14 August, 2017
List of Pain Relievers by Strength
Pain sufferers need relief, and must be treated with the appropriate strength and type of medication for their ailment. Even though most pain can be successfully treated, many patients still suffer needlessly, according to the book "Palliative Care Consultant," by Phyllis Grauer and colleagues. Pain is commonly measured by asking the sufferer to rate the intensity on a scale of zero to 10, with zero meaning no pain, one to three indicating mild pain, four to six indicating moderate pain and seven to 10 indicating severe pain.
Medications for Mild Pain
Acetaminophen is one of the lowest-strength pain relievers and is used to treat mild pain that is not caused by inflammation. Non-steroidal anti-inflammatory drugs, or NSAIDs, treat minor pain, but they are also very effective for relief of bone pain and pain caused by inflammation, according to pain management guidelines from the World Health Organization. Ibuprofen, naproxen and aspirin are common NSAIDs. Ketorolac is an NSAID that can be administered by injection.
Medications for Moderate Pain
Moderate pain is typically treated with a combination of medications used for mild pain with a low dose of opiods. Opioids, or narcotics, because of their habit forming characteristics, are often underused, resulting in needless suffering, say Merck Manuals Online Medical Library, Professional Edition. Common combinations of drugs for moderate pain include acetaminophen with opioids, such as oxycodone or hydrocodone. Imbudone is a medication that combines ibuprofen with hydrocodone. Codeine and propoxyphene are weaker opioids that provide inferior pain relief, according to the article "Oral Analgesics for Acute Nonspecific Pain" by Carolyn J. Sachs, M.D., M.P.H., in the March 1, 2005 issue of the journal American Family Physician. Tramadol, a narcotic-like pain reliever, is also very weak and provides less effective moderate pain relief.
Medications for Severe Pain
The World Health Organization recommends opioid pain relievers for severe pain. Opioids are available in tablet, capsule, patch, injection and liquid form. Concentrated liquids, which can be administered under the tongue to people who are unable to swallow pills, are absorbed through the mucous membrane of the mouth. Morphine, oxycodone, fentanyl, hydromorphone and oxymorphone are commonly used opioids. Immediate-release and long-acting, or time release, formulas are available as well. Severe pain is frequently treated using a long-acting opioid to provide around-the-clock relief, supplemented by an immediate-release opioid if pain still occurs. Although opioids can cause physical dependence and produce withdrawal symptoms, this is not to be confused with addiction. Addiction is characterized by craving, compulsive use and loss of control, and is very rare, Merck explains.
Adjuvant medications are drugs used along with pain relievers, or on their own in some cases, that provide increased pain relief. Nerve, or neuropathic, pain is commonly treated with adjuvant medications such as anticonvusants, antidepressants, corticosteroids and topical capsaicin, the active ingredient in hot pepper, according to Merck. Common adjuvants for visceral pain, or pain in the organs, include antispasmodics, anticholinergics and corticosteroids. Pancreatic colic pain is treated with pancreatic enzymes taken with meals.
- "Palliative Care Consultant"; Phyllis Grauer, John Shuster, Bridget McCrate Protus; 2008
- "American Family Physician"; Oral Analgesics for Acute Nonspecific Pain; 2005
- Merck Manuals Online Medical Library: Professional Edition: Pain
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