Treatment
Pain medication: support suited to your situation
You want to sleep better again or move more easily, but are unsure whether a painkiller is the right approach. Perhaps you already take several medicines and wonder which can be combined. Or you have found that a tablet relieves pain but causes stomach problems or tiredness.
Open individual sections or all the details on this page.
What happens after treatment starts?
A prescription should make clear how to use the medicine and when to seek advice. Ask if any instruction remains unclear. Your observations help at follow-up: what has become easier? Which side effects occur? Have your symptoms changed in any other way?
If medication is given by injection or infusion as part of your agreed treatment at our practice, you remain with us for observation for at least 30 minutes afterwards. Depending on how you feel, this may be longer. Please allow time for this. For agreed medication taken or used at home, your personal treatment instructions apply; this does not require such a stay at the practice.
For breathlessness, impaired consciousness or circulatory collapse, seek help immediately by calling 112. For less urgent questions about how you are tolerating the medicine, use the agreed contact route. Changed symptoms may require a further examination; a repeat prescription does not replace this assessment.
Understanding
A closer look
At OrthoCoast, we want to clarify with you what medication for your orthopaedic symptoms might achieve and which risks matter personally to you. The type of symptoms, your previous experiences and your other medication are key. A generally ‘stronger’ tablet is not automatically the more suitable treatment.
What should the medicine help you achieve?
A painkiller can ease a difficult phase or help you resume appropriately planned movement. It does not replace assessment of the cause. Less pain also does not automatically mean that injured tissue can already tolerate its full usual load.
We therefore discuss a specific goal, such as sleeping more restfully or managing a particular daily activity better again. This includes when you can assess the benefit and what feedback matters. If you feel little relief despite taking the medicine, the plan should be reviewed rather than increasing the amount yourself.
Why does the choice depend on the type of pain?
Pain from an irritated joint is assessed differently from pain caused by nerve damage. Different joint conditions also require different considerations. A medicine that helped someone you know may therefore be poorly suited to your symptoms.
Anti-inflammatory painkillers such as ibuprofen or diclofenac belong to the group known as non-steroidal anti-inflammatory drugs, or NSAIDs (NSAR in German). They can relieve pain in certain orthopaedic conditions. For knee osteoarthritis, a locally applied gel may also be an option. This does not mean they are equally suitable for every body region. Paracetamol also works against certain types of pain but is not anti-inflammatory; its suitability must also match the specific diagnosis.
Further information
Why are different medicines sometimes considered for nerve pain?
For certain confirmed types of nerve pain, medicines originally developed for conditions such as depression or epilepsy may have a role. They affect how pain signals are processed. Such a prescription does not mean that a psychological cause is being assumed.
However, it requires an appropriate diagnosis. Radiating pain alone does not justify every product described as a ‘nerve pain medicine’. We want to explain why a particular medicine is being considered, when its effect can be assessed and which unwanted effects need attention.
What is OrthoCoast’s approach to opioids and medicinal cannabis?
Opioids are a separate group of strong painkillers. They can be appropriate in certain situations; for longstanding orthopaedic pain, they are not an automatic next step. A specific indication, a clear benefit and regular review of the risks are especially important. At OrthoCoast, we do not prescribe opioids or medicinal cannabis.
Possible problems include constipation, tiredness and dizziness. Dependence can develop, and dangerous effects can include breathing problems. If you already take an opioid regularly, do not abruptly change or stop treatment yourself. Discuss any necessary adjustment or gradual withdrawal with the prescribing practice. A pain-relief patch can also contain a potent medicine.
What do you need to know about metamizole?
Metamizole, also known as Novaminsulfon in Germany, is a prescription painkiller with its own uses and risks. It is not an automatically risk-free alternative to other medicines. One known serious side effect is agranulocytosis, in which the number of certain white blood cells falls sharply.
If you develop fever, chills, a sore throat or painful changes to the mucous membranes while taking it or shortly afterwards, take no further metamizole and seek immediate medical assessment. Do not wait for a routine follow-up appointment. This also applies if you tolerated the medicine well in the past.
How do we keep track of all your medication?
Bring an up-to-date medication list or your medication plan, including any printed 2D barcode, to your consultation. The code helps us record your medication plan. Include medicines you only use occasionally, products bought without prescription and dietary supplements. Also mention intolerances and medicines you stopped because of side effects.
If several practices are involved in your care, it should be clear who agreed a change. A new medicine can affect existing medication. Check additional products and alcohol use in advance with your doctor’s practice or pharmacy. If you feel very drowsy or unsteady, do not drive yourself; seek advice about your fitness to drive and continued use of the medicine.
What matters for your decision
Which risks matter with anti-inflammatory medicines?
NSAIDs (NSAR in German) can affect the stomach and intestines, kidneys, heart and circulation, among other things. We therefore ask about previous stomach bleeding, kidney conditions and your other treatment. Your overall situation matters, particularly if you have several conditions. Being available without prescription does not mean a medicine is safe for everyone or for long-term use.
An additional medicine to protect your stomach does not remove all the risks of a painkiller either. Using it as agreed with your doctor and having appropriate reviews remain essential. If you already take a medicine for another condition, tell us its exact name. Different brand names may contain the same substance or one with a similar effect.
Medical support and clarification of costs
At OrthoCoast, your pain medication is planned and monitored by Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. We discuss possible benefits and limitations in the context of your treatment plan.
Medication costs, possible co-payments and additional medical services are separate issues. If you have German statutory health insurance and wish to pay yourself for a medical service your insurer does not cover, you receive a cost estimate beforehand. Once its scope has been clarified, the decision is yours; the self-funded service is provided only after you have signed to confirm that you want the treatment and accept its cost.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
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Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
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Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileYou can discuss medication options with these doctors. We take your questions, previous experiences and everyday life into account.
Frequently asked questions
Can I take an over-the-counter medicine alongside a prescribed one?
Please check the combination beforehand. Medicines bought without prescription can also overlap with your treatment or cause interactions. Tell your doctor’s practice or pharmacy the specific products involved.
Will I have to take painkillers permanently?
A first prescription does not mean this. How long you use the medicine and when it is reviewed depend on the active ingredient, diagnosis and progress. Any trial of stopping or reducing it is agreed with a doctor.
Can I take time to think about a prescribed treatment?
Yes. Raise your questions and concerns. Also ask whether starting promptly is medically important. You should not change medicines you already take regularly solely on the basis of general website information.
What matters at the follow-up appointment?
Bring your current plan and your experiences with it. If follow-up treatment has already been recommended at OrthoCoast, use the agreed follow-up route. Please tell us beforehand about new symptoms, additional medicines or side effects.
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