Pharmaceutical Treatment Options Available:

These options include oral medications, topical gels/creams and patches, and topical application of ice and heat.

Many over-the-counter topical medications are available as gels, creams, sprays, roll-on, and patches.

Over-the-counter medications are readily available at local pharmacies without a prescription.

Prescription medications require a prescription to be sent to your pharmacy.

Oral Medications:

Steroids: Medications used to help reduce pain and inflammation, especially for pain flares, given for a short period of time. Please avoid anti-inflammatory medications such as ibuprofen, Motrin, Aleve, naproxen, etc. while taking steroids.

Anti-inflammatory medications (NSAIDs): Medications used to help reduce pain and inflammation, may be over the counter or prescription.

Examples: Ibuprofen (Motrin/Advil), Aleve (Naprosyn/naproxen), Celebrex (celecoxib), Mobic (meloxicam), oral Voltaren (diclofenac sodium)

Tylenol/Acetaminophen: Over-the-counter medication utilized to help reduce pain. When given in combination with an NSAID this has an additive effect in overall pain relief.

Neuropathic pain medications: Oral medications aimed specifically at helping to reduce nerve pain

Examples: Gabapentin, Amitriptyline, Cymbalta (duloxetine), Lyrica (pregabalin)

Muscle relaxers: Medications used to help relax tight, tense muscles, treat muscle spasms and provide pain relief. These are often sedating and can cause you to be very tired. These are not used as a sleep aid.

Examples: Baclofen, Robaxin (methocarbamol), Flexeril (cyclobenzaprine), Skelaxin (metaxalone), Zanaflex (tizanidine), Lorzone (chlorzoxazone)

CBD Oil: This is the non-psychoactive component of cannabis (marijuana). Legal across the US. It can help reduce pain and inflammation. It may be taken orally in many forms including oil, pills, and gummies. It is also available as a topical agent. Always discuss use with your health care provider. (Be aware that it may contain up to 0.03% THC which can at times show positive for THC on a drug test.)

Opioids: Strong prescription medications used for severe pain for short periods of time, can be addictive and must be utilized sparingly for a limited time. These are not prescribed long term from this office.

Examples: Tramadol, hydrocodone

***If you require long-term medication management with opioids for pain control, you will need to be seen at a pain clinic where these medications are prescribed for chronic pain or speak to your primary care physician.***

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Topical Agents:

Ice and Heat: Typically applied in 20-minute intervals as needed for pain.

Gels/Creams: Typically applied in a thin layer 3-4 times daily. These may be over the counter or prescriptions.

Over the counter examples: Voltaren gel (helps reduce inflammation and pain), lidocaine (helps to numb pain), Icy Hot, Aspercreme, BenGay, Salonpas, Biofreeze, CBD oil

Prescription Compound Creams: A combination of prescription medications combined in a cream to help reduce pain. Typically includes medications such as pain relievers, anesthetics, anti-inflammatories, and muscle relaxers). These medications may include lidocaine, piroxicam, orphenadrine, gabapentin, tizanidine, ketoprofen, baclofen, and clonidine.

Patches: Patches tend to provide longer-lasting relief than gels and creams.

Over-the-counter options: Lidocaine, menthol, ICY HOT, Aspercreme, BenGay, Salonpas, Biofreeze