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Advance Pain Management

Pain Relievers

Also called: Analgesics, Pain killers, Pain medicines

Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.

Over-the-counter (OTC) medicines are good for many types of pain. There are two main types of OTC pain medicines: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin) are examples of OTC NSAIDs.

If OTC medicines don’t relieve your pain, your doctor may prescribe something stronger. Many NSAIDs are also available at higher prescription doses. The most powerful pain relievers are opioids. They are very effective, but they can sometimes have serious side effects. There is also a risk of addiction. Because of the risks, you must use them only under a doctor’s supervision.

There are many things you can do to help ease pain. Pain relievers are just one part of a pain treatment plan.

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Pain and opioid use after reversal of sickle cell disease following HLA-matched sibling haematopoietic stem cell transplant

The burden of pain varies among patients with sickle cell disease (SCD). Chronic pain, resulting from multiple aetiologies, is common in SCD. The Analgesic, Anaesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy (ACTTION-AAPT) criteria have recently described subcategories of chronic SCD pain (). Haematopoietic stem cell transplant (HSCT) is the most accessible curative therapy for SCD resulting in disease-free survival in over 85% (). After successful HSCT (as defined by haematological parameters), most patients are weaned off opioids; however, a subgroup of patients continues to experience pain that requires opioid treatment.

We determined the prevalence and correlates of pain requiring continued opioid treatment at 12 months after successful non-myeloablative human leucocyte antigen-matched sibling allogeneic HSCT in a cohort of SCD patients (Fig 1) (). The Institutional Review Board of the National Institutes of Health approved the protocol. All participants provided informed consent. Detailed data on the clinical course, pain, opioid use and laboratory values were prospectively collected within 3 months prior to HSCT and at 12 months post-HSCT (n = 35). Patient Reported Outcomes Measurement Information System (PROMIS) measures were also prospectively collected at the same time points in a subgroup of these patients (n = 20). The PROMIS domains assessed included pain intensity, pain impact, anxiety, depression, satisfaction with social role, physical function, fatigue and sleep disturbance (). All PROMIS raw data were converted to T-scores.

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