Pharmacological Intervention

The goal of pain management is to achieve optimal comfort and function with minimal side effects from analgesic therapy. The pain management plan may include treatment of the cause of the pain (if possible), optimal use of analgesic and adjuvant medication, use of nonpharmacologic interventions, and invasive approaches when appropriate.

Medications are often the first step in the management of pain because they are effective, relatively low risk, inexpensive, and usually have rapid onset. The following three major classes of medications are used alone or, more commonly, in combination to manage pain:

• NSAIDS (aspirin, ibuprofen, naproxen)
• Adjuvant or co-analgesic medications — these medications are those that are not usually thought of as analgesics but which, when given with known analgesics, have synergistic effects or exhibit analgesic activity of their own. Anticonvulsants (gabapentin) and antidepressants (amitriptyiline) are adjuvant medications used to treat neuropathic pain.
• Opioid analgesics