Chronic Pain

Introduction: medication and side effects

Chronic pain is difficult to treat and many of the people we talked to had tried a number of different medications before one, or more, was found that helped. Often people were taking a combination of different types of medication, commonly in combination with non-drug techniques (see also 'Pain management approaches').

The type of pain can influence which medication is most suitable. People we talked to had used a range of different medicines including anti-inflammatory drugs, drugs that contain codeine and paracetamol, tramadol, muscle relaxants (benzodiazepines) and opioids.

Some people had also received drugs that are usually used for either epilepsy (anticonvulsants, antiepileptics) or depression (antidepressants). This is not because they have epilepsy or depression but because these drugs can also help certain types of pain.

Many of the people that we talked to had experienced side effects from these medicines. However, while lots of the drugs prescribed for pain relief can cause a wide range of possible side effects, this does not mean that everybody taking a particular drug will experience them.

Also, people often find it hard to know if a side effect such as heavy sweating or tiredness is due to the medication or some other cause, such as the menopause. One woman who suspected her heavy sweats might be menopausal realised they weren't when she met others (including men) who had the same side effects.

Side effects were often worse in the first month of taking a new medication, so perseverance might be rewarded. However, sometimes the side effects were worse than the pain. People stressed the importance of having a good relationship with their GP and working together to find the best pain relief with the least side effects.

Some found another similar drug or one with slightly different ingredients that gave them less troublesome side effects. A woman described how she had ended up taking the antidepressant drug imipramine for nerve pain because a similar drug, amitriptyline, had made her feel drunk. Others found that they had to try a different type of drug altogether. One man went back to taking tramadol because he could not tolerate the side effects of strong opioids.

Many people commented that the medicine never completely relieved their pain but did reduce it to a level where they could cope. This was important for some people as they felt that they could get on with what they wanted to do. However, others worried that because their pain was dulled their activities might be causing further damage (see also 'Exercise and activity').

People often talked about weighing up the pain relief against the side effects, seeking a balance of the problems and the benefits of taking medication. Although most people stressed that they do not like to take drugs, the short and long term side effects were usually thought worth bearing for the relief from pain.

However, sometimes side effects are so bad, or other techniques so effective, that people decide to stop taking any medication (see also 'Managing, taking and stopping medication').

Some pain medication can interact with alcohol. Whilst many said they avoided alcohol completely others drank in moderation. One woman said she would have a drink sometimes if her tablets weren't helping as much as usual, although she knew it was probably wrong. Several others, who were not using medication, said that a moderate amount of alcohol helped their pain although they knew that it would be wrong to drink excessively or become dependent on alcohol.

A few people discussed the use of cannabis for pain relief. All were aware that possession of cannabis is illegal and that you can be charged and prosecuted. Whilst some felt it helped them relax others tried it but said it did not help the pain and they found the side effects extremely unpleasant. A few people were aware that cannabinoids, derived from cannabis are being tested in the treatment of MS pain and nerve pain.

Last reviewed May 2015.

Last updated November 2010.

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