Medications

Pain medication given to patients with chronic pain has been standardized by the World Health Organization guidelines for pain control.
 

Anti-Inflammatory

Acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin) or naproxen sodium may be used to treat milder pain.
 

Anti-Convulsants

Anti-convulsants may help relieve pain for people with post-herpetic or pudendal neuralgia. Research studies show that gabapentin (Neurontin) can help relieve burning or lancing pain in people with interstitial cystitis. Pregabalin is an anti-convulsant that is similar to gabapentin. It is FDA-approved to treat nerve pain in people with diabetic peripheral neuropathy and post-herpetic neuralgia. It may also help relieve pain for other chronic pain disorders.
 

Anti-Depressants

Research studies show that tricyclic anti-depressants (TCAs) can help improve pain tolerance, restore normal sleep, and help decrease depression. Commonly used TCA medications are imipramine, amytriptyline, or doxepin. Amytriptyline may help increase the activity level and decrease the intensity of pain in a person with chronic pain.

Many doctors are combining the TCAs with newer anti-depressant medications, called selective serotonin reuptake inhibitors (SSRIs). The tricyclic medications are being used at smaller doses, helping relieve pain but limiting the side effects, while the SSRIs are helping with depression. This form of treatment has been especially helpful for patients with chronic pelvic pain and interstitial cystitis.
 

Opioids

Opioids, or “narcotics,” may be given if other medicines do not relieve your pain. Long-acting opioids such as methadone have proven very effective. Opioids must be used carefully due to issues of tolerance, dependence or addiction. You may need to sign an informed consent to accept the risk of addiction and accept responsibility to be aware of the increased possibility of dependence.
 

Other Medications

Many medications may be more effective in relieving pain if they are taken together. Always work closely with your health care provider to plan the best pain control for your condition.

Research studies show that TCAs and anti-cholinergics (dicyclomine hydrochloride, hyoscyamine sulfate) can help people with irritable bowel syndrome. Studies also show that correct use of fiber can greatly help to relieve symptoms. It can help decrease pain and constipation and cause more formed, regular bowel movements. Hormones such as birth control pills, continuous progestogens or a GnRH agonist are used to control monthly menstrual pain and to treat interstitial cystitis, endometriosis and pelvic congestion syndrome. Hormones are usually chosen when NSAIDS have failed to decrease discomfort. Research studies show that GnRH agonists help to relieve chronic pelvic pain and may be used to help diagnose endometriosis.