Medication and chronic pain

Medication can play an important role in managing chronic or persistent pain — but it is rarely the whole answer.

Unlike acute pain, where medication often targets healing tissues, chronic pain usually involves changes in the nervous system. This means medicines may help reduce pain intensity, calm nerve activity, or improve sleep and function, rather than eliminating pain completely.

Types of medication commonly used

Depending on the person and the type of pain, medication may include:

• Simple analgesics such as paracetamol

• Anti-inflammatory drugs (where inflammation is a driver and when safe to use)

• Neuropathic pain medications (such as gabapentinoids or certain antidepressants)

• Medications that support sleep or mood, which can indirectly reduce pain sensitivity

• Opioids, in carefully selected situations and usually at the lowest effective dose

Each medication works differently, and responses vary widely between individuals.

Benefits and limitations

Medication can:

• Take the edge off pain

• Reduce flare severity

• Support participation in movement or rehabilitation

• Improve sleep or concentration

However, medications can also:

• Become less effective over time

• Cause side effects

• Interact with other health conditions or treatments

• Mask problems without addressing underlying contributors

This is why medication is most effective when used as part of a broader pain management plan, rather than as the only strategy.

Opioids and chronic pain

Opioids can be helpful for some people, but they carry particular risks when used long-term for chronic pain, including:

• Tolerance (needing higher doses for the same effect)

• Side effects such as fatigue, constipation, hormonal changes, or brain fog

• Reduced pain control over time for some individuals

For these reasons, many people are supported to:

• Use the lowest effective dose

• Review opioids regularly

• Reduce or stop them gradually if the risks outweigh the benefits

Any changes should always be done slowly and with medical support.

Choice, review, and shared decision-making

There is no “right” or “wrong” medication choice — only what works best for a particular person at a particular time.

Good pain care involves:

• Clear information about benefits and risks

• Regular review of effectiveness

• Willingness to adjust or change treatment

• Respect for individual priorities and values

Stopping or reducing medication is not a failure — and neither is choosing to use it.

Medication is one tool, not a judgement

Needing medication does not mean someone has failed to cope or manage their pain well. Chronic pain is complex, and medication is simply one of many tools that may help someone live more fully.

The aim is not perfection, but balance — using medication to support life, not restrict it.