Jenny L.F. Andrus, MD
Most physicians weigh the risks and benefits of prescribing medications for their patients before doing so, planning that the overall benefit of the drug will far outweigh any possible side effects. Of course, the patient has a responsibility to report any adverse effects that the drug may have to the physician so that the dosage or timing of administration may be changed to reduce side-effects. A different drug altogether may have to be prescribed.
As an Interventional Pain Management Physician, I spend a great deal of time working with my patients to find just the right combination of therapies, which may include pharmaceuticals, interventional procedures, physical therapy, exercise, etc., to help them achieve a manageable quality of life with their chronic pain. It is very important for me to know all the drugs my patients take, as some may exacerbate their chronic pain. You may be surprised to learn about some of the most common culprits, which may be in your medicine cabinet. They are:
- Statins –An estimated 35+ million Americans take these cholesterol-lowering medications. While necessary for our survival, too much cholesterol, especially LDL cholesterol, puts us at higher risk for heart attack, stroke, or heart disease. A well-documented side effect of taking a statin medication is muscle pain in a percentage of individuals who take the drug. Certainly, most people can take statins, even higher doses, without muscle pain. For those who do experience muscle pain, lowering the dosage helps reduce the pain. Talk to your physician before making any modification to your dosage.
- Isotretinoin – This treatment for severe, nodular acne is a form of Vitamin A that can only be prescribed by a physician when all other treatment options have failed. While the list of side-effects this drug has is extensive, it is also notorious for causing mild to severe joint and muscle pain in the later stages of treatment. Thankfully, the treatment period is limited to four months and symptoms typically resolve once the medication is stopped.
- Pregabalin – This medication is an anticonvulsant drug typically used to treat epileptic seizures. It is also used for nerve pain related to certain conditions such as peripheral neuropathy, fibromyalgia, shingles, spinal cord injuries, and other neuropathic pain. In 2019, there were 9 million prescriptions written for this drug, so it is widely used. Pregabalin has quite a list of side-effects as well, and muscle and joint pain can be experienced by some patients who take the drug. For patients who experience this painful side-effect, there are alternative nerve medications that can be tried, such as gabapentin, that do not have the same musculoskeletal pain issues as pregabalin.
- Bisphosphonates – These medications are prescribed to treat osteoporosis, a condition typically seen in senior adults, that causes a loss of bone density, resulting in weak and brittle bones. Bisphosphonates prevent the minerals in the bones from dissolving and leaking into the bloodstream. A common side-effect of these drugs is mild bone, muscle, or joint pain or any combination thereof. If the pain is severe, patients are advised to stop taking the medication immediately and consult with their physician for alternative treatments.
- Blood pressure medication – Some BP medications, known as beta-blockers, are prescribed to lower blood pressure by relaxing the tension in blood vessels and heart cells. Unfortunately, a small percentage of those who take these medications experience joint and back pain. If the pain becomes too intense, discuss with your physician other options, such as diet and exercise, that can help you to lower your blood pressure naturally, without medication.