Living With Chronic Pain: Why Painkillers Are Not the Answer

It starts with one tablet before office. Then one more after a long ride home through traffic. Soon there is a strip in your bag, a tube of pain balm on the bedside table, and a chemist near home who already knows what you want before you ask. The pain eases for a few hours, then quietly comes back. Months pass. Your knees, back or neck still hurt, and now you are also worried about what all these tablets are doing to your stomach and kidneys.

If this sounds familiar, you are not alone, and you are not weak for needing relief. Painkillers have a real place in medicine. But when pain has lasted for months, tablets alone rarely solve it. In this guide, our pain specialists explain what makes pain “chronic”, what long-term painkillers can and cannot do, why the nervous system itself can keep pain going, and how a root-cause approach helps people get their lives back.

What makes pain “chronic”?

Doctors generally call pain chronic when it persists or keeps returning for more than about three months. Acute pain is different: a twisted ankle or a back strain from lifting a gas cylinder hurts sharply at first, then fades as the tissue heals over days to weeks.

Chronic pain often has an ongoing source that was never properly treated. Common examples we see every day include long-standing low back pain (see the common causes of lower back pain), sciatica, knee osteoarthritis, cervical spondylosis, shoulder problems like frozen shoulder in diabetes, heel pain from plantar fasciitis, and widespread aching as in fibromyalgia. Inflammatory conditions such as rheumatoid arthritis or gout can also cause pain that keeps returning until the disease itself is controlled.

Chronic pain is not “all in your head”. It is real, and it affects sleep, work, mood and relationships. That is exactly why it deserves more than a refill.

Why are long-term painkillers not the answer?

Painkillers work on the message, not the source. They can make a bad week bearable, help you sleep, or let you do your exercises. Those are good uses. The problem starts when they become the whole plan, taken daily for months while the cause carries on underneath. Each group of medicines also has its own side effects, which add up with long use, age and other illnesses.

What follows is factual information, not a reason to panic. Many people take these medicines safely under supervision. If you are on any of them regularly, the right step is a review with your doctor, never stopping on your own.

NSAIDs (diclofenac, ibuprofen, aceclofenac, naproxen and similar)

These anti-inflammatory tablets are the most common “pain tablets” in India. With regular use, they can irritate the stomach lining and cause gastritis, ulcers and bleeding, sometimes without much warning pain. They reduce blood flow to the kidneys, which matters more if you are older, dehydrated, diabetic or already have kidney problems. They can raise blood pressure, cause fluid retention, and increase the risk of heart attack and stroke, particularly in people who already have heart disease. Taking an acidity tablet alongside reduces stomach risk but does nothing for the kidneys or heart.

Paracetamol

Paracetamol is gentle on the stomach and is safe at the correct dose. The danger is overuse. Taking more than the recommended daily amount, or taking it from several sources at once (many cold, fever and “combination” pain tablets already contain paracetamol), can damage the liver. Regular alcohol use, low body weight and fasting raise that risk. For long-standing pain, it also tends to give only modest relief, which tempts people to take more.

Opioids and tramadol

Tramadol and stronger opioids are sometimes prescribed for severe pain. Over time, the body gets used to them, so the same dose works less well (tolerance), and stopping suddenly can cause withdrawal symptoms (dependence). Common side effects include constipation, nausea, drowsiness and dizziness. In older adults, that drowsiness can lead to falls and fractures. Tramadol can also interact with some antidepressants. In some people, long-term opioid use can even make the body more sensitive to pain. Any reduction should be gradual and supervised by a doctor.

Muscle relaxants and nerve-pain tablets

Muscle relaxants, often combined with a painkiller in a single tablet, commonly cause drowsiness and slowed reactions, which is a real concern if you ride a two-wheeler or drive to work. Nerve-pain medicines such as pregabalin and gabapentin can help genuine nerve pain, but they may cause sleepiness, dizziness, unsteadiness and weight gain. These are useful tools in the right hands, with a clear plan, not open-ended prescriptions.

What about steroid tablets and injections?

Steroids calm inflammation quickly, which is why they are sometimes given for back, joint and nerve pain, including as an epidural steroid injection. Repeated courses, however, can raise blood sugar, thin the bones and affect weight and mood, as we explain in steroid side effects. This is especially important for people with diabetes: read why steroid-free care matters in diabetes.

Why is the “pain balm and tablet” habit so common?

In many Indian homes, the first response to an aching back or knee is a balm, a hot water bag and a tablet from the nearest medical shop, often without a prescription. It is quick, cheap and familiar. Relatives recommend the tablet that worked for them. A busy job, a long commute and the hope that “it will settle on its own” make a doctor’s visit feel like something for later.

Balms and pain-relief gels are generally safer than tablets for short use, because less medicine reaches the bloodstream. The issue is not the balm itself; it is that the habit hides the problem. Meanwhile, a disc problem may be irritating a nerve, a knee may be losing strength, or a simple deficiency may be going untreated. Believing that pain is just “age” and must be lived with is one of the most common back pain myths we hear.

What is central sensitisation?

Think of your nervous system as a house alarm. Normally, it rings when there is a real intruder and goes quiet afterwards. When pain continues for months, the nerves in the spinal cord and brain can become more sensitive, like an alarm whose volume has been turned up. Now even gentle touch, mild movement or a small strain can set it off. This is called central sensitisation.

It helps explain why some people still hurt after the original injury has healed, why pain can spread to new areas, and why poor sleep, stress and worry make everything feel worse. It is also part of the picture in fibromyalgia and in some people with persistent pain after spine surgery. Painkillers do little to turn this volume down. Better sleep, graded movement, treating the original source and calming stress do much more.

What does a root-cause approach to chronic pain look like?

Root-cause care asks a simple question: why does this person still hurt? The answer usually has more than one part.

• A clear diagnosis. A detailed history and examination, with scans read alongside your symptoms rather than on their own. Pain in several joints, for instance, needs to be sorted into osteoarthritis or rheumatoid arthritis, and morning stiffness can point towards inflammation.
• Hidden contributors. Functional medicine looks at the whole person. Low vitamin D and B12 are very common in India and can cause body aches, tingling and fatigue. Uncontrolled blood sugar slows healing and affects nerves. Thyroid problems, thin bones (osteoporosis) and inflammation all matter too.
• Load on the joints. Every extra kilo adds load to the knees and back with each step. Our guide on weight and joint pain explains why even modest weight loss helps, and diet in arthritis pain covers what to eat.
• Sleep, stress and mood. Poor sleep lowers pain tolerance, and long-term pain often brings low mood or anxiety. These are not signs of weakness; they are part of the problem and deserve treatment.

How Dr Heal treats chronic pain

Our aim is not to take tablets away from you overnight. It is to treat the cause so well that you need them less. A typical plan looks like this:

1. Find the real source. A detailed consultation, examination and medicine review. Our in-house laboratory and radiology at our facilities let us check blood tests and imaging under one roof, and read them against your symptoms.
2. Support healing at the site of pain. When an injection is appropriate, we use our own regenerative medicine, prepared through Dr Heal Pharma. It contains no steroids, painkillers or antibiotics, and is aimed at helping damaged tissue recover rather than simply numbing it.
3. Correct what keeps pain going. Clinical nutrition and functional medicine to address vitamin levels, blood sugar, thyroid, weight, sleep and stress.
4. Rebuild movement with rehabilitation. A guided exercise programme, starting gently and building up, to restore strength, flexibility and confidence.
5. Review medicines together. As pain improves, we work with you, and with any doctor who prescribed your medicines, to reduce tablets safely and step by step. We follow up until you move freely.

Depending on where your pain is, you may want to read about our back pain treatment, knee pain treatment, neck pain treatment or joint pain and arthritis treatment. You can also browse all our treatments or meet our pain specialists.

What can you do at home to manage chronic pain?

• Pace yourself. Avoid the “boom and bust” cycle of doing everything on a good day and paying for it for three days after. Break tasks like cooking, cleaning or gardening into smaller chunks with short rests.
• Move a little every day. Gentle walking, stretching or exercises like these sciatica relief exercises help calm a sensitised nervous system. Start small and add a few minutes each week.
• Protect your sleep. Keep regular sleep and wake times, avoid screens late at night, and limit tea or coffee after the afternoon. If neck pain disturbs sleep, see our tips on neck pain from screen hours.
• Build daily spine habits. Breaks from sitting, sensible lifting and regular activity, as described in daily habits for a healthy spine.
• Keep a medicine list. Write down every tablet, including over-the-counter ones and combination products, so your doctor can check for doubling up.
• Look after your mood. Talk to family, stay connected with friends, and try simple breathing or relaxation practices. Tell your doctor if you feel low for weeks.

Frequently asked questions

Is it safe to take painkillers every day for chronic pain?

Some people need regular medicine under medical supervision, and that can be done safely with monitoring. Taking over-the-counter tablets daily for months without a doctor’s review is not advisable, because side effects on the stomach, kidneys, liver and blood pressure build up quietly.

Should I stop my pain medicines now?

No, not on your own. Some medicines, such as tramadol, pregabalin or arthritis drugs, need to be reduced slowly or continued for good reasons. Speak to the doctor who prescribed them. As the cause of your pain is treated, the dose can often be lowered safely.

Why do painkillers stop working after a while?

The cause may be progressing, the nervous system may have become sensitised, or, with opioids like tramadol, the body may have developed tolerance. In each case, more tablets are rarely the solution; finding and treating the cause is.

Can vitamin deficiency cause chronic body pain?

Yes. Low vitamin D can cause bone and muscle aches, and low B12 can cause tingling, numbness and fatigue. Both are common and easy to test. Correcting them will not fix every pain, but it removes one important contributor.

I have been told I need surgery or more injections. What should I ask?

Ask what exactly is causing your pain, what the procedure aims to fix, and what happens if you wait. Our guide to a second opinion before spine surgery or injections lists useful questions.

Where can I get chronic pain treated without depending on painkillers in Bengaluru?

Dr Heal Pain Cure Hospital treats chronic pain with a root-cause, steroid-free approach at its HSR Layout and Banashankari branches. Both are open 24 hours, and patients come to us from all over Karnataka.

This article is for general information and is not a substitute for a medical consultation. Please do not start, stop or change any prescribed medicine without speaking to your doctor.