Top 5 Medications for Treating Chronic Pain

When it comes to medications for chronic pain, there are seemingly countless choices out there. How do you know what pain medication is right for you? Different types of pain medications are prescribed for different diagnoses, but there are still many choices available. Sometimes, you may have to try a few different kinds of pain medication, or even a combination of a few, in order to get relief.

Medications for Chronic Pain

Verywell / JR Bee

NSAIDs and Acetaminophen

NSAIDs and acetaminophen are non-opioid analgesics, pain medications often used for mild to moderate chronic pain. NSAIDs and acetaminophen may be used alone to treat chronic pain, or they may be combined with other pain medications such as opioids and adjuvant analgesics. They may also be used to control breakthrough pain.

Unlike opioids, many NSAIDs as well as acetaminophen (Tylenol) are available over-the-counter. However, stronger prescription versions are also available for chronic pain treatment. Some examples of NSAIDs used for chronic pain are ibuprofen, naproxen, and meloxicam.

While NSAIDs and acetaminophen are readily available pain medications, they do have potential side effects. Long-term use increases the chance of these side effects; even short-term use can leave you vulnerable. These include nausea, stomach pain, gastrointestinal ulcers, and bleeding as well as increased potential for bruising. Taking large doses of NSAIDs can result in high blood pressure, kidney problems, and fluid retention.

Some types of NSAIDs—in particular, the selective COX-2 inhibitors—may increase your risk for heart attack or stroke. Each medication is different, and you should talk to your healthcare provider about the risks and benefits of each.


Antidepressants are adjuvant analgesics. They are not formulated specifically as pain medications, though they can effectively treat certain types of chronic pain. Antidepressants are thought to control chronic pain in two ways. First, they may change the way pain is perceived from the spinal cord to the brain. Second, they may decrease anxiety and help regulate sleep.

Not all types of antidepressants are useful as chronic pain medications. However, tricyclic antidepressants (TCAs) such as amitriptyline and nortriptyline, selective serotonin reuptake inhibitors (SSRIs) such as duloxetine, and some others such as nefazodone are commonly used to treat both chronic pain syndromes and nerve pain. Monoamine oxidase inhibitors (MAOIs), on the other hand, are not as effective in pain control.

The side effects of antidepressants are generally mild and may include nausea, drowsiness, and dizziness. While rare, antidepressants may worsen depression or cause suicidal thoughts. If you notice changes in your mood or way of thinking, speak to your healthcare provider immediately.


Though it might sound strange, anticonvulsants, usually used to control seizure disorders, can also be used as pain medication. Anticonvulsants are also adjuvant analgesics. Because they work by inhibiting certain types of nerve transmissions, they can decrease neuropathic pain sensations, such as those caused by trigeminal neuralgia or diabetic neuropathy. Anticonvulsants commonly used as pain medications include gabapentin and pregabalin. The most common side effects are dizziness and somnolence.

Topical Analgesics

Topical analgesics are pain medications that are applied to the skin. They are available as creams, lotions or patches. Some types of topical pain medications may be purchased over-the-counter, while others require a healthcare provider’s prescription.

They work in a few different ways, depending on their active ingredients. Some topical analgesics contain pain medication that is delivered through the skin, such as trolamine salicylate (Aspercreme). Others contain a skin irritant that can interfere with pain perception, such as capsaicin.

Opioids (Narcotics)

Opioids are pain medications used for moderate to severe chronic pain. Though their long-term use has been somewhat controversial, most providers believe that opioids, when carefully monitored, have a place in chronic pain management. Opioids may be short-acting or long-acting pain medications. In chronic pain management, the latter is more commonly used.

Different types of opioids are used for different types of chronic pain. These pain medications are available in both pill or patch form. Intravenous opioids are also available, though they are more commonly used for cancer pain or as post-surgical acute pain medication. Some examples of opioids used to treat chronic pain are ​oxycodone and fentanyl. Opioids may be used alone or combined with other pain medications such as acetaminophen.

While opioids are often effective against chronic pain, they do have potential complications. Opioids can cause nausea, drowsiness, constipation, sexual dysfunction, and may lead to physical dependence. If you take opioids regularly for chronic pain, your healthcare provider should monitor you closely for signs of pain medication complications.

Safety Considerations

You may take a certain type of pain medication for your condition, or you may use a variety of those listed above to control your pain. Whatever the case, be sure to use your medication only as directed. Many pain medications have drug interaction warnings, including several of those listed above. If you are taking multiple pain medications, be sure to inform your healthcare provider so they can alert you to any potential complications.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. The Merck Manuals Online Medical Library. Pain: Treatment.

  2. American Chronic Pain Association. APCA medications and chronic pain: Supplement 2007.

By Erica Jacques
Erica Jacques, OT, is a board-certified occupational therapist at a level one trauma center.