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Treatments for Pain

Pain: Marketplace Products, Discounts & Offers

Products, offers and promotion categories available for Pain:

Pain: Research Doctors & Specialists

Research all specialists including ratings, affiliations, and sanctions.

Drugs and Medications used to treat Pain:

Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment or change in treatment plans.

Some of the different medications used in the treatment of Pain include:

  • Etodolac
  • Lodine
  • Lodine XL
  • Aspirin
  • Acetylsalicylic acid
  • ASA
  • Added Strength Analgesic Pain Reliever
  • Adult Strength Pain Reliever
  • Aggrenox
  • Alka-Seltzer Effervescent Pain Reliever and Antacid
  • Alka-Seltzer Night Time
  • Alka-Seltzer Plus
  • Alka-Seltzer Plus Cold
  • Anacin
  • Anacin Maximum Strength
  • Anacin w/Codeine
  • Ancasal
  • APC
  • APC w/Codeine
  • APO-ASA
  • Arthritis Pain Formula
  • Arthritis Strength Bufferin
  • A.S.A. Enseals
  • Asasantine
  • Ascriptin
  • Ascriptin A/D
  • Aspergum
  • Aspirin PROTECT
  • Asprimox
  • Astrin
  • Axotal
  • Azdone
  • Bayer Aspirin
  • Bayer Children's Chewable Aspirin
  • Bayer Enteric Aspirin
  • Bayer Plus
  • BC Powder
  • Buffaprin
  • Bufferin
  • Bufferin Arthritis Strength
  • Bufferin Extra Strength
  • Bufferin w/Codeine
  • Cama Arthritis Pain Reliever
  • Cardioprin
  • Carisoprodol Compound
  • Cope
  • Coricidin
  • Coryphen
  • Coryphen-Codeine
  • C2 Buffered
  • Darvon Compound
  • Dorect Fpr,I;aru As[orom
  • Dristan
  • Easprin
  • Ecotrin
  • 8-Hour Bayer
  • Empirin
  • Empirin w/Codeine No. 2,4
  • Entrophen
  • Excedrin
  • Excedrin Extra Strength Geltabs
  • Excedrin Migraine
  • Fiorinal
  • Firoinal-C
  • Firoinal w/Codeine
  • Genacote
  • Genprin
  • Goody's Headache Powder
  • Halprin
  • Hepto
  • Lortab ASA
  • Low Dose Adult Chewable Aspirin
  • Marnal
  • Maximum Bayer Aspirin
  • Measurin
  • Midol Caplets
  • Momentum
  • Norgesic
  • Norgesic Forte
  • Norwich Aspirin
  • Mpvasem
  • Orphenadrine
  • PAP w/Codeine
  • Percodan
  • Percodan-Demi
  • Phenaphen
  • Phenaphen No. 2, 3, 4
  • Propoxyphene Compound
  • Riphen-10
  • Robaxisal
  • Robaxisal-C
  • Roxiprin
  • 692
  • SK-65 Compound
  • Soma Compound
  • St. Joseph Children's Aspirin
  • Supasa
  • Synalgos
  • Synalgos-DC Tablet
  • Triaphen-10
  • 217
  • 217 Strong
  • 292
  • Vanquish
  • Verin
  • Wesprin
  • Zorprin
  • Clonidine - usually used as a combination treatment for cancer pain
  • Apo-Clonidine - usually used as a combination treatment for cancer pain
  • Catapres - usually used as a combination treatment for cancer pain
  • Catapres-TTS - usually used as a combination treatment for cancer pain
  • Combipres - usually used as a combination treatment for cancer pain
  • Dixarit - usually used as a combination treatment for cancer pain
  • Duraclon - usually used as a combination treatment for cancer pain
  • Novo-Clonidine - usually used as a combination treatment for cancer pain
  • Nu-Clonidine - usually used as a combination treatment for cancer pain
  • Alamine Expectorant
  • Ambenyl Expectorant
  • Ambenyl Syrup
  • Codeine
  • A.B.C. Compound w/Codeine
  • Accopain
  • Actagen-C
  • Actifed w/Codeine
  • Alamine-C
  • Anacin 3 w/Codeine #2-4
  • Atasol-8,-15,-30
  • Ban-Tuss
  • Benylin Syrup w/Codeine
  • Bitex
  • Bromanyl Cough Syrup
  • Bromotuss
  • Bromphen DC
  • Brontex
  • Butalbital Compound
  • Chemdal Expectorant
  • Chem-Tuss NE
  • Cheracol
  • Chlor-Trimeton Expectorant
  • Coactifed
  • Codecon-C
  • Codehist DH
  • Codehist Elixir
  • Codeine Contin
  • Coricidin w/Codeine
  • Co-Dimetane Cough Syrup-DC
  • Dimetane Expectorant-C
  • Dimetapp-C
  • Dimetapp w/Codeine
  • Empracet-30,-60
  • Empracet w/Codeine No. 3,4
  • Emtec-30
  • Exdol-8,-15,-30
  • Extra Strength Acetaminophen with Codeine
  • Glydeine
  • Isoclor Expectorant
  • Lenoltec w/Codeine No. 1,2,3,4
  • Mersyndol
  • Naldecon-CS
  • Normatane
  • Novadyme DH
  • Novahistex C
  • Novo-Gesic
  • Nucochem
  • Nucofed
  • Omni-Tuss
  • Oridol-C
  • Panadol w/Codeine
  • Paveral
  • Pediacof
  • Penntuss
  • Phenaphen w/Codeine No. 2,3,4
  • Phenergan w/Codeine
  • Poly-Histine
  • Promethazine CS
  • Pyra-Phed
  • Robaxacet-8
  • Rounox w/Codeine
  • SK-Apap
  • Tamine Expectorant DC
  • Tecnal C
  • Terpin Hydrate and Codeine
  • 318 AC&C
  • Triafed w/Codeine
  • Triaminic Expectorant w/Codeine
  • Triatec-8,30
  • Tussaminic C Forte
  • Tussaminic C Ped
  • Tussi-Organidin
  • Tylenol w/Codeine
  • Tylenol w/Codeine No. 1,2,3,4
  • Tylenol w/Codeine Elixir
  • VC Expectorant w/Codeine
  • Veganin
  • Celecoxib - mainly used for nonarthritic pain
  • Celebrex - mainly used for nonarthritic pain
  • Rofecoxib - mainly used for nonarthritic pain
  • Vioxx - mainly used for nonarthritic pain
  • Valdecoxib - mainly used for nonarthritic pain
  • Bextra - mainly used for nonarthritic pain
  • Fenamate
  • Meclofenamate
  • Meclodium
  • Meclofenaf
  • Meclomen
  • Mefenamic Acid
  • Apo-Mefanamic
  • Novo-Mefanamic
  • Ponstel
  • Ponstan
  • Hydrocodone
  • Dihydrocodeinone
  • Allay
  • Alor 5/500
  • Anaplex
  • Anexsia
  • Anexsia 7.5
  • Anolor
  • Atuss
  • Ban-Tuss-HC
  • Biohisdex DHC
  • Biohisdine DHC
  • Chemdal-HD
  • Codone
  • Detussin
  • DHC Plus
  • Dicoril
  • Dimetane Expectorant-DC
  • Endal-HD
  • Entuss-D
  • Histinex-HC
  • Histussin HC
  • Hycodan
  • Hycomine
  • Hycomine Compound
  • Hycomine Pediatric Syrup
  • Hycomine-S
  • Hycomine Syrup
  • Hycotuss Expectorant
  • Lorcet-HD
  • Lorcet Plus
  • Lortab
  • Medipain 5
  • Norcet 7
  • Novahistex DH
  • Novahistine DH
  • Polygesic
  • Protuss
  • Robidone
  • Ru-Tuss
  • T-Gesic
  • Triaminic Expectorant DH
  • Tussaminic Expectorant DH
  • Tussend
  • Tussend Expectorant
  • Tussionex
  • Tycolet
  • Vanex
  • Vicodin
  • Vicodin ES
  • Vicoprofen
  • Zydone
  • Meperidine
  • Demerol
  • Demerol APAP
  • Mepergan
  • Pethadol
  • Pethidine
  • Morphine
  • Astramorph
  • Astramorph PF
  • Avinza
  • Duramorph
  • Epimorph
  • Infumorph
  • Kadian
  • M-Eslon
  • Morphine H.P
  • Morphitec
  • M.O.S
  • M.O.S.-S.R
  • MS Contin
  • MS-IR
  • OMS Concentrate
  • Opium Tincture
  • Oramorph SR
  • Paregoric
  • RMS Uniserts
  • Roxanol
  • Roxanol 100
  • Roxanol SR
  • Statex
  • Oxicams
  • Alti-Piroxicam
  • Apo-Piroxicam
  • Brexidol
  • Dom-Piroxicam
  • Feldene
  • Med-Pirocam
  • Novo-Pirocam
  • Nu-Pirox
  • Oxycodone
  • Endocet
  • Endodan
  • Oxycocet
  • Oxycodan
  • OxyContin
  • Percocet
  • Percocet-Demi
  • Roxicet
  • Roxicodone
  • Roxilox
  • SK-Oxycodone
  • Supeudol
  • Tylox
  • Pentazocine
  • Talacen
  • Talwin
  • Talwin Compound
  • Talwin Compound-50
  • Talwin Nx
  • Propionic Acid
  • Fenoprofen
  • Nalfon
  • Flurbiprofen
  • Ansaid
  • Apo-Flurbiprofen
  • Froben
  • Froben-SR
  • Novo-Flurbiprofen
  • Ocufen
  • Ibuprofen
  • Aches-N-Pain
  • Actiprofen
  • Advil
  • Advil Migraine
  • Amersol
  • Apo-Ibuprofen
  • Arthritis Foundation Pain Reliever/Fever Reducer
  • Bayer Select
  • Children's Advil
  • Children's Motrin
  • Children's Motrin Drops
  • Children's Motrin Suspension
  • CoAdvil
  • Dimetapp Sinus
  • Dologesic
  • Dristan Sinus
  • Excedrin IB
  • Genpril
  • Guildprofen
  • Haltran
  • Ibu
  • Ibuprohm
  • Junior Strength motrin Caplets
  • Medipren
  • Medi-Profen
  • Profen-IB
  • Rufen
  • Superior Pain Medicine
  • Supreme Pain Medicine
  • Tab-Profen
  • Ketoprofen
  • Actron
  • Apo-Keto
  • Apo-Keto E
  • Orudis
  • Orudis E-50
  • Orudis E-100
  • Orudis KT
  • Orudis SR
  • Oruvail
  • Oruvail ER
  • Oruvail SR
  • Rhodis
  • Rhodis EC
  • Rhodis EC Suppository
  • Naproxen
  • Aleve
  • Anaprox
  • Anaprox DS
  • Apo-Naproxen
  • Naprelan
  • Naprelan Once Daily
  • Naprosyn
  • Naxen
  • Neo-Prox
  • Novo-Naprox
  • Nu-Naprox
  • Synflex
  • Oxaprozin
  • Daypro
  • Tramadol
  • Ultram
  • Ultracet
  • Direct Formulary Aspirin
  • Halfprin
  • Novasen
  • Anacin 3 w/Codeine No. 2-4
  • Acetaminophen
  • Acephen
  • Aspirin Free Anacin Maximum Strength
  • Cetafen
  • Cetafen Extra
  • Comtrex Sore Throat Maximum Strength
  • ElixSure Fever/Pain
  • Fever ALL
  • Genapap
  • Genapap Children
  • Genapap Extra Strength
  • Genapap Infant
  • Genebs
  • Genebs Extra Strength
  • Mapap
  • Mapap Arthritis
  • Mapap Children's
  • Mapap Extra Strength
  • Mapap Infants
  • Redutemp
  • Silapap Children's
  • Silapap Infants
  • Tylenol
  • Tylenol 8 Hour
  • Tylenol Arthritis Pain
  • Tylenol Children's
  • Tylenol Extra Strength
  • Tylenol Infants
  • Tylenol Junior Strength
  • Tylenol Sore Throat
  • Valorin
  • Valorin Extra
  • Abenol
  • Apo-Acetaminophen
  • Atasol
  • Pediatrix
  • Tempra
  • Actafen
  • Androx
  • Datril
  • Magnidol
  • Neodol
  • Neodolito
  • Sedalito
  • Sinedol
  • Temperal
  • Tylex
  • Capital and Codeine
  • Ratio-Emtec
  • Ratio-Lenoltec
  • Triatec-8
  • Triatec-8 Strong
  • Triatec-30
  • Tylenol Elixir with Codeine
  • Tylenol No. 1
  • Tylenol No. 1 Forte
  • Tylenol No. 2 with Codeine
  • Tylenol No. 3 with Codeine
  • Tylenol No. 4 with Codeine
  • Acetaminophen and Pseudoephedrine
  • Alka-Seltzer Plus Cold and Sinus Liqui-Gels
  • Cetafen Cold
  • Genapap Sinus Maximum Strength
  • Mapap Sinus Maximum Strength
  • Medi-Synal
  • Omex
  • Omex Maximum Strength
  • Sinus-Relief
  • Sinutab
  • Sinutab Sinus
  • Sudafed Sinus and Cold
  • Sudafed Sinus Headache
  • SudoGest Sinus
  • Tylenol Cold, Infants
  • Tylenol Sinus, Children's
  • Tylenol Sinus Day Non-Drowsy
  • Dristan N.D
  • Dristan N.D., Extra Strength
  • Sinutab Non Drowsy
  • Sudafed Head Cold and Sinus Extra Strength
  • Tylenol Decongestant
  • Tylenol Sinus
  • Acetaminophen, Aspirin and Caffeine
  • Excedrin Extra Strength
  • Fem-Prin
  • Genaced
  • Goody's Extra Strength Headache Powder
  • Goody's Extra Strength Pain Relief
  • Pain-Off
  • Vanquish Extra Strength Pain Reliever
  • Acetaminophen, Dextromethorphan and Pseudoephedrine
  • Alka-Seltzer Plus Flu Liqui-Gels
  • Comtrex Non-Drowsy Cold and Cough Relief
  • Infants' Tylenol Cold Plus Cough Concentrated Drops
  • Contac Severe Cold and Flu/Non-Drowsy
  • Sudafed Severe Cold
  • Triaminic Cough and Sore Throat Formula
  • Tylenol Cold Day Non-Drowsy
  • Tylenol Flu Non-Drowsy Maxium Strength
  • Vicks DayQuil Multi-Symptom Cold and Flu
  • Contac Cough, Cold and Flu Day & Night
  • Sudafed Cold & Cough Extra Strength
  • Tylenol Cold Daytime
  • Aspercin
  • Aspercin Extra
  • Bayer Aspirin Regimen Adult Low Strength
  • Bayer Aspirin Regimen Children's
  • Bayer Aspirin Regimen Regular Strength
  • Bayer Extra Strength Arthritis Pain Regimen
  • Bayer Women's Aspirin Plus Calcium
  • Buffinol
  • Buffinol Extra
  • Ecotrin Low Strength
  • Ecotrin Maximum Strength
  • Sureprin 81
  • Asaphen
  • Asaphen E.C
  • ASA 500
  • Coraspir
  • Aspirin and Codeine
  • Empirin with Codeine
  • Cetacaine - mainly used as a topical anaesthetic
  • Benzocaine, Butyl Aminobenzoate, Tetracaine and Benzalkonium Chloride - mainly used as a topical anaesthetic
  • Orabase with Benzocaine - mainly used as a topical anaesthetic
  • Benzocaine, Gelatin, Pectin and Sodium Carboxymethycellulose - mainly used as a topical anaesthetic
  • Buprenorphine
  • Buprenex
  • Subutex
  • Temgesic
  • Butalbital, Aspirin, Caffeine and Codeine
  • Fiorinal with Codeine
  • Phrenlin with Caffeine and Codeine
  • Fiorinal-C 1/2
  • Fiorinal-C 1/4
  • Tecnal C 1/2
  • Tecnal C 1/4
  • Butorphanol
  • Stadol
  • Apo-Butorphanol
  • PMS-Butorphanol
  • Stadol NS
  • Diflunisal
  • Dolobid
  • Apo-Diflunisal
  • Novo-Diflunisal
  • Nu-Diflunisal
  • Duloxetine - mainly used to treat pain associated with diabetic neuropathy
  • Cymbalta - mainly used to treat pain associated with diabetic neuropathy
  • Floctafenine
  • Idarac
  • Hydromorphone
  • Dilaudid
  • Dilaudid-HP
  • Palladone
  • Dilaudid-HP-Plus
  • Dilaudid-XP
  • Hydromorph Contin
  • Hydromorphone HP
  • PMS-Hydromorphone
  • PlusDilaudid Sterile Powder
  • Levorphanol
  • Levo-Dromoran
  • Magnesium Salicylate
  • Doan's Doan's Extra Strength
  • Keygesic
  • Methadone - Severe pain
  • Dolophine - Severe pain
  • Methadone Intensol - Severe pain
  • Methadose - Severe pain
  • Metadol - Severe pain
  • Methotrimeprazine
  • Apo-Methoprazine
  • Novo-Meprazine
  • Nozinan
  • Levocina
  • Sinogan
  • Nalbuphine
  • Nubain
  • Bufigen
  • Nalcryn
  • Oxymorphonement
  • Numorphan
  • Pentazocine Compound
  • Piroxicam and Cyclodextrin
  • Brexidol 20
  • SalsalateAmigesic
  • Mono-Gesic
  • Salflex
  • Amigesic
  • Sodium Salicylate
  • Ziconotide
  • Prialt
  • Alfentanil
  • Rapifen
  • Palfium
  • Dextromoramide
  • Dextropropoxyphene
  • Doloxene
  • Capadex
  • Digesic
  • Paradex
  • Rubesal
  • Diethylamine Salicylate
  • Aceta
  • Anacin-3
  • Apacet
  • Banesin
  • Dapa
  • Dorcol
  • Halenol
  • Neopap
  • Valadol
  • 222 AF
  • Tantaphen
  • Algitrin
  • Analphen
  • Febrin
  • Minofen
  • Sinedol 500
  • Cilag
  • Winasorb
  • Tylex 750

Unlabeled Drugs and Medications to treat Pain:

Unlabelled alternative drug treatments for Pain include:

  • Alprazolam - mainly used in combination with various narcotics to treat cancer pain
  • Alprazolam Intensol - mainly used in combination with various narcotics to treat cancer pain
  • Apo-Alpraz - mainly used in combination with various narcotics to treat cancer pain
  • Med-Alprazolam - mainly used in combination with various narcotics to treat cancer pain
  • Novo-Alprazol - mainly used in combination with various narcotics to treat cancer pain
  • Nu-Alpraz - mainly used in combination with various narcotics to treat cancer pain
  • Xanax - mainly used in combination with various narcotics to treat cancer pain
  • Carbamazepine - mainly for pain associated with depression
  • Apo-Carbamazepine - mainly for pain associated with depression
  • Carbitrol Extended Release - mainly for pain associated with depression
  • Domcarbamazepine-CR- mainly for pain associated with depression
  • Epitol - mainly for pain associated with depression
  • Gen-Carbamazepine CR - mainly for pain associated with depression
  • Mazepine - mainly for pain associated with depression
  • Novo-Carbamaz - mainly for pain associated with depression
  • PMS Carbamazepine - mainly for pain associated with depression
  • Taro-carbamazepine CR - mainly for pain associated with depression
  • Tegretol - mainly for pain associated with depression
  • Tegretol Chewable Tablet - mainly for pain associated with depression
  • Tegretol-CR - mainly for pain associated with depression
  • Tegretol-XR - mainly for pain associated with depression
  • Clonidine - mainly used to treat cancer pain
  • Apo-Clonidine - mainly used to treat cancer pain
  • Catapres - mainly used to treat cancer pain
  • Catapres-TTS - mainly used to treat cancer pain
  • Combipres - mainly used to treat cancer pain
  • Dixarit - mainly used to treat cancer pain
  • Duraclon - mainly used to treat cancer pain
  • Novo-Clonidine - mainly used to treat cancer pain
  • Nu-Clonidine - mainly used to treat cancer pain
  • Methylphenidate - mainly used to treat chronic pain
  • Concerta - mainly used to treat chronic pain
  • Metadate CD and ER - mainly used to treat chronic pain
  • PMS-Methylphenidate - mainly used to treat chronic pain
  • Methylin ER - mainly used to treat chronic pain
  • Ritalin - mainly used to treat chronic pain
  • Ritalin-SR - mainly used to treat chronic pain
  • Nefazodone
  • Lin-Nefazodone
  • Serzone
  • Serzone 5HT2
  • Nortriptyline
  • Aventyl
  • Pamelor
  • Baclofen
  • Lioresal
  • Apo-Baclofen
  • Gen-Baclofen
  • Liotec
  • Nu-Baclo
  • PMS-Baclofen
  • Maprotiline
  • Novo-Mapritiline
  • Ludiomil

Medical news summaries about treatments for Pain:

The following medical news items are relevant to treatment of Pain:

Discussion of treatments for Pain:

Pain -- Hope Through Research: NINDS (Excerpt)

The goal of pain management is to improve function, enabling individuals to work, attend school, or participate in other day-to-day activities. Patients and their physicians have a number of options for the treatment of pain; some are more effective than others. Sometimes, relaxation and the use of imagery as a distraction provide relief. These methods can be powerful and effective, according to those who advocate their use. Whatever the treatment regime, it is important to remember that pain is treatable. The following treatments are among the most common.

Acetaminophen is the basic ingredient found in Tylenol® and its many generic equivalents. It is sold over the counter, in a prescription-strength preparation, and in combination with codeine (also by prescription).

Acupuncture dates back 2,500 years and involves the application of needles to precise points on the body. It is part of a general category of healing called traditional Chinese or Oriental medicine. Acupuncture remains controversial but is quite popular and may one day prove to be useful for a variety of conditions as it continues to be explored by practitioners, patients, and investigators.

Analgesic refers to the class of drugs that includes most painkillers, such as aspirin, acetaminophen, and ibuprofen. The word analgesic is derived from ancient Greek and means to reduce or stop pain. Nonprescription or over-the-counter pain relievers are generally used for mild to moderate pain. Prescription pain relievers, sold through a pharmacy under the direction of a physician, are used for more moderate to severe pain.

Anticonvulsants are used for the treatment of seizure disorders but are also sometimes prescribed for the treatment of pain. Carbamazepine in particular is used to treat a number of painful conditions, including trigeminal neuralgia. Another antiepileptic drug, gabapentin, is being studied for its pain-relieving properties, especially as a treatment for neuropathic pain.

Antidepressants are sometimes used for the treatment of pain and, along with neuroleptics and lithium, belong to a category of drugs called psychotropic drugs. In addition, anti-anxiety drugs called benzodiazepines also act as muscle relaxants and are sometimes used as pain relievers. Physicians usually try to treat the condition with analgesics before prescribing these drugs.

Antimigraine drugs include the triptans- sumatriptan (Imitrex®), naratriptan (Amerge®), and zolmitriptan (Zomig®)-and are used specifically for migraine headaches. They can have serious side effects in some people and therefore, as with all prescription medicines, should be used only under a doctor's care.

Aspirin may be the most widely used pain-relief agent and has been sold over the counter since 1905 as a treatment for fever, headache, and muscle soreness. Biofeedback is used for the treatment of many common pain problems, most notably headache and back pain. Using a special electronic machine, the patient is trained to become aware of, to follow, and to gain control over certain bodily functions, including muscle tension, heart rate, and skin temperature. The individual can then learn to effect a change in his or her responses to pain, for example, by using relaxation techniques. Biofeedback is often used in combination with other treatment methods, generally without side effects. Similarly, the use of relaxation techniques in the treatment of pain can increase the patient's feeling of well-being.

Capsaicin is a chemical found in chili peppers that is also a primary ingredient in pain-relieving creams (see Chili Peppers, Capsaicin, and Pain in the Appendix).

Chemonucleolysis is a treatment in which an enzyme, chymopapain, is injected directly into a herniated lumbar disc (see Spine Basics in the Appendix) in an effort to dissolve material around the disc, thus reducing pressure and pain. The procedure's use is extremely limited, in part because some patients may have a life-threatening allergic reaction to chymopapain.

Chiropractic refers to hand manipulation of the spine, usually for relief of back pain, and is a treatment option that continues to grow in popularity among many people who simply seek relief from back disorders. It has never been without controversy, however. Chiropractic's usefulness as a treatment for back pain is, for the most part, restricted to a select group of individuals with uncomplicated acute low back pain who may derive relief from the massage component of the therapy.

Cognitive-behavioral therapy involves a wide variety of coping skills and relaxation methods to help prepare for and cope with pain. It is used for postoperative pain, cancer pain, and the pain of childbirth.

Counseling can give a patient suffering from pain much needed support, whether it is derived from family, group, or individual counseling. Support groups can provide an important adjunct to drug or surgical treatment. Psychological treatment can also help patients learn about the physiological changes produced by pain.

COX-2 inhibitors ("superaspirins") may be particularly effective for individuals with arthritis. For many years scientists have wanted to develop the ultimate drug-a drug that works as well as morphine but without its negative side effects. Nonsteroidal anti-inflammatory drugs (NSAIDs) work by blocking two enzymes, cyclooxygenase-1 and cyclooxygenase-2, both of which promote production of hormones called prostaglandins, which in turn cause inflammation, fever, and pain. Newer drugs, called COX-2 inhibitors, primarily block cyclooxygenase-2 and are less likely to have the gastrointestinal side effects sometimes produced by NSAIDs. On 1999, the Food and Drug Administration approved two COX-2 inhibitors-rofecoxib (Vioxx®) and celecoxib (Celebrex®). Although the long-term effects of COX-2 inhibitors are still being evaluated, they appear to be safe. In addition, patients may be able to take COX-2 inhibitors in larger doses than aspirin and other drugs that have irritating side effects, earning them the nickname "superaspirins."

Electrical stimulation, including transcutaneous electrical stimulation (TENS), implanted electric nerve stimulation, and deep brain or spinal cord stimulation, is the modern-day extension of age-old practices in which the nerves of muscles are subjected to a variety of stimuli, including heat or massage. Electrical stimulation, no matter what form, involves a major surgical procedure and is not for everyone, nor is it 100 percent effective. The following techniques each require specialized equipment and personnel trained in the specific procedure being used:

  • TENS uses tiny electrical pulses, delivered through the skin to nerve fibers, to cause changes in muscles, such as numbness or contractions. This in turn produces temporary pain relief. There is also evidence that TENS can activate subsets of peripheral nerve fibers that can block pain transmission at the spinal cord level, in much the same way that shaking your hand can reduce pain.
  • Peripheral nerve stimulation uses electrodes placed surgically on a carefully selected area of the body. The patient is then able to deliver an electrical current as needed to the affected area, using an antenna and transmitter.
  • Spinal cord stimulation uses electrodes surgically inserted within the epidural space of the spinal cord. The patient is able to deliver a pulse of electricity to the spinal cord using a small box-like receiver and an antenna taped to the skin.
  • Deep brain or intracerebral stimulation is considered an extreme treatment and involves surgical stimulation of the brain, usually the thalamus. It is used for a limited number of conditions, including severe pain, central pain syndrome, cancer pain, phantom limb pain, and other neuropathic pains.

Exercise has come to be a prescribed part of some doctors' treatment regimes for patients with pain. Because there is a known link between many types of chronic pain and tense, weak muscles, exercise-even light to moderate exercise such as walking or swimming-can contribute to an overall sense of well-being by improving blood and oxygen flow to muscles. Just as we know that stress contributes to pain, we also know that exercise, sleep, and relaxation can all help reduce stress, thereby helping to alleviate pain. Exercise has been proven to help many people with low back pain. It is important, however, that patients carefully follow the routine laid out by their physicians.

Hypnosis, first approved for medical use by the American Medical Association in 1958, continues to grow in popularity, especially as an adjunct to pain medication. In general, hypnosis is used to control physical function or response, that is, the amount of pain an individual can withstand. How hypnosis works is not fully understood. Some believe that hypnosis delivers the patient into a trance-like state, while others feel that the individual is simply better able to concentrate and relax or is more responsive to suggestion. Hypnosis may result in relief of pain by acting on chemicals in the nervous system, slowing impulses. Whether and how hypnosis works involves greater insight-and research-into the mechanisms underlying human consciousness.

Ibuprofen is a member of the aspirin family of analgesics, the so-called nonsteroidal anti-inflammatory drugs (see below). It is sold over the counter and also comes in prescription-strength preparations.

Low-power lasers have been used occasionally by some physical therapists as a treatment for pain, but like many other treatments, this method is not without controversy.

Magnets are increasingly popular with athletes who swear by their effectiveness for the control of sports-related pain and other painful conditions. Usually worn as a collar or wristwatch, the use of magnets as a treatment dates back to the ancient Egyptians and Greeks. While it is often dismissed as quackery and pseudoscience by skeptics, proponents offer the theory that magnets may effect changes in cells or body chemistry, thus producing pain relief.

Narcotics (see Opioids, below).

Nerve blocks employ the use of drugs, chemical agents, or surgical techniques to interrupt the relay of pain messages between specific areas of the body and the brain. There are many different names for the procedure, depending on the technique or agent used. Types of surgical nerve blocks include neurectomy; spinal dorsal, cranial, and trigeminal rhizotomy; and sympathectomy, also called sympathetic blockade (see Nerve Blocks in the Appendix).

Nonsteroidal anti-inflammatory drugs (NSAIDs) (including aspirin and ibuprofen) are widely prescribed and sometimes called non-narcotic or non-opioid analgesics. They work by reducing inflammatory responses in tissues. Many of these drugs irritate the stomach and for that reason are usually taken with food. Although acetaminophen may have some anti-inflammatory effects, it is generally distinguished from the traditional NSAIDs.

Opioids are derived from the poppy plant and are among the oldest drugs known to humankind. They include codeine and perhaps the most well-known narcotic of all, morphine. Morphine can be administered in a variety of forms, including a pump for patient self-administration. Opioids have a narcotic effect, that is, they induce sedation as well as pain relief, and some patients may become physically dependent upon them. For these reasons, patients given opioids should be monitored carefully; in some cases stimulants may be prescribed to counteract the sedative side effects. In addition to drowsiness, other common side effects include constipation, nausea, and vomiting.

Physical therapy and rehabilitation date back to the ancient practice of using physical techniques and methods, such as heat, cold, exercise, massage, and manipulation, in the treatment of certain conditions. These may be applied to increase function, control pain, and speed the patient toward full recovery.

Placebos offer some individuals pain relief although whether and how they have an effect is mysterious and somewhat controversial. Placebos are inactive substances, such as sugar pills, or harmless procedures, such as saline injections or sham surgeries, generally used in clinical studies as control factors to help determine the efficacy of active treatments. Although placebos have no direct effect on the underlying causes of pain, evidence from clinical studies suggests that many pain conditions such as migraine headache, back pain, post-surgical pain, rheumatoid arthritis, angina, and depression sometimes respond well to them. This positive response is known as the placebo effect, which is defined as the observable or measurable change that can occur in patients after administration of a placebo. Some experts believe the effect is psychological and that placebos work because the patients believe or expect them to work. Others say placebos relieve pain by stimulating the brain's own analgesics and setting the body's self-healing forces in motion. A third theory suggests that the act of taking placebos relieves stress and anxiety-which are known to aggravate some painful conditions-and, thus, cause the patients to feel better. Still, placebos are considered controversial because by definition they are inactive and have no actual curative value.

R.I.C.E.-Rest, Ice, Compression, and Elevation-are four components prescribed by many orthopedists, coaches, trainers, nurses, and other professionals for temporary muscle or joint conditions, such as sprains or strains. While many common orthopedic problems can be controlled with these four simple steps, especially when combined with over-the-counter pain relievers, more serious conditions may require surgery or physical therapy, including exercise, joint movement or manipulation, and stimulation of muscles.

Surgery, although not always an option, may be required to relieve pain, especially pain caused by back problems or serious musculoskeletal injuries. Surgery may take the form of a nerve block (see Nerve Blocks in the Appendix) or it may involve an operation to relieve pain from a ruptured disc. Surgical procedures for back problems include discectomy or, when microsurgical techniques are used, microdiscectomy, in which the entire disc is removed; laminectomy, a procedure in which a surgeon removes only a disc fragment, gaining access by entering through the arched portion of a vertebra; and spinal fusion, a procedure where the entire disc is removed and replaced with a bone graft. In a spinal fusion, the two vertebrae are then fused together. Although the operation can cause the spine to stiffen, resulting in lost flexibility, the procedure serves one critical purpose: protection of the spinal cord. Other operations for pain include rhizotomy, in which a nerve close to the spinal cord is cut, and cordotomy, where bundles of nerves within the spinal cord are severed. Cordotomy is generally used only for the pain of terminal cancer that does not respond to other therapies. Another operation for pain is the dorsal root entry zone operation, or DREZ, in which spinal neurons corresponding to the patient's pain are destroyed surgically. Because surgery can result in scar tissue formation that may cause additional problems, patients are well advised to seek a second opinion before proceeding. Occasionally, surgery is carried out with electrodes that selectively damage neurons in a targeted area of the brain. These procedures rarely result in long-term pain relief, but both physician and patient may decide that the surgical procedure will be effective enough that it justifies the expense and risk. In some cases, the results of an operation are remarkable. For example, many individuals suffering from trigeminal neuralgia who are not responsive to drug treatment have had great success with a procedure called microvascular decompression, in which tiny blood vessels are surgically separated from surrounding nerves. (Source: excerpt from Pain -- Hope Through Research: NINDS)

Pain -- Hope Through Research: NINDS (Excerpt)

In 1998, the American Geriatrics Society (AGS) issued guidelines* for the management of pain in older people. The AGS panel addressed the incorporation of several non-drug approaches in patients' treatment plans, including exercise. AGS panel members recommend that, whenever possible, patients use alternatives to aspirin, ibuprofen, and other NSAIDs because of the drugs' side effects, including stomach irritation and gastrointestinal bleeding. For older adults, acetaminophen is the first-line treatment for mild-to-moderate pain, according to the guidelines. More serious chronic pain conditions may require opioid drugs (narcotics), including codeine or morphine, for relief of pain. (Source: excerpt from Pain -- Hope Through Research: NINDS)

Pain -- Hope Through Research: NINDS (Excerpt)

Pain in younger patients also requires special attention, particularly because young children are not always able to describe the degree of pain they are experiencing. Although treating pain in pediatric patients poses a special challenge to physicians and parents alike, pediatric patients should never be undertreated. Recently, special tools for measuring pain in children have been developed that, when combined with cues used by parents, help physicians select the most effective treatments.

Nonsteroidal agents, and especially acetaminophen, are most often prescribed for control of pain in children. In the case of severe pain or pain following surgery, acetaminophen may be combined with codeine. (Source: excerpt from Pain -- Hope Through Research: NINDS)

Pain -- Hope Through Research: NINDS (Excerpt)

As a painkiller, marijuana or, by its Latin name, cannabis, continues to remain highly controversial. In the eyes of many individuals campaigning on its behalf, marijuana rightfully belongs with other pain remedies. In fact, for many years, it was sold under highly controlled conditions in cigarette form by the Federal government for just that purpose. (Source: excerpt from Pain -- Hope Through Research: NINDS)

Pain -- Hope Through Research: NINDS (Excerpt)

Nerve blocks may involve local anesthesia, regional anesthesia or analgesia, or surgery; dentists routinely use them for traditional dental procedures. Nerve blocks can also be used to prevent or even diagnose pain. (Source: excerpt from Pain -- Hope Through Research: NINDS)

Pain: NWHIC (Excerpt)

Over-the-counter drugs like aspirin, acetaminophen (Tylenol), and ibuprofen (Advil) are all marketed as pain-relief medications. To decide which of these FDA-approved drugs is best for you, you may consult with your physician and read the label for side effects. (Source: excerpt from Pain: NWHIC)

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