Medication Management Of Acute And Chronic Pain

Pain is the most common reason people seek medical care. Though pain is one of your body’s most important communication tools, it is also an unpleasant physical and emotional experience. Pain can lead to lost time at work, interference with daily activities, decreased mental health and a drastic reduction in quality of life.

Each patient and their pain is unique. The most effective way to manage your case could be vastly different from what works for someone else, even if the underlying cause is the same. A pain management specialist will work with you to create a personalized treatment plan based around factors such as the source of the pain, the intensity of the pain and how long the pain has persisted. The most common conservative form of pain management is medication use.

What Is the Difference Between Acute and Chronic Pain?

In order to create an appropriate pain management plan, your doctor will first determine whether your pain is acute (sudden) or chronic (long-term).

Acute pain is usually associated with identifiable trauma or injury. It comes on suddenly and often feels sharp. Mild cases may last only moments, while severe acute pain can last for several months. Common sources of acute pain include broken bones, cuts, burns, childbirth and surgery. Once its underlying cause has been treated or has healed, acute pain fades. Patients typically respond to treatment with pain resolution within three months.

Chronic pain lasts longer than three months. It can be continuous, episodic or a combination of both, and is often difficult to treat because the cause is not always clear. Examples of chronic pain include headaches, arthritis, low back pain, pain associated with cancer and pain caused by nerve damage. As reported by patients, chronic pain can lead to financial distress, disturbed sleep, social withdrawal, depression, weight changes, emotional stress and increased irritability.

How Common Is Chronic Pain?

A recent survey of a large group of people of varying ages found that the rate of chronic low back pain was 29 percent. In this survey, 17 percent reported severe headaches or migraines, 15 percent reported neck pain and 5 percent had facial or jaw pain. The National Institutes of Health (NIH) reports that pain affects more Americans than heart disease, cancer and diabetes combined. Approximately 76.2 million people – or one in every four Americans – have struggled with pain that endures for longer than 24 hours and millions more struggle with acute pain. Chronic pain is the most common reason for long-term disability.

When Should I Consult a Specialist About My Pain?

A primary care physician is often able to diagnose and treat pain successfully. However, if your pain lasts longer than expected, or your primary care doctor is unable to treat your pain satisfactorily, it’s time to see a specialist. Pain management doctors complete extensive training in the diagnosis and treatment of pain and its symptoms. From both an academic and an experiential standpoint, they are best equipped to identify the underlying cause of pain and treat it using a comprehensive, multidisciplinary approach. A treatment plan designed by a pain management specialist may include physical therapy, psychological therapy, massage, interventional procedures and medication management, as well as advanced treatments such as nerve blocks, radiofrequency ablation and spinal cord stimulation.

What Medications Are Used to Treat Pain?

The treatment options for pain are as varied as the causes, but the primary goal of every treatment is the same: to reduce pain and restore mobility so you can resume your daily activities without discomfort.

When it comes to medications for acute and chronic pain, there are seemingly endless choices available. Different types of medications are recommended for different diagnoses, and in some cases, a combination of medications is required to attain sufficient relief. You may need to explore multiple possible options before finding the one that works best for you.

Non-Prescription Pain Medications

Milder forms of pain may be alleviated by over-the-counter medications, including:


Acetaminophen (paracetamol or Tylenol) is a well-tolerated medicine with few drug-drug interactions. It can be used safely during pregnancy and is not linked to increased blood pressure. Because of its low cost and safety profile, acetaminophen is considered a reasonable first-line drug option.


Aspirin relieves mild-to-moderate acute pain when given in a dose of 500-1,200 mg. Patients with a history of asthma or urticaria should not take aspirin due to the high risk for allergic reaction. In addition, aspirin should not be used in patients who have ulcers or stomach problems.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs work by inhibiting the enzymes COX-1 and COX-2, producing an anti-inflammatory effect. Most NSAIDs are effective and inexpensive. Examples include naproxen, ibuprofen and ketoprofen.
NSAIDs work better for pain relief than aspirin and acetaminophen, and are often used along with a muscle relaxant for lumbar strain. Topical indomethacin works for mild, localized pain and topical diclofenac offers good pain relief for sprains and strains.


Prescription Pain Medications

More severe types of pain may require prescription medications, including:

COX-2 Selective NSAIDs

Celecoxib (Celebrex) is the only COX-2 selective NSAID still available in America. This medicine is approved for dental pain, bone pain, headache, dysmenorrhea, osteoarthritis, ankylosing spondylitis, and rheumatoid arthritis. Celebrex cost a bit more than traditional NSAIDs, but it is associated with longer pain relief and fewer side effects.


For patients with severe, chronic pain or intractable, acute pain, opioids are used. These drugs often are formulated in combination with an NSAID or acetaminophen. In 2010, hydrocodone/acetaminophen was the most commonly prescribed medication in the U.S. Because of the risk of liver injury, patients should not take combination opioids long-term.

Full Opioid Agonists

Morphine and codeine are full opioid agonists that can be used when opioids combined with NSAIDs or acetaminophen do not control severe pain. These drugs are quite effective due to high affinity for opioid receptors.

Dual-Action Medicines

Tapentadol (Nucynta) is a schedule II controlled substance that is used only for severe acute pain. This drug is a muopioid receptor agonist and norepinephrine reuptake inhibitor. A weaker version is tramadol (Ultram), which is effective for chronic and acute pain.

All Star Pain Management and Regenerative Medicine is a center of excellence in comprehensive pain treatment serving the Annapolis, Greater Baltimore and Washington D.C. areas. If pain is keeping you from living your life the way you want to, our expert team is here to provide support and help you find relief. Schedule a consultation with Dr. Zed by calling 443-808-1808 today. We look forward to designing a treatment plan that allows you to enjoy a fulfilling life once more.


All content has been reviewed and approved by orthopedic specialist Dr. Zvezdomir “Zed” Zamfirov. Dr. Zed’s practice — All Star Pain Management and Regenerative Medicine — proudly serves the Annapolis, Greater Baltimore and Washington D.C. areas.

Call Today to Begin Living Life Pain Free

No one is immune to chronic pain and injury. If your quality of life has continued to be affected by debilitating pain, it’s time to make a change. Schedule a consultation with Dr. Zed at All Star Pain Management and Regenerative Medicine to learn how our cutting-edge treatments can get you back to doing what you love. Call us today to book your appointment and become an all star with us.

Call us today to book your appointment!(443) 808-1808