Pain medication for chronic pain

Pain medication can provide temporary relief for chronic pain, but it does not address the underlying factors that maintain the pain - and has clear limitations with long-term use.

You may have been taking painkillers for months or years. They can help you get through the day, but you wonder whether this is the right path. Or whether you are actually becoming more dependent on them. Or whether there will come a moment when they no longer work.

Those are valid questions. Pain medication can play a role in chronic pain, but it also has clear limits. In this article you'll read what pain medication does in the short and long term, what types exist and when tapering off makes sense.

Short term versus long term

In the short term, pain medication can be useful. During a pain peak, a painkiller can ensure that you can keep functioning and moving - and that is valuable. Movement is actually important with chronic pain.

In the long term, the picture is more nuanced. Painkillers reduce the pain signal, but don't address the underlying factors that maintain chronic pain. With long-term use, they can also have adverse consequences for your load capacity and health.

It's important to take a critical look at the role pain medication plays within your overall functioning in the long term.

Ultimately, your goal is not just to experience less pain, but the goal is much broader: you want to function better.

Types of pain medication

There are three main groups of painkillers, in increasing strength:

• Paracetamol - the most commonly used and relatively safe painkiller for short-term use during acute pain flare-ups.

• NSAIDs (such as ibuprofen and naproxen) - pain-relieving and anti-inflammatory, but can cause stomach problems and other side effects with long-term use.

• Opioids (such as tramadol and morphine) - strong painkillers that belong to acute care and should be used in a tapering manner. With chronic use, there is a risk of tolerance and dependence.

For nerve pain, medications originally developed for depression or epilepsy are sometimes also prescribed.

In practice, the use of pain medication often shifts from mild to increasingly stronger types. But after opioids, there is no stronger pain medication - at most, the dosage can be increased. The gain for functioning is then minimal, while side effects and health risks increase.

The role of pain medication: a few guidelines

When considering what pain medication means for you, the following is important:

• Be critical about the use of pain medication.
  The advice is to taper off pain medication, under the guidance of your GP or pharmacist, to an acceptable minimum.

• Use medication on a time-based schedule.
  Ensure an even amount of medication in your body throughout the day - don't just take it during pain peaks, but at fixed times.

• Pain medication can be taken short-term when there is an acute pain flare-up.
  During an acute pain flare-up (such as a back spasm), short-term use can be helpful to keep moving. As soon as the complaints subside, you also taper off the pain relief.

• Tapering off or stopping all at once.
  Paracetamol and NSAIDs do not need to be tapered off. You can simply stop taking them at once if you want to. For opioids, however, it is advised to taper them off gradually because you may experience withdrawal symptoms if you stop them too quickly. Consult your GP or pharmacist for this!

• Short term vs long term.
  Does the positive effect you experience in the short term outweigh the side effects and the possible consequences for your health and functioning in the longer term?

• Make a plan: Include reducing pain medication in your overall plan to function better - not as a standalone step, but as part of a broader approach.