Managing and Minimizing Side Effects of Pain Medications

For individuals who may need to take pain medications to manage an injury or condition, can knowing the potential side effects help in treatment?

Medications For Pain Side Effects

Over-the-counter and prescription pain medications can help relieve physical discomfort and distress but can also cause side effects. Patients may not manifest side effects when using certain meds or experience mild, limited, severe, or intolerable effects. Pain medication side effects can include:

• Allergic reactions
• Upset stomach
• Bruising
• Dizziness

However, medication side effects don’t affect everyone in the same way.

Pain Relief

The patient and their healthcare provider can decide whether they risk developing side effects and which effects they are more predisposed to. Individuals may be susceptible to side effects from certain medications but are likely to tolerate others. For example, individuals with a history of ulcers may be recommended to avoid anti-inflammatories. For those who have trouble sleeping, it is recommended to avoid pain meds that are known to interfere with sleep.

Reading Labels and Asking Questions

When taking over-the-counter medications, read the label for side effects, then weigh the possible risks against the medicine’s benefits for pain relief. Ask a pharmacist or healthcare provider about anything that is not understood. Some side effects are medical emergencies, such as allergic reactions. Recognizing the signs of an allergic reaction and being prepared to call for emergency help if symptoms present. (American Academy of Allergy, Asthma & Immunology, 2024) These can include:

• Itching
• Hives
• Rash
• Mouth or facial swelling
• Shortness of breath

If a healthcare provider prescribes medication, discuss the anticipated risks and benefits. The prescription will come with a label that lists the side effects associated with the drug.

Opioid Risks

Opioids are powerful prescription meds, usually used for severe, short-term use, like post-surgery pain or after a severe traumatic injury. Some effects of opioids include: (Plein L. M. and Rittner H. L. 2018) Common side effects include sedation, constipation, and nausea. Chronic use can lead to depression and/or sexual dysfunction. With narcotics, there is the risk of addiction that can change an individual’s life, as addiction can be difficult to overcome. One of the reasons the CDC published a guideline on opioid prescriptions was because of the number of overdoses and deaths.

• The CDC recommends that practitioners not prescribe opioids as a first-line treatment for chronic back pain.
• The CDC recommends that healthcare providers initially treat patients with chronic back or neck pain using non-pharmacological therapies or medications other than opioids.
• Opioids should only be used if the expected benefits for pain and function are anticipated to outweigh the risks to the patient.

With more than half of regular opioid users experiencing back pain, they aren’t proven to help return individuals to work or normal life faster, nor did they improve functioning when used for the treatment of an acute episode. (Deyo R. A. Von Korff M. and Duhrkoop D. 2015) The effectiveness of opioids is about 30% for short-term relief and did not improve physical functioning.

Examples and Comparisons

Examples of common medications used to treat back pain.

Advil

• Active Ingredient – Ibuprofen
• Drug Class – NSAID
• Over-the-counter or Prescribed – Available over-the-counter
• Side Effects – GI-related symptoms and Reye’s Syndrome in children

Aleve and Other Generic Brands

• Active Ingredient – Naproxen
• Drug Class – NSAID
• Over-the-counter or Prescribed – Available as both depending on strength.
• Side Effects – GI-related symptoms, headaches

Tylenol and Other Generic Brands

• Active Ingredient – Acetaminophen
• Drug Class Analgesic – pain reliever
• Over-the-counter or Prescribed – Available as both and can be prescribed with codeine.
• Side Effects – Potential liver damage

Lyrica

• Active Ingredient – Pregabalin
• Drug Class – Anticonvulsant
• Over-the-counter or Prescribed – Prescribed FDA-approved for shingles pain and neuropathy in diabetes. Other uses off-label.
• Side Effects – Dizziness, drowsiness, swelling, weight gain.

Neurontin

• Active Ingredient – Gabapentin
• Drug Class – Anticonvulsant
• Over-the-counter or Prescribed – Prescribed FDA-approved for shingles pain
• Side Effects – Dizziness, drowsiness, allergic reaction, withdrawal, and seizures.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic therapy is among the more conservative treatment options and may be tried first. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself.

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Chronic Body Pain Recovery

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References

American Academy of Allergy, Asthma & Immunology. (2024). Anaphylaxis Symptoms & Diagnosis. www.aaaai.org/conditions-treatments/allergies/anaphylaxis

Plein, L. M., & Rittner, H. L. (2018). Opioids and the immune system – friend or foe. British journal of pharmacology, 175(14), 2717–2725. doi.org/10.1111/bph.13750

Deyo, R. A., Von Korff, M., & Duhrkoop, D. (2015). Opioids for low back pain. BMJ (Clinical research ed.), 350, g6380. doi.org/10.1136/bmj.g6380