Managing Pain with Medicine

What are pain medicines?

Pain medicines are medications used for pain relief and comfort. A medicine used to reduce pain is also called an analgesic.

Your health care provider may prescribe medicines for pain if your child has pain due to an illness, a treatment, or a medical procedure. Some types of pain medicines are available without a prescription from a drug store or pharmacy.

Pain management plans have several goals. These include:

• Comfort and pain relief
• Improved function and ability to do daily activities
• Overall quality of life

Types of pain medicines

Your care team will consider several factors to decide how to manage your child’s pain. These include :

• What type of pain your child has
• What is causing your child’s pain
• How often your child is having pain
• How severe the pain is
• How long the pain lasts

Below are some common medicines used for pain relief. Many patients get a combination of treatments to manage pain.

Medicines for mild pain

A health care provider may give acetaminophen (Tylenol®) or non-steroid anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen for mild pain. Other name-brand NSAIDs can also be taken with or without a prescription.

Make sure you know if the pain reliever medicine your child takes is an NSAID. Some children cannot take NSAIDs if they are at risk for bleeding. NSAIDs are never given with certain chemotherapy drugs such as high-dose methotrexate.

Some medicines (aspirin and choline magnesium trisalicylate) are linked to an increased risk for Reye syndrome after a viral illness. Talk to your doctor about how and when to use these medicines.

Medicines for moderate pain

Doctors may prescribe opioids such as codeine, oxycodone, and hydrocodone for moderate pain.

Medicines for severe pain

For more serious pain, doctors may prescribe the opioid drug morphine. For long-lasting pain, patients may use patient-controlled analgesia (PCA). This method allows patients, or in some cases family caregivers, to get a dose of prescribed pain medicine by pressing a button on the PCA pump.

Medicines for neuropathic pain

For nerve-related or neuropathic pain, prescribed medicines may include gabapentin (an anti-seizure medication) and amitriptyline (an antidepressant drug). In some cases, doctors may prescribe steroid medicines to reduce pain and inflammation.

How pain medicines are given

Common ways to give pain medicines include:

• By mouth
• By injection (shot)
• Through a needle in a vein by IV
• By a special catheter in the back (epidural)
• Through a cream or patch on skin

Nerve block

A nerve block is another treatment for pain relief. It involves the injection of either a local anesthetic or a drug into or around a nerve to block pain. Nerve blocks help control pain that cannot be controlled in other ways.

Medicines for procedure-related pain relief

Hospitals and clinics usually offer several pain management options if your child might have pain or discomfort from a procedure. In addition to pain medicines, your care team may recommend strategies to manage pain without medicines.

Pain management medicines for procedures may include:

• Creams and patches placed on the skin to numb the area
• Sedation that causes relaxation or sleepiness
• Local or regional anesthesia to numb or cause a loss of feeling in a specific area of the body
• General anesthesia so the patient is not conscious and has no awareness of pain or other stimuli, like a very deep sleep

Pain medication safety

Your child may take pain medicines either at the hospital or at home.

• It is important to get the proper dosage at the proper time.
• Your child should only have medicines approved by the doctor, including over-the-counter medicines. Certain medicines can interfere with other treatments, cause side effects such as bleeding, or worsen existing side effects.
• Your child should not stop taking pain medicines abruptly. Gradually stop pain medicines to help avoid side effects. The slow decrease allows time for the body to adjust to not having the medicine.
• Keep all medicines out of the reach of children and pets. Know how to store and dispose of medicines safely.
• Do not give a pain medication that was not prescribed for your child for their current pain relief needs. The dose of medicine for a child is often based on weight. An adult dose could be dangerous for your child.
• Do not share pain medications with others.

Families often fear addiction to pain medicines such as opioids. Talk with your child’s care team about your concerns.

Let your care team know if you have concerns about your child’s pain level. See Measuring Pain in Children to learn how to assess your child’s pain.

Questions to ask your care team about pain medicines

• How should this medicine be given?
• What are the possible risks and side effects of the pain medicine?
• Can my child stop this medicine if they feel better?
• What are other pain management options for my child’s pain?
• What should I do if my child’s pain does not improve or gets worse?

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