If a 2-week course of over-the-counter painkillers does not work, ask for help from your GP or pharmacist. The Pain Toolkit is a collection of helpful tips and strategies to manage persistent pain, developed by someone with long-term pain.

This pain management meditation course for pain relief, from Meditainment , is free, easy to follow and proven to help people cope with chronic pain. It's part of the Pathway through Pain online course, which is provided by the NHS in some areas for people with persistent pain.

Page last reviewed: 6 September Next review due: 6 September Home Live Well Pain Back to Pain. Ways to manage chronic pain. Lack of activity can make: you stiffen up your muscles and bones weaker you sleep less well you become lonely and depressed pain feel worse You may also find it becomes harder to get going again.

A better approach to reducing pain is a combination of: exercise staying at work physical therapy painkillers Exercise Choose an exercise that won't put too much strain on yourself.

Good options include: walking swimming using an exercise bike dancing, yoga or pilates Activity and stretching needs to become part of your lifestyle so you routinely do exercise a little and often. Go to work if you can It's important to try to stay in work even if you're in pain.

Being at work may distract you from the pain and might not make it worse. Physical therapy Pain experts often recommend a short course of physical therapy. Painkillers for long-term pain It's safe to use over-the-counter painkillers to reduce your pain so you can be more active.

Online help for pain There's a lot of online information if you're living with pain. General pain websites Charity: Action on Pain Charity: Pain Concern Self-help tips The Pain Toolkit is a collection of helpful tips and strategies to manage persistent pain, developed by someone with long-term pain.

MMWR Recommendations and Reports. Price MR, et al. Systematic review of guidelines-recommended medications prescribed for treatment of low back pain. Przybyla GW, et al. Paracetamol — An old drug with new mechanisms of action.

Celecoxib oral. Understanding drug overdoses and death. Shah A, et al. Characteristics of initial prescription episodes and likelihood of long-term opioid use — United States, MMWR Morbidity and Mortality Weekly Report. Tricyclic antidepressants. IBM Micromedex. See also Antidepressants for chronic pain Collecting Pennies Through the Pain Neurofibromatosis.

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Follow Mayo Clinic. Get the Mayo Clinic app. Block COX -1 and COX -2 enzymes involved in pain and inflammation. Mild to moderate pain accompanied by swelling and inflammation Arthritis pain and pain resulting from muscle sprains and strains, back and neck injuries, overuse injuries, and menstrual cramps.

When taken as directed, generally safe for short- and long-term use Available without a prescription. May cause nausea, stomach pain, stomach bleeding or ulcers When taken in high doses, can lead to kidney problems, fluid retention and high blood pressure Increased risk of side effects for older adults.

When more than the recommended dose is taken or when taken with alcohol, increased risk of kidney damage and liver failure over time. As effective as NSAIDs without damaging stomach lining at regular doses.

Headache and dizziness When taken in high doses, can lead to stomach bleeding, kidney problems, fluid retention, high blood pressure, heart attack and stroke Increased risk of side effects for older adults.

Neuropathic pain, chronic headaches, fibromyalgia May be considered for chronic low back pain. Can be in doses much lower than what is currently used to treat depression Side effects generally mild, depending on the type of antidepressant. Drowsiness possible with tricyclic antidepressants Can take several weeks to produce desired effects May worsen depression and cause suicidal thoughts in a small number of people.

May cause dizziness, drowsiness, nausea, reduced coordination and weight changes May worsen depression and cause suicidal thoughts in a small number of people. Blocks opioid receptors, which stop the release of chemicals that cause pain Can stop the transmission of pain signals.

Acute pain, such as pain that follows surgery or a bone fracture Typically prescribed for a few days or less. Our team helps patients achieve maximum pain relief with minimally invasive procedures.

We address not only the physical cause of chronic pain, but its psychosocial cause allowing patients to find significant, long-term relief.

Pain management techniques are continually evolving and improving. We, at Chronic Pain Relief, stay engaged in the medical community to give patients access to the most advanced treatments available.

We utilize continuously evolving literature, to provide state of the art care. Our patients are like family. We offer every patient personalized and compassionate care. With restored function, mobility, and comfort, patients get back to the activities they love — free of pain.

Chronic pain can be managed with or without prescription opioids, but many of the nonopioid options have been shown to work better with fewer side effects. Examples include:. Take control of how you manage your pain and ask your doctor about different options. Keep in mind that sometimes you may feel worse before you feel better when starting a new treatment program.

Work with your doctor to find safe and effective care to help you reach your goals. If after talking to your doctor about your pain treatment, you are prescribed opioids, be sure to ask about the risks and benefits. To help ensure your treatment is safe and effective, your doctor may:. Side Effects of Opioid Therapy.

Prescription opioids carry serious risks of addiction and overdose. The use of prescription opioids can have several side effects as well, even when taken as directed:.

Skip directly to site content Skip directly to search. Español Other Languages. Opioid Therapy and Different Types of Pain. Español Print. Minus Related Pages. What are Prescription Opioids? Common prescription opioid drugs include: Hydrocodone such as Vicodin®, Norco® Oxycodone such as OxyContin®, Percocet® Morphine such as MS Contin®, Kadian®.

Acute and Subacute Pain Management. Opioid medications are one of many ways to reduce severe acute pain, but many other options can provide relief with fewer side effects, including: Over-the-counter medications like acetaminophen such as Tylenol® , ibuprofen such as Advil®, Motrin® , and naproxen such as Aleve® Application of heat or ice Physical therapy, acupuncture, acupressure, massage, or spinal manipulation Music therapy Transcutaneous electrical nerve stimulation TENS Exercise It is important to note that continuing opioid therapy during the subacute time frame might represent the start of long-term opioid therapy.

Chronic Pain Management. Examples include: Over-the-counter medications like acetaminophen Tylenol® , ibuprofen Advil®, Motrin® , and naproxen Aleve® Physical therapy and exercise Cognitive behavioral therapy CBT Certain antidepressant and antiseizure medications. Patient Safety Is an Important Part of Pain Care Before starting opioids to treat pain, you can: Learn about prescription opioids and know the risks.

Consider ways to manage pain that do not include opioids. Examples include: Physical therapy Exercise Nonopioid medications, such as acetaminophen or ibuprofen Cognitive behavioral therapy CBT Make the most informed decision with your doctors. Talk To Your Doctor About What Kind of Pain Care Is Right for You.

If You Are Prescribed Opioids for Pain Management Follow up with your doctor within the first few days of starting your prescription to ensure opioids are helping. You should also discuss what kind of pain relief and improvement you can expect overall.

Opioids can reduce pain in the short-term but will not likely relieve all your pain. Also discuss any side-effects you are experiencing. Develop your personal pain management plan with your doctor which may include: Your personal treatment goals, which describe what you may achieve as you make progress Information about treatment options Referral to specialists as needed Side Effects of Opioid Therapy Prescription opioids carry serious risks of addiction and overdose.

The use of prescription opioids can have several side effects as well, even when taken as directed: Tolerance —meaning you might need to take more of a medication for the same pain relief Physical dependence —meaning you have symptoms of withdrawal when a medication is stopped, or you take less Increased sensitivity to pain Constipation Nausea and vomiting Dry mouth Sleepiness Dizziness Confusion Low levels of testosterone that can result in lower sex drive, energy, and strength Itching and sweating.

To learn more about risks of opioids and how to reduce them:. Muscle relaxants: These medications are most often used in the acute setting of muscle spasm, and they have minimal side effects.

The most common side effects seen with these medications are drowsiness and dizziness. Opioids: When used appropriately, opioids may be effective in controlling certain types of chronic pain. They tend to be less effective or require higher doses in nerve-related pain.

Long-acting opioids are rarely recommended for chronic pain conditions. One of the most frequent side effects of opioids is constipation, which can be treated by drinking lots of liquids but may need to be treated with OTC medications.

Breathing problems are the most detrimental side effects of opioids, therefore this medication should not be combined with alcohol or benzodiazepine medications.

Excessive drowsiness should be discussed with your physician. Nausea is another side effect that may be difficult to treat and may require changing to another opioid or prescription of antinausea medications.

If I am taking narcotic opioid medication for chronic pain, does that mean I am addicted? Addiction has a genetic basis and a psychological aspect.

Addiction is associated with a craving for the abused substance such as an opioid and continued, compulsive use of that substance despite harm to the person using the substance. In addition to having a genetic predisposition, there may be an environmental influence affecting both the development and manifestation of the additive behavior.

Tolerance occurs after prolonged exposure to a drug. The effects of that drug results in progressive decrease in its effectiveness. Physical dependence usually is seen in the form of drug withdrawal after the drug has been abruptly stopped or rapidly reduced.

It can also be seen when an opioid antagonist e. It is a state of adaptation. Withdrawal symptoms last from approximately 6 to a peak of 24 to 72 hours after the drug has been withdrawn. Some of the symptoms include nausea, vomiting, sweating, abdominal pain, or diarrhea.

These symptoms can occur after taking the opioid for as short a period as 2 weeks. It is not a sign of addiction. Which nerve block procedures are performed for the treatment of chronic pain?

What are some of the side effects and risks associated with these nerve blocks? Epidural steroid injection: Epidural steroid injections are performed in the back or neck. The injection allows the doctor to place anti-inflammatory steroid medication, with or without a local anesthetic, into the epidural space close to the area that is generating pain.

These injections are always performed under X-ray for accuracy and safety. Common side effects include soreness of the back or neck at the point where the needle enters the skin. Some temporary numbness may occur, but tell your doctor if you experience numbness or weakness that lasts more than 8 hours.

Epidural steroid injections may be placed in the lumbar low back , thoracic mid back , or cervical neck regions. Facet joint injection: The facet joints assist with movement and stabilization of the spine both in the neck and back.

Injection into these joints can provide relief of neck or back pain; these injections are always performed under X-ray guidance. Patients may feel soreness in the neck or back when the needle is inserted.

You will be positioned to lay on your stomach for this injection. A needle is placed in your neck or back and advanced to the level of the joint under x-ray visualization. This injection or nerve block is often used to learn more about what is causing the pain. A longer-lasting injection may be needed if you have significant pain relief from this injection.

An example of a longer-lasting injection is radiofrequency ablation, which uses electric current to heat up an area of nerve tissue to stop it from sending pain signals. Lumbar sympathetic block: A lumbar sympathetic nerve block is performed for pain in the leg that is thought to be caused by complex regional pain syndrome CRPS type I.

These injections are often performed under fluoroscopic X-ray guidance or ultrasound guidance. Local anesthetic is placed near the lumbar sympathetic chain to relieve the pain.

Your leg will likely become warm immediately following the injection: this is an expected effect and not a complication. Back soreness is one of the more common side effects. If you feel any sharp pains down your leg or to your groin during the injection, you should let the physician know immediately.

There may be some temporary numbness following the injection, but contact your doctor if you experience persistent numbness or weakness lasting more than 8 hours. You will be positioned on your stomach for this injection. The injection is performed at the level of lumbar vertebrae two and three, in the lower back.

A needle is placed under X-ray guidance, just anterior to the vertebral body to the side of the affected area where the ganglion is located. When the needles are positioned, a small amount of dye is injected to make sure the needle is in the right spot.

After the doctor is satisfied that the contrast dye is in the right place, they will inject numbing medicine then remove the needle. Celiac plexus block: A celiac plexus block is performed under fluoroscopic X-ray guidance to relieve pain in patients with chronic abdominal pain or cancer in areas of the abdomen causing significant pain.

You will be positioned on your stomach for this injection, and a needle is placed in the area of the back to target the sympathetic nerves of the abdomen. A small amount of dye is deposited through the needles and, if appropriately placed, numbing medicine is delivered to the area of a group of nerves called the celiac plexus.

For chronic pain, this injection is performed in a series of three. For cancer pain, a single diagnostic injection is used to see whether a more permanent injection may help with the pain.

If the diagnostic nerve block provides significant pain relief, the longer lasting injection may be done using either phenol or alcohol solution. Stellate ganglion block: A stellate ganglion block is an injection that is performed for the treatment and management of complex regional pain syndrome CRPS of the hand, arm, or shoulder.

It also can be used to help improve blood flow to the hand or arm in certain conditions that result in poor circulation of the hand. Side effects may include soreness in the neck where the needle was placed. In some instances, the side effects may include droopiness of your eyelid on the side that is injected, along with a temporarily stuffy nose and sometimes temporary difficulty in swallowing or hoarseness of the voice.

This injection is performed with fluoroscopic X-ray guidance or ultrasound imaging. You will be lying on your back for this injection.

Minus Related Pages. On This Page. Nonpharmacologic and Nonopioid Therapies for Acute Pain Nonopioid Therapies Are Preferred for Subacute and Chronic Pain Nonopioid Medications for Subacute and Chronic Pain Noninvasive Nonpharmacologic Approaches to Subacute and Chronic Pain.

Nonpharmacologic and Nonopioid Therapies for Acute Pain. Clinicians can consider using nonopioid therapies to treat common types of acute pain including: Low back pain Neck pain Dental pain Kidney stone pain Pain related to musculoskeletal injuries such as sprains, strains, tendonitis, and bursitis Pain related to minor surgeries typically associated with minimal tissue injury and mild postoperative pain e.

Nonopioid Medications Noninvasive Nonpharmacologic Topical or oral nonsteroidal anti-inflammatory drugs NSAIDs Acetaminophen Triptans, antiemetics, and dihydroergotamine for migraine Ice Heat Elevation Rest Immobilization Exercise For additional information regarding nonopioid therapy approaches for treating acute pain, please refer to Recommendation 1 in the Clinical Practice Guideline.

Nonopioid Therapies Are Preferred for Subacute and Chronic Pain. Nonopioid Medications for Subacute and Chronic Pain. Some examples include: Topical NSAIDs Oral NSAIDs Acetaminophen Tricyclic and tetracyclic antidepressants Serotonin and norepinephrine reuptake inhibitor SNRI antidepressants Anticonvulsants e.

Noninvasive Nonpharmacologic Approaches to Subacute and Chronic Pain. Examples of Low-Cost Options for Physical Activity for Pain Management 1. Walking in public spaces. Use of public recreation facilities for group exercise.

Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians Nonpharmacologic and Pharmacologic Management of Acute Pain From Non—Low Back, Musculoskeletal Injuries in Adults: A Clinical Guideline From the American College of Physicians and American Academy of Family Physicians American Dental Association: Statement on the Use of Opioids in the Treatment of Dental Pain Pharmacologic Stepwise Multimodal Approach for Postpartum Pain Management ACOG Clinical Consensus No.

Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, MMWR Recomm Rep ;71 No. RR-3 rra1 Physical Activity Guidelines Advisory Committee.

Washington, DC: US Department of Health and Human Services, Office of Disease Prevention and Health Promotion; Last Reviewed: June 14, Source: Centers for Disease Control and Prevention , National Center for Injury Prevention and Control. Facebook Twitter LinkedIn Syndicate.

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For more information on CDC's web notification policies, see Website Disclaimers. Try to be active every day instead of only on the good days when you're not in so much pain. This may reduce the number of bad days you have and help you feel more in control. But try to avoid overdoing it on good days and paying for this by having more bad days.

Try these flexibility exercises and sitting exercises you can do at home. It's important to try to stay in work even if you're in pain. Research shows that people become less active and more depressed when they don't work. Talk to your supervisor or boss if parts of your job are difficult to begin with, but stress that you want to be at work if that's the case.

If you have been off work for 4 to 6 weeks, plan with your doctor, therapist or employer how and when you can return. You could go back to work gradually. For instance, you might start with 1 day a week and gradually increase the time you spend at work.

You could also agree changes to your job or pattern of work if it helps — a health and safety rep or occupational health department may be useful here. This helps you to move better, relieves your pain, and makes daily tasks and activities easier, like walking, going up stairs or getting in and out of bed.

Physical therapy for persistent pain can involve manipulation, stretching exercises and pain-relief exercises. Physical therapy is usually delivered by a physiotherapist, chiropractor or osteopath, or in some cases, an occupational therapist.

Physiotherapists can give you advice on the right type of exercise and activity. Occupational therapists can support you with environmental changes that can help you remain in work and function better at home.

If you have physical therapy, you should begin to feel the benefits after a few sessions. Your GP may be able to refer you for physical therapy on the NHS, although physical therapy is only available privately in some areas. In others, there's direct access to NHS physiotherapy without the need for a GP referral.

Find physiotherapy services in your area. Your GP can also refer you for exercise referral classes, and some centres have specific classes for lower back pain. It's safe to use over-the-counter painkillers to reduce your pain so you can be more active.

But it's important to use painkillers carefully, as they have side effects. Paracetamol for adults is the simplest and safest painkiller.

You could also try anti-inflammatory tablets like ibuprofen for adults as long as you don't have a condition such as a stomach ulcer that prevents you using them.