Reflex Sympathetic Dystrophy Syndrome
Complex Regional Pain Syndrome

RSD(S)-CRPS Advisory
Chronic Pain Medicines
Chronic Pain Medicines

What drugs can treat chronic pain?
Many medicines can decrease pain, including the ones listed below. Each one may have side
effects. Some side effects can be serious. It's important to listen to your family doctor
carefully when he or she tells you how to use your pain medicine. If you have questions
about side effects or about how much medicine to take, ask your doctor or your pharmacist.

Acetaminophen (one brand name: Tylenol) helps many kinds of chronic pain. Remember,
many over-the-counter and prescription pain medicines have acetaminophen in them. If
you're not careful, you could take more acetaminophen than is good for you. Taking too
much acetaminophen could cause liver damage. If you often have to take more than 2
acetaminophen pills a day, tell your doctor.

Nonsteroidal Anti-inflammatory drugs (NSAIDs)
Other drugs that help with pain are called nonsteroidal anti-inflammatory drugs, or NSAIDs.
Examples include aspirin, ibuprofen (two brand names: Motrin, Advil) and naproxen (two
brand names: Aleve [over the counter], Naprosyn [prescription]). These medicines can be
taken just when you need them, or they can be taken every day. When these medicines are
taken regularly they build up in the blood to levels that fight the pain of inflammation
(swelling) and also give general pain relief. Many of these medicines are available in
low-dose forms without a prescription.

If your doctor wants you to take an NSAID, always take it with food or milk because the
most common side effects are related to the stomach. If you are taking other pain
medicines, don't take NSAIDs without first talking to your doctor.
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Narcotics can be addictive, so your family doctor will be careful about prescribing them.
For many people with severe chronic pain, these drugs are an important part of their
therapy. If your doctor prescribes narcotics for your pain, be sure to carefully follow his or
her directions. Tell your doctor if you are uncomfortable with the changes that may go
along with taking these medicines, such as inability to concentrate or think clearly. Do not
drive when taking these medicines.

When you're taking narcotics, it's important to remember that there is a difference between
"physical dependence" and "psychological addiction." Physical dependence on a medicine
means that your body gets used to that medicine and needs it to work properly. When you
don't have to take the pain medicine any longer, your doctor can help you slowly and safely
decrease the amount of medicine until your body no longer "needs" it.

Psychological addiction is the desire to use a drug whether or not it's needed to relieve pain.
Using a narcotic this way can be dangerous and may not help your pain. If you have a
psychological addiction to a narcotic, your doctor may give you another drug to help with
your psychological problems. Or your doctor might recommend that you talk to a
counselor. Your doctor might also change the medicine that you are addicted to by lowering
the dose, changing to another drug or stopping the medicine altogether.

Narcotic drugs often cause constipation (difficulty having bowel movements). If you are
taking a narcotic medicine, it's important to drink at least 6 to 8 glasses of water every day.
Try to eat 2 to 4 servings of fresh fruits and 3 to 5 servings of vegetables every day. Be
sure to tell your doctor if constipation becomes a problem for you. He or she may suggest
taking laxatives to treat or prevent it.

Other medicines
Many drugs that are used to treat other illnesses can also treat pain. For example,
carbamazepine (one brand name: Tegretol) is a seizure medication that can treat some kinds
of pain. Amitriptyline (one brand name: Elavil) is an antidepressant that can also help with
chronic pain in many people. Your doctor may want you to try one of these medicines to
help control your pain. It can take several weeks before these medicines begin to work well.

Remember -- if you are taking any pain medicine, be sure to ask your doctor or pharmacist
before you take any other medicine, either prescription or over-the-counter.

Are drugs the only way to treat chronic pain?
No. Many other treatments can also decrease pain. They can actually change the body's
chemicals that produce pain. Almost anything we do to relax or get our minds off our
problems may help control pain. It's important to add relaxing activities to your daily life,
even if you are already taking medicine for pain. You might have to use stress reduction
methods for several weeks before you notice a decrease in pain. Your doctor can give you
tips about stress reduction and relaxation methods.

Written by editorial staff.

Treatment of Nonmalignant Chronic Pain by DA Marcus, M.D. (American Family Physician
March 1, 2000,

Reviewed/Updated: 05/07
Created: 09/00

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