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What are Pain Relief Medications?

Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.

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. Thus, effective medication for nerve pain will likely have a different mechanism of action than arthritis pain medication.

Over-the-counter (OTC) medicines are good for many types of pain. There are two main types of OTC pain medicines: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin) are examples of OTC NSAIDs.

If OTC medicines don’t relieve your pain, your doctor may prescribe something stronger. Many NSAIDs are also available at higher prescription doses. The most powerful pain relievers are opioids. They are very effective, but they can sometimes have serious side effects. There is also a risk of addiction. Because of the risks, you must use them only under a doctor’s supervision.

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. Different medications are used depending on the type of pain. For minor complaints, such as muscle sprains or headaches, an over-the-counter (OTC) pain reliever will usually do. Prescription pain relievers, especially opiate analgesics — are normally reserved for moderate-to-severe pain – such as that seen after surgery, trauma, or from certain diseases like cancer or rheumatoid arthritis. Other common “painful” situations in which analgesics find use include labor, back pain, fibromyalgia, and urinary tract infections.

Strongest pain medications

Opioid analgesics, in general, are the strongest pain-relieving medications. The benchmark drug in this class is morphine — with other opioids falling above or below it in terms of pain-relieving potential. Near the bottom of the list is codeine, usually prescribed in combination with acetaminophen to relieve, for example, pain resulting from dental work. Codeine is only about 1/10th as powerful as morphine. Opioids more powerful than morphine include hydromorphone (Dilaudid) and oxymorphone (Opana). But the strongest opioid in community use is fentanyl which, in its intravenous form, is 70 to 100 times more potent than morphine. Fentanyl is also available as a long-release patch (Duragesic) and as a lozenge that dissolves in the mouth (Actiq). Sufentanil is even more powerful than fentanyl, but its use, at present is restricted to the intravenous route. However, a transdermal patch containing sufentanil is in clinical trials.

Side effects of pain medications

All NSAIDs come with the risk of gastrointestinal ulceration and bleeding. A newer class of anti-inflammatories, the COX-2 inhibitors, was developed to reduce this risk. It did not, though, eliminate it. In fact, another major issue emerged with these drugs: the possibility of severe and deadly vascular problems with long-term use, including heart attack and stroke.

Acetaminophen

Most users of acetaminophen experience few, if any, side effects. But the drug can cause liver damage, especially when taking too much or if taken with alcohol.

Opioids

Opioid analgesics commonly cause drowsiness, dizziness, and respiratory depression. However, these side effects usually disappear with continued use. However, constipation, another common side effect, tends to persist. In addition, opioid use may lead to addiction or dependence.