Painkillers

Painkillers are usually prescribed to help reduce any form of pain (headache, stomach, joints, back, etc.). For our purposes, painkillers will help you manage the discomfort caused by arthritis, whether it’s chronic or acute.  You must remember that they will not treat the disease; they will only mitigate the symptoms.

 

Several treatments named here are available over the counter. They are therefore easy to access and can really help you. Do not forget that even if you can get them on the shelves of your pharmacy, they are not without risk and we suggest you check with your pharmacist and your doctor to find out if these drugs are compatible with the ones you’re already taking.

 

The different classes of drugs commonly used to treat pain are:

 

Non-opioids:

 

  • which are usually acetaminophen, for example Tylenol; Non-steroidal anti-inflammatory drugs (NSAIDs, you can click here and here), such as Advil / Ibuprofen, Aspirin, Celebrex, Diclofenac, just to name a few. They exist in tablet form, suppositories and gel/cream for a more local application. They have few side effects if taken as recommended by the doctor. Acetaminophen and NSAIDs can be taken together for better management of painful symptoms. On the other hand, it is necessary to avoid combining two anti-inflammatories such as Diclofenac and Ibuprofen since they belong to the same class of drugs. Negative effects on your health could occur such as an increased blood pressure, an increased risk of heart problems and digestive bleeding.

 

Opioids:

 

  • This class of drug is used when non-opioids are ineffective. They are mostly narcotics, like codeine and they can be taken in combination with Tylenol. These medications have side effects such as constipation, decreased alertness and drowsiness. This class of drugs is more or less used since opioid use can be addictive and the combination of acetaminophen and NSAID can also relieve arthritis pain.

 

  • For stronger opioids like morphine, Dilaudid, fentanyl, etc., your rheumatologist will prescribe them as a last resort when everything else failed. They bring their share of side effects and can create an addiction.

 

Your doctor may prescribe medications that are usually used to treat other conditions, but with recognized effects on pain, such as Cymbalta, Lyrica, and Flexeril, as well as some antidepressant or antiepileptic drugs. He will prescribe them in addition to other painkillers to increase your level of relief.

 

Note how you react to different medications and the relief they gave you. It will be easier for your rheumatologist to adjust your pain treatment if he has that information.

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© 2016 Institut de Rhumatologie de Montréal

révision Septembre 2018.

L'IRM remercie Abbvie, Amgen, Lilly, Merck, Novartis, Pfizer, Roche, Sanofi et UCB pour leur support.

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