Acute pain can be hard to ignore. It often comes on suddenly and is intense, typically resulting from an injury, illness, or surgery.
Acute pain usually lasts less than two to three months, says Trishul Kapoor, MD, in the department of pain management at the Cleveland Clinic in Twinsburg, Ohio. “This type of pain tends to resolve once the underlying issue is addressed.”
Even so, treating acute pain is important — not only to alleviate discomfort but to support healing and reduce the risk of long-term complications, including the transition to chronic pain. Depending on the cause and severity of your pain, combining methods to control the pain is often the best approach, says Dr. Kapoor. Here are some strategies your doctor may suggest to manage the acute pain while your body recovers.
1. Over-the-Counter (OTC) Medications
You can get fast-acting pain relief without a prescription. Acetaminophen and nonselective nonsteroidal anti-inflammatories (NSAIDS) are the first line in most pain treatments. These medications work by inhibiting prostaglandin production, which is a chemical that triggers pain, swelling, and inflammation.
Acetaminophen may be helpful for mild to moderate pain and is generally gentler on the stomach and kidneys. But taking more than the recommended dose of this medication can increase your risk of liver damage. If you have liver disease, a history of alcoholism, or malnutrition, it’s important to discuss acetaminophen with your doctor before taking it. And if you drink regularly, you should avoid acetaminophen altogether since alcohol can increase your risk for severe liver damage.
[1]
[2]
NSAIDs such as ibuprofen and naproxen can reduce pain, fever, and inflammation, though they should be avoided or used with caution by people with stomach ulcers, cardiovascular disease, kidney disease or bleeding disorders.
[3]
Combining acetaminophen and a NSAID like ibuprofen reduces the amount you need to take of each medicine, lowering risk of side effects, and is more effective than using either medication alone, says Kapoor. A typical combination would be alternating doses every three hours (taking a dose of acetaminophen, then waiting three hours and taking ibuprofen, and so on).
2. Pain-Numbing Procedures
Injectable nerve block agents or nerve block catheters are types of regional anesthesia techniques for pain management. Nerve blocks can be given as a single shot injected locally around a nerve or group of nerves to temporarily block pain during and after surgery.
[4]
Alternatively, a catheter — a tiny tube inserted under the skin — may be administered after surgery to deliver continuous anesthesia to the pain site.
[5]
Another numbing medication is lidocaine, which is available as OTC and prescription patches or creams.
[6]
Kapoor says these methods are becoming increasingly common because they reduce the use of opioids and speed up recovery after surgery.
3. Corticosteroids
Prednisone, dexamethasone, or other types of steroids can be used to treat acute pain by reducing inflammation, says Kapoor. “However, the effectiveness depends on the type of pain and there are risks of hyperglycemia [high blood sugar] and adrenal suppression [inadequate production of cortisol, a serious, potentially-fatal health condition] with prolonged use,” he says.
[7]
The doses need to be short-term because of these possible side effects.
4. High-Tech Alternatives
Current research is using technology for more pain management options, says Kapoor. Recent studies have shown that virtual reality (VR) can be effective in reducing pain intensity and has been effective with wound care in burn victims or other painful medical procedures.
[8]
A study of patients coming to the emergency department in acute pain found that VR was very effective in reducing pain, anxiety, and fear.
[9]
Research has also found that wearables such as smartwatches can be used to guide lifestyle choices that can help reduce pain, such as guidance on exercise and stress-management.
[10]
5. Physical Activity
“Exercise and movement can be beneficial through engagement in gentle activities, aquatic therapy, physical therapy, yoga, and tai chi,” says Kapoor. Exercise impacts the nervous system in multiple ways, such as releasing endorphins to block pain. Those who exercise regularly typically have reduced pain and inflammation, but the optimal amount and type of exercise will vary, depending on the type of acute pain and the person’s overall health.
[11]
Different types of physical therapy can be beneficial, too. One meta-analysis found core stability exercises, spinal manipulative therapy, and massage were able to help reduce acute lower back pain.
[12]
6. Combining Approaches to Treat Acute Pain
Putting together a plan that may include multiple therapies and medications is often the preferred approach, says Kapoor. One review stated that a standard plan for managing postoperative pain should include acetaminophen, NSAIDs, steroids, and some type of regional or local anesthetic, reserving opioids as rescue medication.
[13]
“For acute pain, [using] the multimodal approach and getting ahead of the pain is the best approach,” says Medhat Mikhael, MD, pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, California. He adds that treating the associated symptoms of pain, such as nausea, is important, too.
7. Opioid Prescription Medications for Pain
“Opioids are not recommended as a first-line therapy and should be reserved for severe, refractory pain when non-opioid therapies are contraindicated or ineffective,” says Kapoor. For severe traumatic injuries, invasive surgeries, or severe acute pain, immediate-release formulations at the lowest effective dose can be prescribed for no more than three days, he says.
In the form of drugs like morphine, codeine, methadone, fentanyl, and oxycodone, opioids work by blocking pain receptors in the nervous system and they trigger brain responses that make us feel good. While there are some cases in which an opioid prescription is justified, the possibility of opioid abuse is one of the reasons they are prescribed with caution. However, there are other reasons they may not be the best choice, says Kapoor:
- They are associated with hypogonadism [when the body makes little or no sex hormones], worsened mood, exacerbation of depression and anxiety, tolerance, diminished efficacy, osteoporosis, and opioid-induced abnormal hypersensitivity to pain.
- There is a risk of opioid medications causing severe life-threatening respiratory depression when mixed with other sedatives, muscle relaxants, antihistamines, or alcohol.
- The risk of addiction is increased not only in patients with a history of substance use disorder but also those with depression and anxiety.
The Takeaway
- Acute pain is sudden and intense and is usually associated with an underlying issue such as injury, illness, or surgery.
- There are multiple ways to treat acute pain, such as using over-the-counter medications, regional nerve blocking agents, and steroids — but combining approaches works best.
- The use of opioids to treat pain should not be the first-line treatment but they may be used when the pain is severe and not responding to other treatments.
