“Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever.”
– Lance Armstrong
Medications for Pain
see also:
Tapentadol (Nucynta)
Methadone (for Pain)
Buprenorphine (for Pain)
Gabapentin (Neurontin) & Pregabalin (Lyrica)
Alpha-2 Adrenergic Agonists
Clonidine (Catapres)
Tizanidine (Zanaflex)
NMDA Antagonists
NSAIDs (Non-Steroid Anti-Inflammatory Drugs)
Complementary and Alternative Medicine Alternatives for Pain:
see also:
Combination Therapy
Definitions and Terms Related to Pain
Key to Links:
Grey text – handout
Red text – another page on this website
Blue text – Journal publication
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Medications for pain fall into a several classes:
OTC (Over-the-Counter) Medications
OTC medications do not require a prescription but may be the same as prescription drugs. OTC medications also
include natural or synthetic supplements used for pain. Supplements of this nature are covered in the “Complementary and Alternative Medicine” section of education on this web site.
Tylenol (acetaminophen)
NSAIDs (Non-Steroidal Anti-inflammatory Drugs):
Topical Medications (see below for more information)
“Topical” pain medications are applied directly to the skin, typically overlying the area of pain to achieve a localized effect. Topical medications may be prescription or non-prescription over-the-counter (OTC) or may be “compounded,” i.e. specifically formulated by a physician and made by a special compounding pharmacy. The term “transdermal” applies to medications applied topically but designed for systemic absorption, through the skin and into the bloodstream to be distributed throughout the body for a generalized effect – as opposed to a topical medication applied for local effect. Butrans and Fentanyl are examples of transdermal pain medications.
Topical Medications – Prescription
Topical Medications – OTC
- Topical Meds: (Non-Opioid) for Pain
also see:
Opioids
Medications for Pain – Overview
Medications for Pain – Safe Disposal
- Safe Disposal of Medicines > Disposal of Unused Medicines: What You Should Know
- Safe Disposal of Medicines > Medication Disposal: Questions and Answers
- Flush list Medicine guides
Neuromodulators
The term “neuromodulator” is not commonly used but refers to medications for pain who’s mechanism of action is based on the drug’s modulation, or effect on, nerves, spinal cord and/or brain. Neuromodulators include medications originally used in the treatment of other conditions such as seizures, depression or muscle spasm but also found effective in treating pain, especially nerve pain, central pain and fibromyalgia.
Neuromodulators for pain originally used to treat seizures (anti-epileptic drugs or AEDs) include:
- Gabapentin (Neurontin) – Gabapentin & Lyrica
- Pregabalin (Lyrica) – Gabapentin & Lyrica
- Topiramate (Topamax)
- Lamotrigine (Lamictal)
Neuromodulators originally used to treat depression include two classes of antidepressants:
SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors):
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor)
- Milnacipran (Savella)
TCA’s (tricylic antidepressants ) TCA’s commonly used for pain include:
- Amitriptyline (Elavil)
- Doxepin (Silenor)
Neuromodulators used to treat muscle spasm/pain:
- Baclofen
- Tizanidine (Zanaflex)
Neuromodulators used to treat other conditions:
Alpha-2 Adrenergic Receptor Agonists:
- Clonidine (Catapres)
- Tizanidine (Zanaflex)
Complementary and Alternative Medications for Pain:
See: Complementary and Alternative Medicine
References
Alpha-2 Adrenergic Receptor Agonists
- Alpha-2 Adrenergic Receptor Agonists – A Review of Current Clinical Applications – 2015
- Relating Chronic Pelvic Pain and Endometriosis to Signs of Sensitization and Myofascial Pain and Dysfunction – 2017
- Effectiveness of ultrasound therapy for myofascial pain syndrome – a systematic review and meta-analysis – 2017
- Efficacy of Deep Dry Needling on Latent Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain – A Randomized, Controlled Clinical Trial Pilot Study – 2017
- The Possible Role of Meditation in Myofascial Pain Syndrome: A New Hypothesis – 2017
- Myofascial Pain Syndrome – A Treatment Review – 2013
- Tizanidine is effective in the treatment of myofascial pain syndrome. – 2002
Combination Therapy
- Combination Drug Therapy for the Management of Chronic Neuropathic Pain – 2023
- Pharmacotherapy for neuropathic pain in adults-a systematic review and meta-analysis
Emphasis on Education
Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.
For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.
Should you wish more information regarding any of the subjects listed – or not listed – here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.
For more information, please contact Accurate Clinic.
Supplements recommended by Dr. Ehlenberger may be purchased commercially online or at Accurate Clinic.
Please read about our statement regarding the sale of products recommended by Dr. Ehlenberger.
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