nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, ibuprofen, and naproxen are examples. These drugs are usually used to treat mild to moderate pain. NSAIDs not only relieve pain, but they may also reduce the inflammation that often accompanies and worsens pain. NSAIDs are often taken by mouth. Some NSAIDs (ketorolac diclofenac, and ibuprofen) can also be given by injection into a vein (intravenously) or muscle (intramuscularly). Indomethacin can be given as a rectal suppository. Diclofenac is also available as a cream. Although widely used, NSAIDs can have side effects, sometimes serious ones.
People who take NSAIDs for a long time are more likely to have these problems. Such people need to have regular appointments with their doctor to check for high blood pressure, kidney failure, and ulcers or bleeding in the digestive tract and to evaluate their risk of heart disease and stroke. Taking NSAIDs for a short time is unlikely to cause serious problems. The risk of side effects may be increased for some groups of people, such as the following:
Older people and people who have heart failure, high blood pressure, or a kidney or liver disorder require a doctor’s supervision when they take NSAIDs. Some prescription heart and blood pressure drugs may not work as well when taken with NSAIDs. NSAIDs vary in how quickly they work and how long they relieve pain. Although NSAIDs are about equally effective, people respond to them differently. One person may find a particular drug to be more effective or to have fewer side effects than another. Aspirin (acetylsalicylic acid) has been used for about 100 years. Aspirin is taken by mouth and provides 4 to 6 hours of moderate pain relief. Because aspirin can irritate the stomach, it may be combined with an antacid (called buffered) or coated so that it passes quickly through the stomach and dissolves when it reaches the small intestine (called enteric coated). These products are intended to reduce stomach irritation. However, buffered or enteric-coated aspirin can still irritate the stomach because aspirin also reduces the production of substances that help protect the stomach’s lining. These substances are called prostaglandins. Aspirin increases the risk of bleeding throughout the body because it makes platelets less able to function. Platelets are cell fragments in the blood that help blood clot. Anyone who has an increased tendency to bleed (a bleeding disorder such as hemophilia) or uncontrolled high blood pressure should not take aspirin except under a doctor’s supervision. People who take aspirin and anticoagulants (drugs that make blood less likely to clot), such as warfarin, are closely monitored to avoid life-threatening bleeding. Usually, aspirin should not be taken in the week before scheduled surgery. Aspirin can aggravate asthma. People with nasal polyps are likely to develop wheezing if they take aspirin. A few people, who are sensitive (allergic) to aspirin, may have a severe allergic reaction (anaphylaxis Anaphylactic Reactions Anaphylactic reactions are sudden, widespread, potentially severe and life-threatening allergic reactions. Anaphylactic reactions often begin with a feeling of uneasiness, followed by tingling... read more ), leading to a rash, itching, severe breathing problems, or shock Shock Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death. Blood pressure is usually low... read more . Such a reaction requires immediate medical attention. NSAIDs such as ibuprofen, ketoprofen, and naproxen are generally believed to be gentler on the stomach than aspirin, although few studies have compared the drugs. Like aspirin, these drugs can cause digestive upset, ulcers, and gastrointestinal bleeding. They can make asthma worse and increase blood pressure. Taking one of these drugs probably slightly increases the risk of stroke, heart attack, and blood clots in the arteries of the legs. The risk may be lower with naproxen than with other NSAIDs. Thus, naproxen may be a better choice when people with a high risk of these disorders require NSAIDs. Although ibuprofen, ketoprofen, and naproxen generally interfere with blood clotting less than aspirin does, people should not take these drugs with anticoagulants (such as warfarin) except under a doctor’s close supervision. People who are allergic to aspirin may also be allergic to ibuprofen, ketoprofen, and naproxen. If a rash, itching, breathing problems, or shock develops, medical attention is required immediately. Coxibs, such as celecoxib, are a group of drugs that differ from other NSAIDs. Other NSAIDs block the following two enzymes:
Coxibs tend to block mainly COX-2 enzymes. Thus, coxibs are as effective as other NSAIDs in the treatment of pain and inflammation. But coxibs are less likely to damage the stomach and to cause nausea, bloating, heartburn, bleeding, and peptic ulcers. They are also less likely to interfere with clotting than are other NSAIDs. Because of these differences, coxibs may be useful for people who cannot tolerate other NSAIDs and for people who are at high risk of certain complications (such as gastrointestinal bleeding) from use of other NSAIDs. Such people include the following:
However, coxibs, like other NSAIDs, appear to increase the risk of heart attack, stroke, and blood clots in the legs. As a result, before people with certain conditions are given a coxib, they are told about the risk and the need to be closely monitored. These conditions include
Coxibs, like other NSAIDs, are not appropriate for people who have heart failure or who are at increased risk of heart failure (such as those who have had a heart attack).  Acetaminophen is roughly comparable to aspirin in its potential to relieve pain and lower a fever. But unlike NSAIDs, acetaminophen has the following characteristics:
How acetaminophen works is not clearly understood. Acetaminophen is taken by mouth or a suppository inserted into the rectum, and its effects generally last 4 to 6 hours. Opioid pain relievers (analgesics)—sometimes called narcotics—are effective for many different types of pain. Usually, they are the strongest pain relievers. Opioids are chemically related to morphine, a natural substance extracted from poppies. Some opioids are extracted from other plants, and other opioids are produced in a laboratory. Opioids are often prescribed for a few days to treat severe pain that is likely to lessen quickly (such as pain due to injury or after surgery). Doctors usually switch people to nonopioid pain relievers as soon as possible because opioids may have side effects and there is a risk of misuse or addiction. Opioids are not usually recommended to treat people with chronic pain. Before prescribing opioids for any type of chronic pain, doctors consider
Doctors may refer people to a pain specialist or a mental health care practitioner who has expertise in substance misuse if the risk of having a problem is high. For example, people who have had an addiction usually need such a referral. When doctors prescribe an opioid for chronic pain, they explain the risks and side effects of opioids. People are advised
If an opioid is prescribed, doctors have usual practices to ensure the person's safety. Doctors typically ask the person to get opioid prescriptions only from one doctor and fill prescriptions at the same pharmacy every time. They see the person frequently for follow-up visits and monitor the use of the drug to make sure it is safe and effective. For example, doctors may periodically test the person's urine to determine whether the drug is being taken correctly. They also ask the person to sign an agreement that specifies conditions required for opioid use, including any monitoring that may be needed. To avoid misuse by others, the person should keep opioids in a safe place and dispose of any unused drugs by returning them to the pharmacy. Opioids have many side effects. Side effects are more likely to occur in people with certain disorders:
kidney failure
Overview of Kidney Failure This chapter includes a new section on COVID-19 and acute kidney injury (AKI). Kidney failure is the inability of the kidneys to adequately filter metabolic waste products from the blood. Kidney... read more , a
liver disorder
Overview of Liver Disease Liver disease can manifest in many different ways. Characteristic manifestations include Jaundice (a yellowish discoloration of the skin and whites of the eyes) Cholestasis (reduction or stoppage... read more ,
chronic obstructive pulmonary disease
Chronic Obstructive Pulmonary Disease (COPD) Chronic obstructive pulmonary disease is persistent narrowing (blocking, or obstruction) of the airways occurring with emphysema, chronic obstructive bronchitis, or both disorders. Cigarette... read more
The following commonly occur when opioids are used:
Less common side effects of opioids include
Drowsiness is a common side effect of opioids. For some people who take opioids, drowsiness disappears or decreases within a few days. If people continue to feel drowsy, a different opioid can be tried because the degree of drowsiness caused by different opioids varies. Before an important event that requires alertness, people may be given a stimulant drug (such as methylphenidate or modafinil) to offset the drowsiness. For some people, drinking a caffeinated beverage helps offset the drowsiness. When feeling drowsy after taking an opioid, people should avoid driving and take extra care to prevent falls and accidents. Confusion can also result from taking opioids, especially if people are older. Opioids increase the risk of falls in older people. Nausea sometimes occurs in people with pain, and opioids can increase the nausea. Antiemetic drugs taken by mouth, suppository, or injection help prevent or relieve nausea. Some commonly used antiemetic drugs are metoclopramide, hydroxyzine, and prochlorperazine. The itching caused by taking opioids may be relieved by an antihistamine such as diphenhydramine, taken by mouth or given intravenously. For most people, nausea and itching disappear or decrease within a few days. But constipation and retention of urine usually decrease much more slowly, if at all. Serious side effects can occur when people take too much of an opioid. These side effects include a dangerous slowing of breathing (respiratory depression), coma, and even death. The following adds to the risk of developing respiratory depression and of dying from respiratory arrest:
Some of these side effects can be reversed with naloxone, an antidote usually given intravenously or sprayed into the nose. For people who are at increased risk of opioid side effects (including respiratory depression), doctors may prescribe naloxone when they prescribe the opioid. Nurses and family members or caregivers should watch for serious side effects of opioids and, if such side effects occur, be ready to inject naloxone or spray it into the person's nose. Doctors or pharmacists usually teach the person taking the opioid and family members or caregivers how to administer naloxone. When possible, opioids are taken by mouth
(orally Oral route
Drugs are introduced into the body by several routes. They may be Taken by mouth (orally) Given by injection into a vein (intravenously, IV), into a muscle (intramuscularly, IM), into the space... read more Some people who need to take opioids for a long time and are helped by an opioid taken by mouth cannot tolerate its side effects. For these people, an opioid can be injected directly into the space around the spinal cord through a pump
(intrathecally
Injection routes Opioid misuse may be intentional or unintentional. It includes any use that differs from what is prescribed. Diversion involves selling or giving a prescribed drug to others. Abuse refers to recreational use of the drug. That is, the drugs are taken for the feelings of pleasure or sensations they produce, rather than to treat pain or another medical condition. Up to one third of people taking opioids for a long time to treat chronic pain misuse them. Adjuvant analgesics are drugs that are usually used to treat other disorders, but can also relieve pain. Adjuvant analgesics are thought to work by changing the way nerves process pain. An adjuvant analgesic is the first and only drug used to treat pain due to nerve damage (neuropathic pain Neuropathic Pain Neuropathic pain is caused by damage to or dysfunction of the nerves, spinal cord, or brain. (See also Overview of Pain.) Neuropathic pain may result from Compression of a nerve—for example... read more ) and conditions such as fibromyalgia Fibromyalgia Fibromyalgia is characterized by poor sleep, fatigue, mental cloudiness, and widespread aching and stiffness in soft tissues, including muscles, tendons, and ligaments. Poor sleep, stress, strains... read more . The adjuvant analgesics most commonly used for pain are
Antidepressants can often relieve pain in people even when they do not have depression. Tricyclic antidepressants (such as amitriptyline, nortriptyline, and desipramine) may be more effective for this purpose than other antidepressants, but newer antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and norepinephrine reuptake inhibitors (SNRIs, including duloxetine, venlafaxine, and milnacipran) may have fewer of the side effects that limit how much of the drug can be taken. Tricyclic antidepressants are effective for neuropathic pain Neuropathic Pain Neuropathic pain is caused by damage to or dysfunction of the nerves, spinal cord, or brain. (See also Overview of Pain.) Neuropathic pain may result from Compression of a nerve—for example... read more , headaches Overview of Headache A headache is pain in any part of the head, including the scalp, upper neck, face, and interior of the head. Headaches are one of the most common reasons people visit a doctor. Headaches interfere... read more , fibromyalgia Fibromyalgia Fibromyalgia is characterized by poor sleep, fatigue, mental cloudiness, and widespread aching and stiffness in soft tissues, including muscles, tendons, and ligaments. Poor sleep, stress, strains... read more , and visceral (organ) hypersensitivity syndromes (such as chronic abdominal pain Chronic Abdominal Pain and Recurring Abdominal Pain Chronic abdominal pain is pain that is present for more than 3 months. It may be present all the time (chronic) or come and go (recurring). Chronic abdominal pain usually occurs in children... read more or pelvic pain Pelvic Pain in Women Pelvic pain is discomfort that occurs in the lowest part of the abdomen. Pain that occurs externally in the genital area (vulva, or labia) is called vulvar pain. Many women have pelvic pain... read more ). The doses of tricyclic antidepressants used to treat pain are usually too low to treat depression or anxiety. Thus, if tricyclic antidepressants are used to treat pain, additional drugs are usually needed to treat depression or anxiety if present. Duloxetine appears to be effective for neuropathic pain due to diabetes (called
diabetic neuropathy
Nerve damage in diabetes People with diabetes mellitus have many serious long-term complications that affect many areas of the body, particularly the blood vessels, nerves, eyes, and kidneys. (See also Diabetes Mellitus... read more
People may respond to one antidepressant and not to others, so sometimes doctors try a few drugs until an effective one is found. Antiseizure drugs may be used to relieve neuropathic pain. Gabapentin and pregabalin are commonly used, but many others, including carbamazepine, clonazepam, lacosamide, lamotrigine, oxcarbazepine, phenytoin, topiramate, and zonisamide, help relieve pain in some people. Pregabalin can be used to relieve pain caused by
fibromyalgia
Fibromyalgia Fibromyalgia is characterized by poor sleep, fatigue, mental cloudiness, and widespread aching and stiffness in soft tissues, including muscles, tendons, and ligaments. Poor sleep, stress, strains... read more or nerve damage due to diabetes
(diabetic neuropathy
Nerve damage in diabetes People with diabetes mellitus have many serious long-term complications that affect many areas of the body, particularly the blood vessels, nerves, eyes, and kidneys. (See also Diabetes Mellitus... read more
Topical anesthetics, such as lidocaine applied as a lotion, an ointment, or a skin patch, can be used to control pain due to some conditions. Mexiletine, used to treat abnormal heart rhythms, is sometimes used to treat neuropathic pain. Corticosteroids, such as prednisone and dexamethasone, can be taken by mouth if severe pain is caused by inflammation (as occurs in gout). Low doses of ketamine (an anesthetic) are sometimes given intravenously in a hospital to people who have complex regional pain syndrome when other treatments are ineffective. In addition to drugs, many other treatments can help relieve pain. Neuromodulation methods use electric stimulation include to change how nerves process pain. Techniques include the following:
Physical or occupational therapy may be used to relieve chronic pain and help people function better. Sometimes doing exercises or increasing activity level helps. For example, walking regularly can help relieve lower back pain more effectively than resting in bed.
Cognitive behavioral therapy may reduce pain and pain-related disability and help people cope. This type of therapy includes counseling to help people focus on coping with the pain, rather than on its effects and limitations. It may include counseling to help people and their family work together to manage pain. The importance of psychologic support for people in pain should not be underestimated. Friends and family members should be aware that people in pain suffer, need support, and may develop depression and anxiety, which may require psychologic counseling.
What is used to cure disease or relieve pain?Medicines are chemicals or compounds used to cure, halt, or prevent disease; ease symptoms; or help in the diagnosis of illnesses.
What is the most common treatment for reducing pain?Common OTC pain medications include:. Acetaminophen: This drug (Tylenol®) dulls pain receptors in the brain. ... . Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs lower the production of prostaglandins. ... . Combination: Some pain relievers contain both acetaminophen and aspirin (an NSAID).. What is treatment that alleviate pain without curing the disease?Palliative care is used to manage a disease or medical condition that is serious or life threatening by easing pain and other associated physical, emotional, or psychosocial symptoms. Palliative care also eases other distressing symptoms, like depression, anxiety, fatigue, insomnia, and shortness of breath.
What are the names of 3 medications that doctors prescribe to reduce severe pain?Narcotics (also called opioids) are used for moderate to severe pain and require a doctor's prescription. They may be habit-forming. They can also be dangerous when taken with alcohol or certain other drugs. Examples of narcotics are codeine, morphine, and oxycodone.
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A treatment or medicine to cure a disease or reduce pain that is not very serious
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