Non-opioid and Topical Medications for Chronic Pain

There are many non-opioid medications and topical pain relief for chronic pain.

Non-opioid Medication

Opioids are not the only medication option to manage chronic pain. Certain medications—even those not intended for the treatment of pain—have been shown to help some people.

  • NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin (Bayer) and ibuprofen (Advil), are available over the counter or in prescription strength.
  • Acetaminophen. Acetaminophen (Tylenol) works by blocking the transmission of pain signals to the brain and is available over the counter or in prescription strength. It is not an anti-inflammatory.
  • Antidepressants. Antidepressant medication, such as duloxetine (Cymbalta, Irenka), has been proven effective in managing certain types of chronic pain even without the presence of depression and are available by prescription only.
  • Anticonvulsants (antiseizure medication). Anticonvulsants, such as pregabalin (Lyrica), work by calming errant nerve signals in the brain, which cause neuropathic pain. Anticonvulsants are available by prescription only.
  • Muscle relaxants. Muscle relaxants, such as diazepam (Valium, Diastat), relax tight, tense muscles. Muscle relaxants are often used to treat pain associated with musculoskeletal problems, such as back pain and whiplash. They are available with a prescription.
  • Naltrexone. Naltrexone is typically prescribed to people recovering from drug or alcohol addiction. For some people, such as people with Fibromyalgia or complex regional pain syndrome, low doses of naltrexone (Revia, Vivitrol) can help minimize pain.

All medications carry risks and side effects. A doctor can help select which drugs are appropriate for a given condition or type of pain.

Topical Pain Relief

Topical pain relief can be prescription, over the counter, or, in some cases made at home.

  • Capsaicin. Pain from certain conditions, such as osteoarthritis and fibromyalgia, can be lessened with capsaicin (Capzasin). It comes in cream or gel form. It is made from chili peppers and delivers a hot sensation to the area it is applied.
  • Lidocaine. Lidocaine (Lidioderm, Xylocaine) is a local anesthetic cream that causes temporary numbness minimizing pain in the treatment area. It is generally used for arthritis and other musculoskeletal conditions.
  • Trolamine salicylate. This cream is often recommended for arthritis pain. Trolamine salicylate (Aspercream, Myoflex) is chemically similar to aspirin and has a slight anti-inflammatory effect.
  • Counterirritants. Counterirritants (Icy Hot, Gold Bond) cause a hot or cold feeling brought on by ingredients, such as menthol, wintergreen, and eucalyptus. Often used for sore muscles, counterirritants can typically be used with other forms of pain relief.

Topical pain relievers should always be tested on a small area of the skin, as some can cause irritation.