Choosing a drug or a combination of drugs for pain depends on the type and severity of pain. Every individual is different and therefore it may take time to establish the treatment that is right for you.
While most pain relief drugs have some side effects, they are generally not serious. Not everyone experiences side effects. They can be reduced by treatment or by changing to a different medication. Your doctor should advise you about any side effects that you should look for, and what to do if you experience them. You can also ask your pharmacist for a drug information printout.
There is evidence to show that drugs for chronic pain should be taken regularly, such as every 4 hours, rather than waiting until pain is experienced.
Drugs used to control pain include:
- aspirin and paracetamol are very effective drugs for mild to
moderate pain; aspirin or paracetamol may be used, for example,
to treat pain caused by:
- mouth ulcers
- ulcers in the skin
- cancer in the bone
- paracetamol is generally considered to be a better choice than aspirin for mild to moderate pain because it has less effect on the stomach and on blood clotting.
- aspirin and paracetamol can also be used with stronger pain drugs such as morphine if you have moderate or severe pain. If aspirin or paracetamol does not give complete pain relief, stronger pain drugs such as morphine or codeine will be required.You should take no more than 8 (eight) pain killers containing paracetemol per day unless told to do so by your doctor.
- non-steroidal anti-inflammatory drugs (NSAIDs) There is evidence to show that NSAIDs can be effective in treating:bone pain pain caused by inflammation (redness and swelling) eg ulcers in the skin, cancer in the liver causing pain, and compression of a nerve NSAIDs may affect the stomach or cause bleeding in some individuals. NSAIDs should not be taken with aspirin. NSAIDs should be used in consultation with your doctor.
- drugs containing codeine are effective for moderate pain. These drugs often also contain paracetamol.
- there is evidence to show that morphine and other strong opioid drugs are safe and effective for moderate to severe pain.
- injection into skin or muscle.
- injections into a vein. This method is rarely used to treat cancer pain.
Other
- fentanyl patches are another opioid alternative to morphine. They are applied to the skin as a patch for effective control of pain.
- morphine or other opioid drugs can be given for acute pain that cannot be controlled by other means by injecting it into:the spinal canal. This is called epidural or intrathecal pain relief.
- bisphosphonates stop the activity of special bone cells that break down bone. They are used to control cancer in the bone and bone pain.
- steroids may be used to relieve pain caused by:
- cancer pressing on a nerve
- cancer in the brain
- cancer in the liver. Common steroids are dexamethasone and prednisolone.
- muscle relaxants such as benzodiazepines can help relax muscles if you have muscle spasm pain.
- antidepressants can be used with morphine or other opioid drug for pain that involves the nerves to increase the effectiveness of the morphine or opioid drug.
Other medical treatments for pain
- Radiotherapy
- Radiotherapy is the most effective method of controlling pain in the bones and is also useful for pain in other sites in the body.
- Antibiotics or anti-fungals
- Antibiotics or anti-fungal may be used to treat infection causing pain.
