Non-Opioid Treatments For Pain Relief
Non-opioid treatments for pain
Acute and chronic pain is a major public health issue in the US. Nearly 1 in 5 US adults experience chronic pain.1 And as a leading health complaint, acute pain results in more than 115 million emergency visits each year.2
Treating patients’ pain can be challenging as there are benefits and risks to consider. In response to the opioid health crisis, opioids are no longer considered first-line treatment for most types of acute and chronic pain.3 New guidance recommends non-pharmacologic and non-opioid treatments as first-line therapies.4
Read on for facts and guidelines to help you and your patients develop an effective treatment plan based on their needs.
The troubling facts about opioids
Opioid misuse remains a public health crisis–for every 48 patients prescribed an opioid in the emergency department, 1 will become a long-term user5
Chronic use of opioids can lead to opioid use disorder in as many as 40% of users3
Physicians and other healthcare professionals are prescribing opioids less. Opioid prescriptions have decreased by 44.4% between 2011-2020, including a 6.9% decrease from 2019-20206
Every day, 128 Americans die from an opioid overdose7
The need exists to manage acute and chronic pain with less reliance on highly addictive opioids.
Non-opioid treatments
For many types of pain, opioids are no longer considered first-line treatment.4 In fact, many acute pain conditions can be managed most effectively with nonopioid medications (such as nonsteroidal anti-inflammatory drugs [NSAIDs] and acetaminophen).4 Recommending over the counter (OTC) analgesics when acute pain presents can prevent exposure to the risks of opioids and reduce the possibility of reliance on opioids in the future. There are opportunities to reduce exposure to opioids with equally effective monotherapy and combination therapy OTC medications.8
OTC NSAIDs, combination analgesics, and acetaminophen have well-established safety profiles without the same dependence potential as opioids. Therefore, they should be considered for all types of acute pain where non-pharmacologic treatments are not effective or would not be considered effective as monotherapy.
NSAIDs, acetaminophen, or a combination of ibuprofen and acetaminophen are an effective initial treatment approach for acute pain. Medication selection should be based on minimizing risks for the specific patient.9
When pain speaks, respond with relief
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A portfolio of proven pain relief
At Haleon, our mission is to make everyday health more achievable, more inclusive, and more sustainable. To that end, we offer a range of effective treatments for individualized pain care.
- #1 doctor-recommended OTC oral NSAID
- Provides powerful relief of acute pain with a fast onset, lasting effect, and proven safety profile10-15
- 1st FDA-approved acetaminophen and ibuprofen combination
- Provides powerful relief of minor aches and pains with a fixed-dose, pain-fighting pair of ingredients
- #1 doctor-recommended topical pain brand*16
- Delivers powerful, targeted relief of mild-to-moderate osteoarthritis (OA) pain and relieves pain at the source, minimizing systemic exposure
- Excedrin Migraine is the #1 neurologist-recommended OTC treatment for migraine†17
- Excedrin Migraine delivers migraine relief fast (in 30 minutes for some patients) and is long-lasting (up to 6 hours), safe, and well tolerated
*Based on surveyed doctors. Voltaren is approved for the use of Arthritis pain.†Among OTC medicines for migraines.
Managing pain conditions without opioids
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Musculoskeletal pain (non-low back)
Musculoskeletal injuries are common. In 2010, they accounted for more than 65 million health care visits in the US and 4 of 5 injuries that were treated in a physician’s office were musculoskeletal. One-fifth of patients presenting with pain in the outpatient setting receive an opioid prescription and opioid prescriptions for acute musculoskeletal injuries, such as ankle sprains, are common.18 Opioid-sparing analgesics can provide much needed relief without the risk of addiction related to opioid use.
Treatment recommendations:
- The American College of Physicians (ACP) recommends NSAIDs as a first-line oral treatment option for patients with an inadequate response to nonpharmacologic therapy for back pain19
- The ACP and The American Academy of Family Physicians recommend18:
- Topical NSAIDs, with or without menthol gel, should be used as first-line therapy for adults with acute pain from non-low back, musculoskeletal injuries
- Oral NSAIDs and acetaminophen may be considered as options for pharmacologic treatment for adults with acute pain from non-low back, musculoskeletal injuries
- Opioids, including tramadol, should not be used as first-line treatments for adults with acute pain from non-low back musculoskeletal injuries
Advil is recommended front line
Ibuprofen in Advil is strongly recommended for musculoskeletal pain (non-low back) when nonpharmacologic options are not appropriate. Oral NSAIDs have evidence of pain reduction at <2 hours and at 1 to 7 days after treatment. They also showed greater likelihood of symptom relief with acute pain musculoskeletal injuries (not including lower-back).18
Musculoskeletal pain is often associated with inflammation of the underlying tissue. Advil works at the source to relieve pain caused by inflammation. Learn more about the proven, efficacious pain-relieving power of Advil.
Advil Dual Action is greater than the sum of its parts
Advil Dual Action is indicated for musculoskeletal pain, including the treatment of back pain. It contains an advanced combination of acetaminophen and ibuprofen and provides 8 hours of back pain relief. Learn how Advil Dual Action fights pain 2 ways.
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Osteoarthritis (OA) pain
OA is the most common form of arthritis and can affect the hands, hips, shoulders, knees, and other joints.
Treatment recommendations:
- Evidence-based OA treatment guidelines recommend topical NSAIDs, like Voltaren, as a first-line option for the treatment for OA of the knee
- The American College of Rheumatology strongly recommends20:
- Topical NSAIDs, like Voltaren, first-line in the treatment of knee OA (conditionally recommended for hand OA pain)
- Oral NSAIDs, like Advil, first-line in the treatment of knee, hand, and hip OA
Voltaren, the #1 doctor-recommended topical pain brand*16
Voltaren relieves OA pain in the hand, wrist, elbow, foot, ankle, and knee. It penetrates deep through the skin at the site of pain. For patients with more than 2 joints affected, consider an oral NSAID, such as Advil.
In placebo-controlled studies of OA of the hand and knee, statistically significant and clinically meaningful improvements in pain, stiffness, and mobility were demonstrated with Voltaren as early as Week 1 and maintained throughout the studies.21-23
Learn why Voltaren is the #1 doctor-recommended topical pain brand.
*Based on surveyed doctors. Voltaren is approved for use in arthritis pain.
Advil, the #1 NSAID brand preferred by patients
Advil is an initial oral medication of choice for treatment of OA pain, regardless of anatomic location. Oral NSAIDs, like Advil, are the mainstay of pharmacologic management of OA pain and their use is strongly recommended. Learn more about the proven efficacy of Advil.
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Dental pain
Nearly 60% of adolescents and young adults who visited an emergency department for a dental disorder were prescribed opioids. Controlling postprocedural pain can be achieved by targeting the source of pain (inflammation), which NSAIDs are able to achieve. Opioid drugs on the other hand interfere with the perception and do not target pain caused by inflammation.24,25
Treatment recommendations:
The American Dental Association (ADA) recommends:
- NSAIDs have been shown to be more effective at reducing pain than opioid analgesics, and are therefore recommended as first-line therapy for acute management
- For mild-to-moderate dental pain — Ibuprofen first-line treatment
- For moderate-to-severe pain — Ibuprofen + acetaminophen first-line treatment
- For acute pain — Ibuprofen + acetaminophen first-line treatment
- Bree Collaborative and Washington State Agency Medical Directors’ Group: “Prescribe non-opioid analgesics as the FIRST line of pain control for dental procedures. Prescribe combinations of NSAIDs and acetaminophen following dental procedures where post-operative pain is anticipated unless there are contraindications”26
- Regardless of the dental procedure, the analgesic efficacy of nonopioid analgesics such as acetaminophen and NSAIDs such as ibuprofen is typically underestimated. For decades, studies have repeatedly found that NSAIDs are superior to opioids at conventional dosages. They also produce a lower incidence of side effects than opioids, including the potential for abuse27
Advil, the #1 dentist-recommended OTC pain reliever, is clinically proven to be superior to prescription Tylenol with codeine for acute, postsurgical dental pain28
Advil is clinically proven to be an effective medication for reducing or stopping dental pain, among a variety of other pain conditions. Postoperative dental pain is associated with inflammation in underlying tissues. Advil works at the site of pain to relieve pain caused by inflammation.
Advil Dual Action fights dental pain 2 ways
Advil Dual Action is a combination of ibuprofen and acetaminophen. Combinations may provide incremental benefit and decrease maximum daily dosage of individual agents.9
A recent meta-analysis comparing OTC and prescription pain relievers in The Journal of the American Dental Association found a combination therapy of ibuprofen with acetaminophen (like Advil Dual Action), generally more effective than a prescription opioid-containing regimen, and with a lower risk of adverse effects, in the treatment of acute dental pain from third-molar extractions.
Advil Dual Action is the first pain-relief medication approved by the US Food and Drug Administration that combines acetaminophen and ibuprofen.
Learn more about managing dental pain with Advil.
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Migraine pain
Migraines are a common condition and can be severely debilitating. Acute migraines are often treated in the emergency department (ED). Use of opioids in the ED to treat this condition has been associated with increased risk of revisits, hospital admissions, and increased ED length of stay. 36% of adolescents and young adults who visited the ED with a migraine received an opioid prescription.29
Treatment recommendations:
The American Academy of Neurology (AAN) recommends combination NSAIDs (aspirin, acetaminophen, and caffeine) as a first-line option for acute migraine attacks30
AAN also recommends oral NSAIDs as a reasonable first-line treatment choice for mild-to-moderate migraine30
Use as directed.
Excedrin for acute moderate-to-severe pain*
Excedrin Migraine is the #1 neurologist-recommended OTC for migraine treatment.31 In clinical studies, patients with moderate to severe migraines experienced effective relief with just one dose. Recommend Excedrin as first-line therapy in the treatment of migraine.
Learn more about Excedrin for migraine pain relief.
*18 years of age and older.
With Haleon, deliver better everyday health with humanity
Customizing a treatment plan for patients
With the Haleon family of OTC pain products, you can customize an opioid-sparing pain management plan for your patients. The approach to pain management must ultimately involve a shared decision-making process between clinicians and individual patients.
Treatment also largely depends on patients’ individual needs, coexisting conditions, and patient preference. Working together, you can customize a pain management plan without the risks of opioid medications.
Give your patients safe and effective pain relief
Advil’s proven efficacy and safety profile
Discover why Advil is the #1 NSAID brand preferred by patients.
Discover Advil Dual Action
Learn how Advil Dual Action combines 2 distinct mechanisms of action (MOA) to fight dental pain in 2 ways.
Voltaren for arthritis pain
Find out why Voltaren is the #1 doctor-recommended topical pain brand.
Patient resources
Access resources designed to help your patients as they navigate their pain symptoms.
