From the Guidelines
To treat pain, the most effective approach is to use a combination of pharmacological and non-pharmacological interventions, with a focus on reducing inflammation, blocking pain signals, and improving quality of life, as recommended by the most recent and highest quality study 1.
Treatment Options
- For mild to moderate pain, start with over-the-counter pain relievers like acetaminophen (Tylenol) 325-650 mg every 4-6 hours or ibuprofen (Advil, Motrin) 200-400 mg every 4-6 hours, as recommended by 1.
- For more severe pain, consider prescription pain medications, such as gabapentinoids, serotonin-norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants (TCAs), as suggested by 1.
- Additional measures include:
- Practicing relaxation techniques like deep breathing or meditation
- Engaging in gentle exercises or stretches as recommended by a healthcare provider
- Considering complementary therapies like massage or acupuncture, as recommended by 1
Non-Pharmacological Interventions
- Cognitive behavioral therapy (CBT) is recommended for chronic pain management, as it promotes patient acceptance of responsibility for change and the development of adaptive behaviors, as stated in 1.
- Yoga is recommended for the treatment of chronic neck/back pain, headache, rheumatoid arthritis, and general musculoskeletal pain, as suggested by 1.
- Physical and occupational therapy are also recommended for chronic pain, as they can help improve function and reduce pain, as stated in 1.
Pharmacological Interventions
- Gabapentinoids, such as pregabalin, are effective in treating pain in diabetic neuropathy, as shown in 1.
- SNRIs, such as duloxetine, are also effective in treating pain in diabetic neuropathy, as suggested by 1.
- TCAs, such as amitriptyline, can be used to treat pain, but may have more side effects, as stated in 1.
Important Considerations
- Always follow dosage instructions and consult a healthcare provider for persistent or severe pain, as underlying conditions may require specific treatments.
- Be aware of potential side effects and interactions with other medications, as stated in 1 and 1.
From the FDA Drug Label
Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain. The treatment for mild to moderate pain is ibuprofen 400 mg every 4 to 6 hours as necessary for relief of pain 2.
- The dose should not exceed 3200 mg total daily dose.
- Doses greater than 400 mg were no more effective than the 400 mg dose in controlled analgesic clinical trials.
From the Research
Treatment Options for Pain
- Non-pharmacological interventions, such as exercise and cognitive-behavioural therapy (CBT), have been shown to be effective in managing chronic pain 3, 4, 5
- A multidisciplinary approach, combining pharmacological and non-pharmacological interventions, is often recommended for effective pain management 3, 4, 6
- Lifestyle changes, including reduced smoking and alcohol consumption, and increased physical activity, can also contribute to better pain alleviation 6
Non-Pharmacological Interventions
- Exercise programs have been found to lead to significant reductions in chronic pain, with mean reductions of -1.9 score points for the Short Form (SF)-36 item for pain experience and -2.8 pain VAS units 7
- Cognitive-behavioural therapy (CBT) has also been shown to be effective in managing chronic pain, particularly when combined with exercise and other non-pharmacological interventions 3, 5
- Other non-pharmacological interventions, such as acupuncture, self-hypnosis, and transcutaneous electrical nerve stimulation (TENS), have limited evidence to support their effectiveness in reducing chronic pain 7
Considerations for Treatment
- The effectiveness of non-pharmacological interventions can vary depending on individual patient factors, such as disease characteristics, pain characteristics, and lifestyle factors 4, 6
- A comprehensive treatment plan should take into account the patient's specific needs and circumstances, and may involve a combination of pharmacological and non-pharmacological interventions 3, 4, 6