Medications can play an important role in managing pain. In fact, medications are the most common treatment for both acute and chronic pain. When used properly, medications help relieve pain, treat conditions that can accompany pain — such as anxiety or sleep problems — and improve quality of life.

In addition to the potential relief they provide, all pain medications carry a risk of side effects. Here's what you need to know about the most common types of prescription pain medications.

Prescription NSAIDs

Some of the medications you buy over the counter for pain relief are also available in more powerful, prescription-strength formulas. All of these medications fall in the non-steroidal anti-inflammatory drug (NSAID) category. NSAIDs relieve pain by preventing the body's cyclooxygenase (COX) enzymes from working. COX enzymes make hormone-like substances called prostaglandins, which contribute to pain and inflammation. NSAIDs are most often prescribed for arthritis and for the pain resulting from muscle sprains, strains, back and neck injuries, and menstrual cramps.

Another type of NSAID, called a COX-2 inhibitor, works slightly differently from traditional NSAIDs. A COX-2 inhibitor blocks only the COX-2 enzyme — the one that's more likely to cause pain and inflammation. The COX-2 inhibitor is most frequently prescribed for people with rheumatoid arthritis, osteoarthritis, menstrual cramps, and injury-related pain.

Side effects: If you take more than the recommended dose (and sometimes even the recommended dose) of NSAIDs, side effects can include nausea, stomach pain, bleeding, and ulcers. NSAIDs also increase the risk of cardiovascular problems, such as heart attack and stroke — and they can interact with drugs prescribed to treat heart diseases, such as blood thinners, antihypertensive drugs, and aspirin. Large doses of NSAIDs can also lead to kidney problems, fluid retention, and high blood pressure. The older you are, the higher the risk of developing these conditions is.

Another concern with NSAIDs is the "ceiling effect" — meaning there's a limit to how much pain they can control. Beyond a certain dosage, NSAIDs won't deliver any additional pain-relieving benefit. For this reason, even prescription NSAIDs might not be powerful enough to relieve moderate to severe pain.

Opioids

Opioid medications (also called narcotics) are currently the most commonly prescribed medications in the United States. But a physician must have a special license to prescribe opioids, which are regulated as controlled substances by the U.S. Drug Enforcement Administration.

Because opioids are powerful drugs, they are often used to relieve pain from cancer, terminal illness, severe injury, or surgery. Individuals with severe osteoarthritis or rheumatoid arthritis, low back pain, or neuropathic pain also can be prescribed opioids.

Opioids fall into two categories: agonists and antagonists. Both types of opioids provide powerful pain relief that's difficult to match using other methods. But this strength comes with some serious risks.

Side effects: Opioid side effects can include dizziness, nausea and vomiting, gastrointestinal issues, cardiovascular issues, sexual dysfunction, fatigue, mental cloudiness, unclear thinking, and mood changes. These side effects can make it difficult to function normally — preventing driving a car, operating machinery, or even returning to work. In some cases, opioids can even cause changes in the nervous system, amplifying your perception of pain and making you feel more uncomfortable (hyperalgesia).

Opioids are highly addictive, which can lead to misuse and abuse. Trends in the United States reflect this problem. Prescriptions for opioid pain relievers have quadrupled since 1999. During the same period, the rate of opioid overdose has tripled. In fact, prescription opioid addiction, overdose, and deaths are at an all-time high in the United States.

Given these statistics, the use of opioid analgesics can be controversial. In some cases, the risks of opioid use outweigh their benefits. Other NSAIDs, such as analgesics, should be considered first. And when opioids are prescribed, the lowest effective dose should be given for the shortest amount of time.

Other pain-related medications

Because pain is complicated and involves many aspects of your body, mind, and life circumstances, traditional pain relievers might not provide enough relief. Your health care professional can prescribe other medications for pain relief or help manage the side effects of existing medications.

Antidepressants

In addition to relieving symptoms of depression, some antidepressants can also contribute to pain relief. There may be two reasons for this: firstly, by helping to manage depression, they boost energy and improve mood, which makes the pain feel more tolerable, secondly, antidepressants can also directly relieve pain by changing the way pain signals are transmitted within the central nervous system.

Antidepressants that might help with pain relief include:

• Tricyclic antidepressants;

• Serotonin and norepinephrine reuptake inhibitors.

Side effects: Side effects of different antidepressants vary, but can include drowsiness, dry mouth, blurred vision, constipation, insomnia, nausea, fatigue, weight gain, blood pressure changes, confusion, and dizziness. They also can interfere with the way the heart produces electrical impulses (cardiac conduction). As a result, antidepressants are not usually recommended for individuals with heart diseases.

Anti-seizure medications

Although these medications were initially developed to control or reduce epileptic seizures, they were later found to help manage pain — particularly the shooting pain that results from nerve damage. It's believed that anti-seizure medications work by "quieting" damaged nerves to slow or prevent uncontrolled pain signals.

Side effects: Side effects can include dizziness, drowsiness, nausea, short-term memory disturbance, weight gain, and lack of balance and coordination. More severe but less common side effects include blood, skin, and liver disorders.

Adjuvants

Adjuvants are medications commonly prescribed in conjunction with pain medications. They are intended to:

• Help control side effects, such as nausea or fatigue;

• Manage other pain-related symptoms, such as insomnia or anxiety;

• Boost pain-relieving power.

Adjuvants include topical analgesics that help relieve joint or muscle pain. Muscle relaxants, which help reduce painful muscle spasms, also fall into this category.

Pain is complex, and so is treating it. You may find that you benefit from multiple strategies and resources to eliminate or minimize your pain. Work with your health care professional to find the treatment approach that's right for you.