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Non-Opioid Analgesics
Non-opioid analgesics are broken down into three categories: acetaminophen,nonsteroidal anti-inflammatory drugs (NSAIDs), and COX-2 inhibitors.
Of the three types of non-opioids pain relievers
Opioid Analgesics
Opioid drugs are medically used for pain relief, anesthesia, and to treat opiate addiction. They are not associated with the same organ toxicity or side effects typically associated with NSAIDs.
While safe when used as prescribed, opioids can cause drowsiness, nausea,constipation, hypoventilation (abnormally shallow breathing), and euphoria in some. This is particularly true for older adults who are more prone to these effects.
Moreover, long-term use is associated with a risk of drug tolerance (where the drug gradually loses its effect), dependence (addiction), and withdrawal. As a result, most opioid drugs are controlled substances requiring a doctor’s prescription. According to the Centers for Disease Control and Prevention, in 2016, more than 11.5 million Americans reported misusing prescription opioids in the past year.
There are three broad categories of opioid drugs used to treat pain
A Word From Verywell
Analgesics can be extremely effective in managing arthritis pain and used safely if taken as prescribed. While most doctors will focus on non-opioid drugs for treatment, there may be situations where severe, acute pain may requirestronger opioid medications. This would only be for short-term relief to avoid any risk of dependence.
At the same time, it is still not clear how effective low-dose opioids are when compared to other non-opioid forms of therapy. As such, if you have severe, unrelenting arthritis pain, consider meeting with apain management specialistwho can talk you through your full range treatment options, both pharmaceutical and non-pharmaceutical.
Frequently Asked QuestionsNonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen), are the most effective medications for reducing pain and inflammation, so they may be better for knee pain than Tylenol (acetaminophen).However, they can cause kidney, stomach, or heart problems if used excessively or for long periods of time, so talk to your doctor about a treatment plan.Learn MoreKnee Pain Symptoms and TreatmentsIt’s ok to take pain medication before working out, but you may be tempted to push yourself too far.Be careful not to overdo the exercise, which could make an injury worse.Learn MoreExercising Safely with ArthritisTopical analgesics are rubbed onto the place where you feel pain and the medication is absorbed through the skin. These may be a better option for arthritis pain in some cases.For instance, topical NSAIDs can help with pain without causing stomach or kidney problems like oral NSAIDs.Learn MoreWhat You Should Know About Topical Analgesics
Frequently Asked Questions
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen), are the most effective medications for reducing pain and inflammation, so they may be better for knee pain than Tylenol (acetaminophen).However, they can cause kidney, stomach, or heart problems if used excessively or for long periods of time, so talk to your doctor about a treatment plan.Learn MoreKnee Pain Symptoms and Treatments
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen), are the most effective medications for reducing pain and inflammation, so they may be better for knee pain than Tylenol (acetaminophen).However, they can cause kidney, stomach, or heart problems if used excessively or for long periods of time, so talk to your doctor about a treatment plan.
Learn MoreKnee Pain Symptoms and Treatments
It’s ok to take pain medication before working out, but you may be tempted to push yourself too far.Be careful not to overdo the exercise, which could make an injury worse.Learn MoreExercising Safely with Arthritis
It’s ok to take pain medication before working out, but you may be tempted to push yourself too far.Be careful not to overdo the exercise, which could make an injury worse.
Learn MoreExercising Safely with Arthritis
Topical analgesics are rubbed onto the place where you feel pain and the medication is absorbed through the skin. These may be a better option for arthritis pain in some cases.For instance, topical NSAIDs can help with pain without causing stomach or kidney problems like oral NSAIDs.Learn MoreWhat You Should Know About Topical Analgesics
Topical analgesics are rubbed onto the place where you feel pain and the medication is absorbed through the skin. These may be a better option for arthritis pain in some cases.For instance, topical NSAIDs can help with pain without causing stomach or kidney problems like oral NSAIDs.
Learn MoreWhat You Should Know About Topical Analgesics
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.FDA.gov.FDA drug safety communication: prescription acetaminophen products to be lLimited to 325 mg per dosage unit; boxed warning will highlight potential for severe liver failure.National Library of Medicine. MedlinePlus.Pain relievers.Tai FWD, McAlindon ME.Non-steroidal anti-inflammatory drugs and the gastrointestinal tract.Clin Med (Lond). 2021;21(2):131-134. doi:10.7861/clinmed.2021-0039UptoDate.COX-2 inhibitors and gastroduodenal toxicity: Major clinical trials.Nissen SE, Yeomans ND, Solomon DH, et al.Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis.N Engl J Med. 2016;375(26):2519-2529. doi:10.1056/NEJMoa1611593Centers for Disease Control and Prevention. Opioid Overdose.Addiction and overdose.American Addiction Centers.Hydrocodone (vicodin, norco) addiction & rehab near me.Cleveland Clinic.What’s the Best Way to Find Relief from Your Knee Arthritis Pain?MedlinePlus.Over-the-counter pain relievers.Derry S, Wiffen PJ, Kalso EA, et al.Topical analgesics for acute and chronic pain in adults ‐ an overview of Cochrane Reviews.Cochrane Database of Systematic Reviews. (5). doi:10.1002%2F14651858.CD008609.pub2Additional ReadingCenters for Disease Control and Prevention. “Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines—United States, 2012.“MMWR. 63(26);563-568.Cicero, J.; Ellis, M.; Surratt, H. et al. “Factors influencing the selection of hydrocodone and oxycodone as primary opioids in substance abusers seeking treatment in the United States.“PAIN.154(12):2639. DOI: 10.1016/j.pain.2013.07.025.National Institute on Drug Abuse. “America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.” Washington, D.C.Yoon, E.; Babar, A.; Choudhary, M. et al. “Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update.".Journal of clinical and translational hepatology. 4(2):131-42. DOI: 10.14218/JCTH.2015.00052.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.FDA.gov.FDA drug safety communication: prescription acetaminophen products to be lLimited to 325 mg per dosage unit; boxed warning will highlight potential for severe liver failure.National Library of Medicine. MedlinePlus.Pain relievers.Tai FWD, McAlindon ME.Non-steroidal anti-inflammatory drugs and the gastrointestinal tract.Clin Med (Lond). 2021;21(2):131-134. doi:10.7861/clinmed.2021-0039UptoDate.COX-2 inhibitors and gastroduodenal toxicity: Major clinical trials.Nissen SE, Yeomans ND, Solomon DH, et al.Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis.N Engl J Med. 2016;375(26):2519-2529. doi:10.1056/NEJMoa1611593Centers for Disease Control and Prevention. Opioid Overdose.Addiction and overdose.American Addiction Centers.Hydrocodone (vicodin, norco) addiction & rehab near me.Cleveland Clinic.What’s the Best Way to Find Relief from Your Knee Arthritis Pain?MedlinePlus.Over-the-counter pain relievers.Derry S, Wiffen PJ, Kalso EA, et al.Topical analgesics for acute and chronic pain in adults ‐ an overview of Cochrane Reviews.Cochrane Database of Systematic Reviews. (5). doi:10.1002%2F14651858.CD008609.pub2Additional ReadingCenters for Disease Control and Prevention. “Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines—United States, 2012.“MMWR. 63(26);563-568.Cicero, J.; Ellis, M.; Surratt, H. et al. “Factors influencing the selection of hydrocodone and oxycodone as primary opioids in substance abusers seeking treatment in the United States.“PAIN.154(12):2639. DOI: 10.1016/j.pain.2013.07.025.National Institute on Drug Abuse. “America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.” Washington, D.C.Yoon, E.; Babar, A.; Choudhary, M. et al. “Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update.".Journal of clinical and translational hepatology. 4(2):131-42. DOI: 10.14218/JCTH.2015.00052.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
FDA.gov.FDA drug safety communication: prescription acetaminophen products to be lLimited to 325 mg per dosage unit; boxed warning will highlight potential for severe liver failure.National Library of Medicine. MedlinePlus.Pain relievers.Tai FWD, McAlindon ME.Non-steroidal anti-inflammatory drugs and the gastrointestinal tract.Clin Med (Lond). 2021;21(2):131-134. doi:10.7861/clinmed.2021-0039UptoDate.COX-2 inhibitors and gastroduodenal toxicity: Major clinical trials.Nissen SE, Yeomans ND, Solomon DH, et al.Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis.N Engl J Med. 2016;375(26):2519-2529. doi:10.1056/NEJMoa1611593Centers for Disease Control and Prevention. Opioid Overdose.Addiction and overdose.American Addiction Centers.Hydrocodone (vicodin, norco) addiction & rehab near me.Cleveland Clinic.What’s the Best Way to Find Relief from Your Knee Arthritis Pain?MedlinePlus.Over-the-counter pain relievers.Derry S, Wiffen PJ, Kalso EA, et al.Topical analgesics for acute and chronic pain in adults ‐ an overview of Cochrane Reviews.Cochrane Database of Systematic Reviews. (5). doi:10.1002%2F14651858.CD008609.pub2
FDA.gov.FDA drug safety communication: prescription acetaminophen products to be lLimited to 325 mg per dosage unit; boxed warning will highlight potential for severe liver failure.
National Library of Medicine. MedlinePlus.Pain relievers.
Tai FWD, McAlindon ME.Non-steroidal anti-inflammatory drugs and the gastrointestinal tract.Clin Med (Lond). 2021;21(2):131-134. doi:10.7861/clinmed.2021-0039
UptoDate.COX-2 inhibitors and gastroduodenal toxicity: Major clinical trials.
Nissen SE, Yeomans ND, Solomon DH, et al.Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis.N Engl J Med. 2016;375(26):2519-2529. doi:10.1056/NEJMoa1611593
Centers for Disease Control and Prevention. Opioid Overdose.Addiction and overdose.
American Addiction Centers.Hydrocodone (vicodin, norco) addiction & rehab near me.
Cleveland Clinic.What’s the Best Way to Find Relief from Your Knee Arthritis Pain?
MedlinePlus.Over-the-counter pain relievers.
Derry S, Wiffen PJ, Kalso EA, et al.Topical analgesics for acute and chronic pain in adults ‐ an overview of Cochrane Reviews.Cochrane Database of Systematic Reviews. (5). doi:10.1002%2F14651858.CD008609.pub2
Centers for Disease Control and Prevention. “Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines—United States, 2012.“MMWR. 63(26);563-568.Cicero, J.; Ellis, M.; Surratt, H. et al. “Factors influencing the selection of hydrocodone and oxycodone as primary opioids in substance abusers seeking treatment in the United States.“PAIN.154(12):2639. DOI: 10.1016/j.pain.2013.07.025.National Institute on Drug Abuse. “America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.” Washington, D.C.Yoon, E.; Babar, A.; Choudhary, M. et al. “Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update.".Journal of clinical and translational hepatology. 4(2):131-42. DOI: 10.14218/JCTH.2015.00052.
Centers for Disease Control and Prevention. “Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines—United States, 2012.“MMWR. 63(26);563-568.
Cicero, J.; Ellis, M.; Surratt, H. et al. “Factors influencing the selection of hydrocodone and oxycodone as primary opioids in substance abusers seeking treatment in the United States.“PAIN.154(12):2639. DOI: 10.1016/j.pain.2013.07.025.
National Institute on Drug Abuse. “America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.” Washington, D.C.
Yoon, E.; Babar, A.; Choudhary, M. et al. “Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update.".Journal of clinical and translational hepatology. 4(2):131-42. DOI: 10.14218/JCTH.2015.00052.
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