Over-the-counter painkillers such as paracetamol and ibuprofen can be helpful for some pains. For many patients seen in the Pain Clinic, the relief that these give is insufficient or is associated with unpleasant side effects. Prescription painkillers can be subject to the same problems.
A review of previous painkillers that have been tried and “failed” can give clues as to what might help in the future. Sometimes drugs from groups of medicines other than the usual painkillers can be helpful; such drugs are known as secondary analgesics. These secondary analgesics are used by pain doctors around the world to treat painful conditions. Secondary analgesics include medications also used for epilepsy and depression, but in Pain Clinics they are prescribed solely for pain.