What medication is used for orthopedic pain? An overview

October 10, 2025 •

4 min read

According to the Mayo Clinic, over 50 million Americans suffer from chronic pain, with many cases stemming from musculoskeletal and orthopedic issues. Determining what medication is used for orthopedic pain depends on the specific cause, severity, and patient health profile, encompassing everything from simple over-the-counter options to targeted injections and prescription drugs.

Quick Summary

Different medications, from over-the-counter NSAIDs and acetaminophen to prescription muscle relaxants, corticosteroids, and opioids, can address orthopedic pain. Topical applications and nerve blocks also offer targeted relief. The appropriate treatment varies by the cause and severity of the pain, necessitating a multimodal approach.

Key Points

NSAIDs vs. Acetaminophen: NSAIDs like ibuprofen and naproxen reduce both pain and inflammation, while acetaminophen (Tylenol) is primarily for pain and lacks anti-inflammatory effects.
Topicals for Localized Pain: Topical NSAIDs (diclofenac gel) and creams like capsaicin offer localized relief with fewer systemic side effects than oral medications.
Injections for Targeted Relief: Corticosteroid injections deliver powerful anti-inflammatory effects directly to the inflamed site (e.g., a painful joint) but are used sparingly to avoid tissue damage.
Opioids are for Severe, Short-Term Pain: Due to high risks of dependency, opioids (e.g., hydrocodone) are used only for severe acute pain, such as after surgery or a fracture, for the shortest possible duration.
Nerve Pain Requires Specific Medication: Shooting or burning nerve-related orthopedic pain, like from a pinched nerve, often responds best to nerve-modulating medications such as anti-seizure drugs (gabapentin) or certain antidepressants (duloxetine).
Multimodal Management is Key: Combining different pain-relief strategies, such as using NSAIDs with acetaminophen or integrating physical therapy, minimizes medication risks and maximizes long-term relief.

Understanding Orthopedic Pain

Orthopedic pain originates from the musculoskeletal system, involving bones, joints, muscles, tendons, and ligaments. It can be acute, such as from a sports injury or post-surgical recovery, or chronic, as with conditions like osteoarthritis or rheumatoid arthritis. The right medication depends on the pain type and underlying cause.

Acute vs. Chronic Pain Management

Treatment for acute pain often focuses on short-term relief and reducing inflammation to facilitate healing. For chronic conditions, management is aimed at sustained symptom control to improve quality of life and function. A personalized, multimodal approach is often most effective, combining medication with physical therapy and other strategies.

Over-the-Counter (OTC) Medications

For mild to moderate orthopedic pain, several medications are readily available without a prescription. These are often the first line of defense before considering stronger options.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs work by blocking enzymes that cause pain and inflammation.

Ibuprofen (Advil, Motrin): A common choice for mild to moderate pain, effective for reducing inflammation. It is relatively short-acting and typically taken every 4 to 6 hours.
Naproxen (Aleve): A longer-acting NSAID, taken twice daily, which can be beneficial for consistent, all-day pain management.
Risks and Considerations: Long-term or high-dose use of NSAIDs can lead to side effects like stomach irritation, bleeding, ulcers, and kidney problems. They may also increase the risk of heart attack or stroke, especially COX-2 inhibitors like celecoxib.

Acetaminophen (Tylenol)

Acetaminophen is an analgesic that elevates the pain threshold in the central nervous system but does not reduce inflammation.

Usage: Best for mild to moderate pain without inflammation.
Risks: It is considered safer for the stomach than NSAIDs, but exceeding the recommended dosage can cause liver damage. Patients should be cautious, as acetaminophen is a common ingredient in many other medications.

Prescription-Only Medications

When OTC options are insufficient, or for more severe pain, a doctor may prescribe stronger medications.

Corticosteroid Injections

Corticosteroids are powerful anti-inflammatory agents that can be injected directly into the affected joint or tissue.

Mechanism: They suppress the immune response and decrease inflammation at the injection site.
Conditions Treated: Effective for conditions like arthritis, bursitis, and tendonitis.
Usage: Injections provide effective, temporary relief lasting several months. However, frequent injections can weaken tissues and worsen joint damage over time, so they are typically limited to a few per year.

Muscle Relaxants

These medications are prescribed for muscle spasticity and spasms that contribute to orthopedic pain, particularly in the back and neck.

Examples: Common examples include cyclobenzaprine (Flexeril) and tizanidine.
Side Effects: Can cause sedation, dizziness, and confusion.

Opioid Analgesics

Opioids are strong pain relievers, but due to their high risk of dependency and addiction, their use is reserved for severe acute pain and short durations, such as after a bone fracture or surgery.

Examples: Hydrocodone and oxycodone are common examples.
Risks: Include addiction, misuse, overdose, and significant side effects like constipation, nausea, and drowsiness.

Medications for Neuropathic Pain

Certain orthopedic conditions, like nerve compression from a herniated disc, can cause nerve pain (neuropathic pain), which presents as shooting or burning sensations.

Antidepressants: Some antidepressants, like duloxetine, can effectively manage chronic nerve pain related to musculoskeletal conditions.
Anti-seizure Medications: Gabapentin (Neurontin) and pregabalin (Lyrica) are used to quiet overactive pain signals from nerves.

Topical Treatments

For localized pain, topical medications offer relief with fewer systemic side effects than oral medications.

Topical NSAIDs: Gels containing diclofenac (Voltaren) are applied directly to the painful joint. They provide targeted anti-inflammatory effects.
Capsaicin Creams: Made from chili peppers, these creams deplete nerve cells of a chemical (substance P) that transmits pain signals.
Menthol/Counterirritants: Products like Icy Hot create a cooling or warming sensation that distracts from the pain.

Comparison of Orthopedic Pain Medications


Medication Class	Best For	Mode of Action	Over-the-Counter Options	Common Side Effects	Special Considerations
NSAIDs	Mild-to-moderate pain and inflammation	Blocks pain and inflammatory enzymes (COX)	Ibuprofen, naproxen	Stomach upset, bleeding, kidney issues	Use lowest dose for shortest time. Consider GI/CV risks
Acetaminophen	Mild-to-moderate pain (no inflammation)	Increases pain threshold in CNS	Tylenol	Liver damage at high doses	Safe for stomach but watch total daily intake
Corticosteroids	Localized, severe inflammation	Powerful anti-inflammatory (injected)	No (prescription injection only)	Tissue damage with frequent use	Temporary relief. Use sparingly to avoid tissue damage
Muscle Relaxants	Muscle spasms and spasticity	Sedative effect on CNS to relax muscles	No (prescription only)	Drowsiness, dizziness, confusion	Typically for short-term use
Opioids	Severe, acute pain (short-term)	Mimics natural endorphins, blocking pain signals	No (prescription only)	Constipation, nausea, sedation, addiction risk	High addiction potential; strictly short-term use
Antidepressants/Anti-seizure	Chronic nerve-related pain	Modifies nerve signaling	No (prescription only)	Nausea, dizziness, drowsiness	Often take weeks to become effective
Topical Agents	Localized mild pain/inflammation	Targets specific area, local effect	Diclofenac gel (Voltaren), capsaicin cream	Mild skin irritation	Lower systemic side effects than oral counterparts

Multimodal Approach to Orthopedic Pain

A multimodal strategy combines different types of medication and other therapies to minimize side effects and maximize relief. For example, combining an NSAID with scheduled acetaminophen can enhance pain relief while limiting opioid use after surgery. For chronic conditions like arthritis, medication is often paired with physical therapy, exercise, and lifestyle changes. Regional nerve blocks may also be used during and after surgery to control pain effectively with fewer side effects than systemic opioids.

Conclusion

For orthopedic pain, a wide range of medications is available, from familiar over-the-counter options to more potent prescription drugs and targeted injections. NSAIDs and acetaminophen are foundational for many conditions, while corticosteroids and nerve-modulating drugs offer solutions for specific types of inflammation and nerve pain. With the serious risks associated with prolonged opioid use, a multimodal approach is now the standard of care, ensuring effective relief with minimal long-term risk. Always consult a healthcare professional to determine the most appropriate and safest medication plan for your specific condition. For more information on managing chronic pain, resources like the American Academy of Family Physicians offer additional guidance on non-opioid strategies.

Frequently Asked Questions

For mild-to-moderate pain and inflammation from a simple sprain, an over-the-counter NSAID like ibuprofen or naproxen is typically the first choice. Topical NSAIDs may also be effective for targeted relief.

For localized musculoskeletal pain, topical NSAIDs, like diclofenac gel, can be as effective as oral versions but carry a lower risk of systemic side effects like stomach upset.

Muscle relaxants are generally prescribed for short-term use to relieve muscle spasms associated with conditions like back or neck pain, or a herniated disc.

To minimize risks like tissue damage, doctors typically recommend limiting corticosteroid injections to no more than a few times per year, with at least 3-6 months between injections in the same joint.

Acetaminophen can help with the pain component of inflammatory conditions, but it does not address the underlying inflammation. For pain accompanied by swelling, an NSAID is usually more effective.

Opioids carry serious risks, including high potential for dependency, addiction, and overdose. They are generally only prescribed for severe, acute pain for very limited periods.

Medications for nerve pain, such as anti-seizure drugs (gabapentin) or certain antidepressants, modify the way nerves transmit pain signals. They are used for chronic neuropathic pain that doesn't respond well to standard NSAIDs or acetaminophen.