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Most pain regimens start with acetaminophen (brand name: Tylenol) or a nonsteroidal anti-inflammatory drug (NSAID, pronounced EN-sed). Mild but persistent discomfort, such as breast and underarm surgery pain, can usually be managed by these medications alone.
There are many NSAIDs, including:
ibuprofen (brand names: Advil, Motrin, Nuprin)
naproxen (brand names: Naprosyn, Naprolan)
naproxen sodium (brand names: Aleve, Anaprox)
ketoprofen (brand name: Orudis)
indomethacin (brand name: Indocin)
piroxicam (brand name: Feldene)
nabumetone (brand name: Relafen)
The response to NSAIDs varies from person to person and medication to medication. If pain doesn't lessen or end when you use one NSAID, that doesn't mean it won't improve if you try another.
You may need to try different NSAIDs before finding the right one for your pain. Never take more than the maximum dose recommended by the manufacturer. If you're taking aspirin, Coumadin (chemical name: warfarin), or other blood thinners, or if...
Narcotics, or opioids (pronounced OH-pee-oydz), provide the main relief for this level of pain. There are both long-acting and short-acting opioid pain medicines:
Long-acting opioids include:
oxycodone (brand names: Roxicodone, OxyIR, OxyContin)
fentanyl (brand name: Duragesic)
morphine (brand names: MS Contin, Oramorph, Avinza, Kadian, Roxanol)
methadone (brand name: Dolophine)
Short-acting opioids include:
morphine (brand name: MSIR)
oxycodone (brand name: Percocet)
hydrocodone (brand names: Vicodin, Vicoprofen, Lortab, Lorcet, Hycodan, Zydone)
hydromorphone (brand name: Dilaudid)
fentanyl—rapid acting (brand name: Actiq)
meperidine (brand name: Demerol)
Dosage is adjusted to suppress your pain around-the-clock. Long-acting medication helps so that most of your day is pain free, and ideally you won't need to get up in the middle of the night to take another dose. Short-acting drugs are used to treat episodes of breakthrough pain.
There are many different opioids to try f...
References Anema JR, Steenstra IA, Bongers PM, et al. Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both? A randomized controlled trial. Spine . 2007;32(3):291-298; discussion 299-300. Cherkin DC, Sherman KJ, Avins AL, et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch Intern Med . 2009;169(9):858-66. Chou R, Atlas SJ, Stanos SP, Rosenquist RW. Nonsurgical interventional therapies for low back pain: a review of the evidence for an American Pain Society clinical practice guideline. Spine . 2009;34(10):1078-93. Review. Chou R, Baisden J, Carragee EJ, Resnick DK, Shaffer WO, Loeser JD. Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline. Spine . 2009;34(10):1094-109. Review. Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet . 2009;373(9662):463-72. R...
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