Managing Pain with Medicine

What are pain medicines?

Pain medicines are medicines used to reduce or prevent pain. They are also called analgesics. Your health care provider may prescribe medicine to help manage pain caused by an illness, treatment, or medical procedure.  

Some pain medicines from a drug store or pharmacy are available without a prescription. These medicines are called over-the-counter (OTC) medicines. Talk to your care team about what medicines are safe for your child. 

Pain management plan 

Your child’s care team will make a pain management plan that may include pain medicines and other pain relief methods. The goals of a pain management plan include: 

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

Types of pain medicines

Your care team will consider several factors when choosing medicines for pain management. These include: 

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

Specific medicines are prescribed based on your child’s pain score and the severity of their pain. Medicines for severe pain should not be used for non-severe pain. Once prescribed, a nurse cannot change the pain medicine order. If your child’s pain is not being managed well, let your care team know so they can adjust the pain management plan if needed.   

See Measuring Pain in Children to learn how the care team assesses your child’s pain. 

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, ketorolac, or naproxen for pain. Other name-brand or generic NSAIDs can also be taken with or without a prescription. Do not take over-the-counter NSAIDs and prescribed NSAIDs together.  

Make sure you know if the pain medicine your child takes is an NSAID. Some children cannot take NSAIDs if they are at risk for bleeding. NSAIDs are not 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 health care provider about how and when to use these medicines. Aspirin is sometimes found in other medicines, such as Pepto-Bismol. Check the ingredient list and ask your health care provider or pharmacist before giving any new medicine to your child. 

Medicines for moderate to severe pain 

Doctors may prescribe stronger pain medicines for moderate-to-severe pain. These may include: 

• Fentanyl 
• Hydromorphone  
• Methadone 
• Morphine  
• Oxycodone

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 near the source of pain
• By a special catheter in the back (epidural)
• Through a cream or patch on the skin

Nerve block

Medicines can be given around a nerve to reduce pain in that area of the body. One way to do this is to give the medicine as a single injection (shot). This is called a nerve block injection. Another way is to place a small catheter near the nerve and connect it to a medicine pump. This is called a nerve block infusion.  

Patient-controlled analgesia (PCA)

PCA is a pain relief method in which your child controls when they get a dose of medicine. When they press a button, a pump delivers a preset dose of medicine into their IV. The medicine goes into the bloodstream to provide general pain relief. The button-released pain medicine is used along with a continuous infusion of pain medicine.  

Clinician-administered boluses: If your child has a PCA pump, a care team member may be able to give an extra dose of medicine through the pump. This extra dose is called a “bolus dose” or “boost” and requires a physician’s order. It may be given before painful care or movement or to help with severe or breakthrough pain, depending on your child’s pain score. Giving a bolus dose can help control pain and allow your child to have smaller doses of medicine more often.  

Patient-controlled regional anesthesia (PCRA) 

PCRA is another pain relief method that lets your child control when they get pain medicine. When they press a button, a pump delivers a preset dose of medicine through a small tube placed in the body. The pump also delivers a continuous infusion of pain medicine for pain control. 

PCRA helps to manage pain in a specific area or region of the body. These medicines are different than some other pain medicines, which work on the whole body.  

Medicines for procedure-related pain relief

Hospitals and clinics usually offer several pain management options if your child has 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. Follow these tips for pain medication safety.  

• It is important to give the correct dose at the right time. Do not give the medicine more often or in greater amounts than prescribed. 
• Keep track of your child’s medicines and pain level. Let your care team know if your child’s pain continues or gets worse.  
• Only give medicines approved by your child’s health care provider, including over-the-counter (OTC) medicines. Certain medicines can interfere with other treatments, cause side effects such as bleeding, or worsen side effects your child already has. 
• Your child should not stop taking pain medicines suddenly. Follow your care team’s instructions on how to stop pain medicines to help avoid side effects. This helps the body 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 medicine that was not prescribed for your child’s 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 medicines with others. 
• If your child is prescribed opioids for pain, you may be given naloxone nasal spray for emergency use. Naloxone can reverse opioid effects and treat an opioid overdose. 

Families often worry about addiction to pain medicines such as opioids. Some medicines can be habit-forming with long-term use. Talk with your child’s care team about your concerns.  

Questions to ask your care team about pain medicines

• How and when should this pain medicine be given? 
• What are the possible risks and side effects of the pain medicine? Does the medicine have a risk of dependence or misuse? 
• Can my child stop this medicine if they feel better? 
• What are other pain management options? 
• What should I do if my child’s pain does not improve or gets worse? 
• When should I call the care team or seek medical help? 

Related Content