There are many options for pain relief, below are the top 5 most effective pain relievers including over-the-counter acetaminophen and NSAIDs and prescription corticosteroids (steroid medications), opioids, and antidepressants. It’s important to work with a healthcare professional to find the most effective and tolerable treatment plan.

Over-the-Counter Pain Relievers (non-prescription)

• • Acetaminophen (Tylenol)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Advil, Motrin), naproxen(Aleve), and diclofenac gel (Voltaren).

Tylenol (acetaminophen):  relieves mild to moderate pain and generally is easy on the stomach. May cause severe liver disease if used often or at high doses, or with moderate alcohol intake.

Advil/Motrin (ibuprofen):  relieves mild to moderate pain, but may cause stomach ulcers, kidney damage, strokes, or heart attacks. Diclofenac (Voltaren gel): relieves arthritis pain, generally well tolerated when used as directed.

Prescription Pain Relievers

• • Corticosteroids
  • Opioids
  • Antidepressants
  • Anticonvulsants (anti-seizure medications)
  • NSAIDs
  • Lidocaine patches (5%)

What Are Corticosteroids?

Prescription corticosteroids provide relief for inflamed areas of the body by easing swelling, redness, itching, and allergic reactions. Corticosteroids can be used to treat allergies, asthma, arthritis and pain. Corticosteroids are therefore prescribed in the lowest dose possible for the shortest time.

Potential ill effects: 

• • Stomach ulcer disease and gastritis
  • Irritability and trouble sleeping
  • Elevated blood sugar and a depressed immune system

What Are (prescription) Opioids?

Opioids are medications similar to opium with addictive properties prescribed after surgery.  Examples:

• • Codeine
  • Fentanyl
  • Hydrocodone-acetaminophen
  • Morphine
  • Oxycodone
  • Oxycodone–acetaminophen

Opioids are effective for severe pain and do not cause ulcers. However, they can be extremely addictive, especially if used to treat chronic pain. Other negative effects:

• • Drowsiness & breathing problems
  • Nausea and vomiting
  • Constipation
  • Itching
  • Addiction

Why try an Antidepressant or pain relief?

This class of drugs treat pain and emotional conditions by adjusting levels of neurotransmitters (natural chemicals) in the brain. Chronic pain conditions treated by low-dose antidepressants include some types of headaches (like migraines) and menstrual pain. Examples: Fluoxetine, amitriptyline, duloxetine, venlafaxine.

Other Pain Treatment?

• Pregabalin (Lyrica) and gabapentin (Neurontin), and topiramate (Topamax), are examples of anti-seizure medications used for pain, especially nerve pain and fibromyalgia.
• Lidocaine patch (4%-5%), which is a prescription medication.
• Muscle relaxers work by depressing the central nervous system, helping relieve muscle tension and spasm and often causing drowsiness.
• Chiropractic or Physical therapy
• Spinal cord stimulation:  A small device is surgically implanted into the back. It sends mild electric pulses to interrupt the pain signals.

Summary:

There are many, many options to treat pain! An effective pain treatment regimen for one person may not work for another. Experience, expertise, patience, and willingness to listen (and understand), is most important to find the most effective and tolerable regimen for each patient.