Pain Medications

Pain is an unfortunate symptom of many conditions we help treat. There are many different kinds of pain medication, and this can be quite confusing. Any new medication should be discussed with your doctor to make sure it is OK for you to take.


Anti-inflammatory medications are those that combat inflammation (which causes pain). Most of these are considered "non-steroidal anti-inflammatory drugs," or NSAIDs. As the name implies, these work on inflammation but do not contain steroids. Common examples of these are ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and aspirin. These work very well for most people, but can cause an upset stomach or ulceration. Some people with a history of stomach ulcers might be offered celecoxib (Celebrex), which works like other NSAIDs but does not have the same effect on the stomach lining. NSAIDs can interfere with blood clotting and kidney function as well, so again, you should consult with your doctor before taking these.


Steroids are another type of anti-inflammatory. Steroid injections (of a kind of "cortisone") can be very effective when used to treat inflammation of a specific area (an inflamed tendon or joint, for example). Some people will have pain after an injection, and sometimes the skin can get lighter in that area. Anytime the skin is poked or cut, there is a potential for infection. We need to be particularly careful with patients who are diabetic, because a steroid can raise blood sugar for 5-7 days, so that needs to be watched closely. Steroids also can be taken orally, but these have more side effects and risks than the injection. I generally do not prescribe oral steroids for the conditions that I treat.


Narcotics (opioids) are strong pain medications we usually use to help with pain after surgery or broken bones. They include such examples as oxycodone (Roxicodone), hydrocodone, codeine, and tramadol (Ultram). They can cause drowsiness, dizziness, constipation, nausea, and other side effects; they also can be very addictive, so they should be used only for pain as directed (NOT for sleep!). Some of these come with acetominophen (Tylenol) in them. The most common of these are hydrocodone/acetominophen (Norco) and oxycodone/acetominophen (Percocet). Too much acetominophen can cause your liver to fail, so do not take additional acetominophen if there already is some in your narcotic pain medicine! The narcotic pain medications do impair your judgment and reaction time, so it is also important not to drive, operate heavy machinery, or make important decisions while taking this kind of medicine.


Some people feel no effect or only side effects when they take narcotic pain relievers; everyone has different responses to different medicines.


Usually the right anti-inflammatory--when it is an option--is the most effective for pain relief. As always, talk to your doctor before starting any new medications, and keep an open mind: we recommend anti-inflammatories because they work!