Medicines can often help control chronic pain. In some cases, it may take several weeks for the medicine to work.

Medicine may work best when it's used along with other types of treatment, such as physical therapy and counseling, to address the different causes of chronic pain.

Sometimes a medicine loses some or all of its ability to work when it is used daily over a long period of time. This is because your body develops a tolerance to it.

Pills for pain

You will likely start with medicines that cause the fewest side effects (such as acetaminophen). The dose will be increased or the medicines will be changed as needed.

• Acetaminophen, such as Tylenol.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, for example), and naproxen (Aleve, for example).
• Tricyclic antidepressants, such as amitriptyline.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta).
• Corticosteroids, such as prednisone.
• Oral medicines that act like a local anesthetic.
• Anticonvulsants, such as gabapentin (Neurontin) and pregabalin (Lyrica).
• Opiate pain relievers, such as hydrocodone (for example, Vicodin). These may be used when other medicines do not help.

Medicines you put on your skin

A variety of creams, gels, sprays, and patches may be used to relieve chronic pain, including:

• Topical analgesics. These are pain relievers that are applied directly to the skin, such as EMLA cream or a lidocaine patch (Lidoderm). Some creams or gels can be made at the pharmacy according to your doctor's directions. Some may contain capsaicin, a naturally occurring substance found in chili peppers.
• Cooling spray. This involves using a cooling spray (such as Biofreeze) directly on the skin. This may be repeated several times.

Injections

Injected medicines—shots—may be used to treat chronic pain, including:

• Nerve block injections. An anesthetic is injected into the affected nerve to relieve pain. The anesthetic may relieve pain for several days, but the pain often returns. Although nerve blocks do not normally cure chronic pain, they may allow you to begin physical therapy and improve your range of motion.
• Epidural steroid injections (injecting steroids around the spine). Although these injections have been used for many years and may provide relief for low back or neck pain caused by disc disease or pinched nerves, they may not work for everyone.
• Trigger point injections. These may relieve pain by injecting a local anesthetic into trigger points (or specific tender areas) linked to chronic fascial pain or fibromyalgia. These injections do not relieve chronic pain in everyone.