Non-NSAID pharmacologic treatment options for the management of chronic pain

Thomas J. Schnitzer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


Chronic pain affects 75 million US citizens. A number of pharmacologic treatments are available for chronic pain that does not respond adequately to nonpharmacologic methods. Long the mainstay of chronic pain management, nonsteroidal anti-inflammatory drugs (NSAIDs) are known to be associated with gastrointestinal (GI) and renal toxicities, a particular problem for the elderly population, which commonly experiences chronic pain, such as that associated with osteoarthritis (OA). Several non-NSAID, non-narcotic therapies are available for noninflammatory pain. Acetaminophen is as effective as NSAIDs for the management of mild-to-moderate OA pain and is the recommended first-line therapy by the American College of Rheumatology (ACR). Propoxyphene, widely believed to be safe and effective, may, in fact, be no more effective - and perhaps less effective - than acetaminophen or ibuprofen. A relatively new analgesic, tramadol, appears to be a useful therapy for patients who do not receive adequate pain relief with acetaminophen and are at risk for NSAID-related side effects. For localized chronic pain associated with OA, topical capsaicin is also an effective analgesic.

Original languageEnglish (US)
Pages (from-to)45S-52S
JournalAmerican Journal of Medicine
Issue number1 B
StatePublished - Jul 27 1998

ASJC Scopus subject areas

  • Medicine(all)

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