Treating pain: Conventional medical care

Medications can play an important role in managing pain. In fact, medications are the most common treatment for both acute and chronic pain. When used properly, medications help relieve pain, treat conditions that can accompany pain — such as anxiety or sleep problems — and improve quality of life.

In addition to the potential relief they provide, all pain medications carry the risk of side effects. Here's what you need to know about the most common types of prescription pain medications.

Prescription NSAIDs

Some of the medications you buy over the counter for pain relief, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), are also available in more powerful, prescription-strength formulas. All of these medications fall in the nonsteroidal anti-inflammatory drug (NSAID) category. NSAIDs relieve pain by preventing the body's cyclooxygenase (COX) enzymes from working. COX enzymes make hormone-like substances called prostaglandins, which contribute to pain and inflammation. NSAIDs are most often prescribed for arthritis and for the pain resulting from muscle sprains, strains, back and neck injuries, and menstrual cramps.

Another type of NSAID, called a COX-2 inhibitor, works slightly different from traditional NSAIDs. A COX-2 inhibitor blocks only the COX-2 enzyme — the one that's more likely to cause pain and inflammation. The COX-2 inhibitor celecoxib (Celebrex) is most often prescribed for people with rheumatoid arthritis, osteoarthritis, menstrual cramps and injury-related pain.

Side effects: If you take more than the recommended dose (and sometimes even the recommended dose) of NSAIDs, side effects can include nausea, stomach pain, bleeding and ulcers. NSAIDs also increase your risk of cardiovascular problems, such as heart attack and stroke — and they can interact with drugs prescribed to treat heart disease, such as blood thinners, antihypertensive drugs and aspirin. Large doses of NSAIDs can also lead to kidney problems, fluid retention and high blood pressure. The older you are, the higher your risk of developing these conditions.

Another concern with NSAIDs is the "ceiling effect" — meaning there's a limit to how much pain they can control. Beyond a certain dosage, NSAIDs won't deliver any additional pain-relieving benefit. For this reason, even prescription NSAIDs might not be powerful enough to relieve moderate to severe pain.

July 26, 2016 See more In-depth