Medication and treatments for persistent pain

Medication

Sadly, medications can’t cure persistent pain. They can only lessen it by 30-40%, at best, and often by less. 

If drugs don’t provide the relief you expected, it can lead to frustration and worry. This, in turn, adds to the stress of pain and a vicious cycle sets in.

Getting the best out of the medication:

• Use the correct doses and right timings
• Don’t wait until pain levels are severe before using medication
• If not helping then discuss reducing usage with your GP before cutting down over time or stopping
• Use the resource on this page to help you explore reviewing your medication (medication prompt sheet). 
• Often people have much more to ask about the situation than just their medication.  This ‘pain concerns form’ can help prepare for an appointment with a clinician and guide important questions.  

Persistent pain is different to short lived or new pain:

• Persistent pain is different: As explained in the ‘understanding pain’ section, persistent pain is different and just relying on medications does not work like it does with things such as a new headache or a sprained ankle.  
• Benefits vs harms: Some people find the benefits of pain medication are outweighed by the side effects in the longer term.
• Allowing you to move: Staying as fit as possible, and moving as normally as possible is very important in living with persistent pain. Pain medication can be seen as ‘helpers’ to reduce pain levels, allowing people to move and helping bodies stay strong.
• Choice of medication: Your GP practice or pharmacist will advise you on the best type of medication for your condition and when and how to take it – but will not suggest taking pain medication every time there is a spike of pain.
• Limited choice though: Sadly, there is a rather short list of medications that are available for persistent pains. As more research finds what does and does not help, the list of medications available has reduced rather than increased. 

Are your medications working?

Visit the Painkillers Don’t Exist website

Opioids

The British Pain Society guidance for patients using opioids:

• Harms usually outweigh gains: If you are using morphine-like drugs called opioids – such as tramadol, dihydrocodeine, fentanyl, slow release morphine, do ensure you have had a recent review of all of your options as we know long term use of such medication has a long list of harms but only 10% of people will get any ease from such medication for persistent pains. 
• Side effects: The most common morphine side effects are constipation, drowsiness, dry mouth, feeling sick and depression or low mood. You may need help from your GP or pharmacist to manage these. You can arrange your own free medicine use review with your pharmacist to ensure you’re using them correctly and safely. Use the guidance at the bottom of this page to help you prepare for a review.
• Support: Talk to your GP practice to help you make the right choices about your current medication – whether to continue, change, reduce the dose or stop. Many people who become a ‘pain self-manager’ discover they can, with support from their GP, reduce or stop their morphine type medications and feel much better.

Watch this success story of a lady called Louise about her life after opioids for a real world example of this – player.vimeo.com/video/363248769