Medicines and pain
Use this content to learn more about the role of medicines in chronic pain management.
Use this content to learn more about the role of medicines in chronic pain management.
This module is designed to help you understand the role of medicines, the risks, side-effects and potential benefits if doctors recommend adding them into your pain care toolbox.
Learning more about the safe use of medicines adds another tool to your pain management toolkit, as your recovery is better when care is holistic.
The information here should not be used as a stand-alone guide, nor should medicines be used as stand-alone treatment.
Before you decide to take medicine for pain, have a chat with your doctor or pharmacist.
These health professionals will help you check whether the medicine is safe for you. They do this by considering your health and your other medicines, because some medicines or combinations may be dangerous for you.
Doctors will assess, in discussion with you, whether other treatments would be beneficial, in addition to medicines for pain.
You can use our medical screening tool. This screening tool is designed to assess if you have any symptoms or signs that mean you need to see a doctor. Upon completing the check, you can download your report to your computer, phone, or print it to take to your doctor.
Words that can help you in discussions with your doctor or pharmacist about using pain medicines:
Lots of factors can influence your pain, so learning what these factors are for you, means care can be better tailored and focused on you as a whole person. Check out our Pain Management modules for practical tips and info. Medicines are recommended for some young people, some of the time, to help with their pain care.
Medicines are just one part of a broader management plan and are commonly used:
There are lots of things that can help with managing your pain other than medicines, or in combination with medicines.
Our making sense of your pain management modules gives you practical tips on what these factors are and how you can manage them as part of your care plan.
If you need help from family and friends, share the helping others help you.
Before you decide to take an over-the-counter medicine for pain, have a chat with your doctor or pharmacist. These health professionals will assess your needs and history, as well as other medications you are on.
If an over-the-counter or prescription medication is recommended by your doctor, it’s good to feel informed, so remember to ask your doctor:
Our 6-step guide to safer use of prescribed pain medicines: use this guide to help you safely use your prescribed medication as part of your pain management plan.
If the medicine causes tolerance or dependence, to avoid withdrawal symptoms and harm, it’s important to gradually reduce and stop with medical advice. If the doctor recommends you take such medicines, ask them to help you understand and manage the risk of dependence.
If you have unused medicines, dispose of them safely through a pharmacy or Return of Expired and Unwanted Medicine. This protects others and the environment.
Remember that medications are only part of the tools used to help support you moving forward with valued life activities and progressing the skills you have learnt in our other Pain Management modules.
If you do get a positive benefit from a medicine, it’s great to use this window of opportunity to gradually increase your fun activities, explore new activities and progress your functional goals. This holistic approach helps to move you forward towards what you want to do.
People usually want to know that a medicine works. This is really important when there are potential risks or side effects when taking the medicine.
Some pain medicines might reduce your ability to concentrate, drive, or lower your mood. Sometimes medicines have a good effect on pain because of the specific way they work.
Some of a medicine’s effects will be due to other things like hope and expectations, how you feel at the time and your doctor’s confidence. Non-specific ways that a medicine helps is called its ‘placebo’ effect. Medicines should have more than a placebo effect.
Right now, there are lots of science gaps – or evidence gaps – about the use of pain medications for young people living with musculoskeletal pain conditions:
Below, we have created a summary of medicines that might be recommended for your care, what they are recommended for, potential risks, side-effects, potential benefits and the bottom line.
This information is provided to ensure you have the right information to discuss safe and appropriate medicines use with your doctor.
Paracetamol may be recommended for acute pain or fever. Paracetamol might be recommended for short-term use (usually less than two weeks) to help you manage a flare-up of chronic pain.
If you are someone who frequently experiences headaches, seek advice from your doctor as headaches can worsen from paracetamol overuse if consumed more than 14 days per month. Paracetamol is an ingredient in many over-the-counter medicines, so always check the ingredients and don’t double up – check with the pharmacist if you’re uncertain.
Paracetamol is the only analgesic medication classed as safe during pregnancy. All other medicines are not recommended.
Although proven to be safe for healthy people in appropriate and controlled dosages, paracetamol can cause harm if overdosed or overused, including headache, liver failure and death.
Non-steroidal anti-inflammatories may be recommended for temporary relief of pain or inflammation. NSAIDs are ingredients in many over-the-counter medicines, so always check the ingredients and don’t double up on this group – check with the pharmacist if you’re uncertain.
NSAIDs might be recommended for short-term use (usually less than two weeks) to help you manage a flare-up of chronic pain. These medications may also be recommended by a Rheumatologist to help control an inflammatory condition. This is helpful if you are waiting for a disease-modifying anti-rheumatic drug (DMARD) to start having an effect.
Some potential harms for young people have been reported and the incidence of adverse effects can be quite high especially for older type anti-inflammatories. Adverse effects include minor gut symptoms and headache, with more serious effects including bleeding from the bowel. Taking NSAIDs as directed on the package (i.e. with food for most) can decrease the risk of gut ulcers/symptoms.
Opioids might be recommended for acute severe pain. They are not recommended for chronic non-cancer pain except in exceptional circumstances.
Known risks include opioid addiction, overdose and death, sleep apnoea (breathing pauses), sexual and hormone dysregulation, driving impairment, nausea and constipation. The risk of serious harm increases with opioid misuse, higher opioid doses, or when opioids are used in some medication combinations.
On average, more than 1 Australian dies every day due to harm from prescription opioids.
This short clip shows how opioids may work in the short-term, and explains the risks and potential side-effects of longer-term use.
Antidepressant medication may be used to target pain rather than mood if you experience pain due to a problem in the nerves, spinal cord and/or areas of the brain – this is known as ‘neuropathic’ or ‘nerve-related’ pain.
Lower doses of antidepressant medicines are used for pain, than would be recommended for mood management. It’s unclear if one type of antidepressant is more effective or safer than another.
It is unclear whether antidepressants provide pain relief for young people aged 0-19 years with chronic non-cancer pain. Known risks include mood disturbance and suicide risk, amongst others.
Antiepilepsy medication may be used to target pain rather than seizures if you experience pain due to a problem in the nerves, spinal cord and/or areas of the brain – this is known as ‘neuropathic’ or ‘nerve-related’ pain. We currently don’t have evidence to tell us which type of antiepileptic is more effective than another.
In adults, some antiepileptic medicines can be effective in certain chronic pain conditions.
It is unclear whether antiepileptics provide pain relief for young people with chronic non-cancer pain. Yet they are associated with known risks including mood disturbance, suicide risk, and dependence amongst others.
‘Medicinal cannabis’ refers to products that have been standardised so that the ingredients, strength and quality are known. ‘Medicinal cannabis’ may be legal if prescribed by an approved doctor under special circumstances.
It is unclear whether medicinal cannabis provides pain relief for young people with chronic non-cancer pain.
Medicinal cannabis is associated with known harms including impaired driving, impaired breathing function, symptoms of mental illness, and altered brain function.
Finding a health professional team who can support you in your care is important. If you need expert help, please view our further contacts.
Alternatively, painAUSTRALIA includes a directory where you can find a pain specialist near you.
You can also ask your health professionals for their help or their recommendations for clinicians working in pain care.
This module has been co-created by Dr Susan Lord in collaboration with Ms Ellyn Bicknell. The information in this module is based on current best evidence research and clinical practice and lived experience. Some of the information has been adapted from painHEALTH, with acknowledgement to Dr Stephanie Davies, Pain Medicine Specialist.