May 25, 2024
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Coupons for Pain Relief Prescription Drugs

Free Prescription Drug Coupons! Download your FREE discount coupon(s) below to save money on Pain Relief medication at pharmacies across the country. These coupons are pre-activated and can be used immediately to save up to 90% on your prescription drugs.

Pain Relief Drug Coupon List
Drug/Dosage Information Coupon
APAP/CODEINE TAB 300-30mg Drug Info
APAP/CODEINE TAB 300-60mg Drug Info
BUT/ASA/CAF CAP COD 30mg Drug Info
CELEBREX CAP 100mg Drug Info
CELEBREX CAP 200mg Drug Info
CELEBREX CAP 400mg Drug Info
DARVOCET-N TAB 100 Drug Info
HYDROCO/APAP TAB 10-325mg Drug Info
HYDROCO/APAP TAB 10-500mg Drug Info
HYDROCO/APAP TAB 10-650mg Drug Info
HYDROCO/APAP TAB 10-660mg Drug Info
HYDROCO/APAP TAB 5-325mg Drug Info
HYDROCO/APAP TAB 5-500mg Drug Info
HYDROCO/APAP TAB 7.5-325 Drug Info
HYDROCO/APAP TAB 7.5-500 Drug Info
HYDROCO/APAP TAB 7.5-650 Drug Info
HYDROCO/APAP TAB 7.5-750 Drug Info
HYDROCOD/IBU TAB 7.5-200 Drug Info
IBUPROFEN TAB 400mg Drug Info
IBUPROFEN TAB 600mg Drug Info
IBUPROFEN TAB 800mg Drug Info
KETOROLAC TAB 10mg Drug Info
LORCET TAB 10/650 Drug Info
LORCET PLUS TAB 7.5-650 Drug Info
LORTAB 10 TAB Drug Info
LORTAB 7.5 TAB Drug Info
MELOXICAM TAB 15mg Drug Info
MELOXICAM TAB 7.5mg Drug Info
MOBIC TAB 15mg Drug Info
MOBIC TAB 7.5mg Drug Info
NAPRELAN TAB 375mg CR Drug Info
NAPRELAN TAB 500mg CR Drug Info
NAPROSYN TAB 500mg Drug Info
NAPROXEN TAB 500mg Drug Info
NORCO TAB 10-325mg Drug Info
NORCO TAB 5-325mg Drug Info
NORCO TAB 7.5-325 Drug Info
OXYCOD/APAP TAB 10-325mg Drug Info
OXYCOD/APAP TAB 10-650mg Drug Info
OXYCOD/APAP TAB 5-325mg Drug Info
OXYCOD/APAP TAB 7.5-325 Drug Info
PERCOCET TAB 10-325mg Drug Info
PERCOCET TAB 10-650mg Drug Info
PERCOCET TAB 5-325mg Drug Info
PERCOCET TAB 7.5-325M Drug Info
PROPO-N/APAP TAB 100-650 Drug Info
ROXICET SOL 5-325/5 Drug Info
VICODIN TAB 5-500mg Drug Info
VICODIN ES TAB 7.5-750 Drug Info
VICODIN HP TAB 10-660mg Drug Info
VOLTAREN TAB 75mg EC Drug Info
ZIPSOR CAP 25mg Drug Info
ZYDONE TAB 10-400mg Drug Info
Pain Therapy Coupon for Prescription Discounts

Print this free Pain Therapy Coupon and recieve savings on Pain Relief medications such as: Tramadol, Codiene, Hydrocodone.

How To Use
Pharmacy Coupons

These coupons work just like a pharmacy discount card. Simply bring the coupon/card into any CVS/pharmacy, Walgreens, Rite Aid, Walmart, Target, Kmart, Kroger, Longs Drug Store, Safeway, or any participating pharmacy, and enjoy substantial savings on almost every medication available.

Major Pharmacy Chains:

  • CVS Pharmacy
  • Walmart Pharmacy
  • Walgreens
  • Target Pharmacy
  • Rite Aid
  • Safeway
  • Kmart Pharmacy
  • Stop & Shop
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  • Shopko
  • Shop'n Save Pharmacy
  • Albertsons Savon Pharmacy
  • Vons Pharmacy
  • Longs Drugs
  • Cub Pharmacy
  • Bi-Mart Pharmacy
  • Dillons Pharmacy
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  • Randalls
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  • ACME Savon Pharmacy
  • Shaws Osco Pharmacy
See Entire Pharmacy List

Pain Relief Medication Information


Generic name: Hydrocodone bitartrate, Acetaminophen

Brand names: Zydone, Norco, Maxidone, Lorcet, Lortab, Hydrocet, Co-Gesic, Anexsia, Vicodin. Anexsia combines a narcotic analgesic (painkiller) and cough reliever with a non-narcotic analgesic for the relief of moderate to moderately severe pain.


Generic Name: acetaminophen and hydrocodone (a SEET a MIN oh fen and hye droe KOE done)

Brand Names: Anexsia, Dolorex Forte, Hycet, Liquicet, Lorcet, Lortab, Maxidone, Norco, Polygesic, Stagesic, Vicodin, Xodol, Zamicet, Zydone

Vicodin is a tablet containing a combination of acetaminophen and hydrocodone. Hydrocodone is in a group of drugs called narcotic pain relievers.

Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone.

Vicodin is used to relieve moderate to severe pain.

Vicodin may also be used for purposes other than those listed in this medication guide.


Hycodan contains hydrocodone (dihydrocodeinone) bitartrate, a semisynthetic centrally-acting opioid antitussive. Homatropine methylbromide is included in a subtherapeutic amount to discourage deliberate overdosage.


Narcotic analgesic related to codeine, but more potent and more addicting by weight. It is used also as cough suppressant.

Dicodid, a semisynthetic opiate agonist and hydrogenated ketone derivative, is similar to other phenanthrene derivatives, such as codeine. Used as an analgesic, hydrocodone is combined with acetaminophen, ibuprofen, or aspirin to treat pain. Used as an antitussive, hydrocodone is combined with phenylephrine, pseudoephedrine, phenylpropanolamine, guaifenesin, pyrilamine, pheniramine, or chlorpheniramine.

Hydromet Syrup

Generic Name: Hydrocodone/Homatropine (HIGH-droe-KOE-dohn/hoe-MA-troe-peen)

Brand Name: Examples include Hycodan and Hydromet


Brand name(s): Lorcet, Lortab, Norco, Vicodin

This medication is a combination of a narcotic (hydrocodone) and a non-narcotic (acetaminophen) used to relieve moderate to severe pain. Hydrocodone works by binding to opioid receptors in the brain and spinal cord, and acetaminophen decreases the formation of prostaglandins, therefore relieving pain.

Lorcet 10/650

On this Page Treatment & Uses Safety Information Before Using Treating Overdose Side Effects

Generic Name: acetaminophen and hydrocodone

Brand Names: Anexsia, Dolorex Forte, Hycet, Liquicet, Lorcet 10/650, Lorcet Plus, Lortab 10/500, Lortab 2.5/500, Lortab 5/500, Lortab 7.5/500, Lortab Elixir, Maxidone, Norco, Polygesic, Stagesic, Vicodin, Vicodin ES, Vicodin HP, Xodol, Xodol 5, Zamicet, Zydone


Generic Name: acetaminophen and hydrocodone

Brand Names: Anexsia, Dolorex Forte, Hycet, Liquicet, Lorcet, Lortab, Maxidone, Norco, Polygesic, Stagesic, Vicodin, Xodol, Zamicet, Zydone


Generic Name: acetaminophen and hydrocodone

Brand Names: Anexsia, Dolorex Forte, Hycet, Liquicet, Lorcet, Lortab, Maxidone, Norco, Polygesic, Stagesic, Vicodin, Xodol, Zamicet, Zydone

Brand Name: Novahistex DHCommon Namehydrocodone - phenylephrine

This medication contains two ingredients, hydrocodone and phenylephrine. Hydrocodone belongs to the family of medications called antitussives (cough suppressants), and phenylephrine belongs to the family of medications called decongestants (relieves congestion). Hydrocodone helps to suppress cough by affecting the cough centre in the brain. Hydrocodone is a narcotic medication and so can be habit-forming if taken for long periods. Phenylephrine works by narrowing blood vessels in the nasal passages and helps to relieve nasal stuffiness.

Hydroco/apap5-500mg 35-92

Hydrocodone/apap = Codeine and tylenol

Oxycodone/apap = Time release Codeine and Tylenol

Oxycodone is generic for percocet which is also used for pain

Tussionex_Pennkinetic_(hydrocodone polistirex and chlorpheniramine polistirex) Extended-Release Suspension


Generic Name: hydrocodone and ibuprofen (hye dro KOE done and eye byoo PRO fen)_Brand Names: Ibudone, Reprexain, Vicoprofen.


Is the brand name of hydrocodone and acetaminophen, also marketed under names including Lorcet, Lortab, Anexsia, Hycet, Norco, Vicodin and Zydone. Hydrocodone is a narcotic pain reliever. Acetaminophen is a less potent painkiller but increases the effects of hydrocodone. The combination aims to relieve moderate to severe pain. Hydrocodone bitartrate is a semi-synthetic opioid derived from codeine and thebaine, both naturally occurring opiates.


Is a narcotic analgesic related to codeine, but more potent and more addicting by weight. It is used also as cough suppressant. [PubChem]


Marketed as Vicodin, Anexsia, Dicodid, Hycodan ( or generically Hydromet ), Hycomine, Lorcet, Lortab, Norco, Novahistex, Hydroco, Tussionex, Gentex, Vicoprofen, Xodol, Bekadid, Calmodid, Codinovo, Duodin, Kolikodol, Orthoxycol, Mercodinone, Synkonin, Norgan, and Hydrokon, hydrocodone is commonly available in tablet, capsule, and syrup form.


A semisynthetic opiate agonist and hydrogenated ketone derivative, is similar to other phenanthrene derivatives, such as codeine. Used as an analgesic, hydrocodone is combined with acetaminophen, ibuprofen, or aspirin to treat pain. Used as an antitussive, hydrocodone is combined with phenylephrine, pseudoephedrine, phenylpropanolamine, guaifenesin, pyrilamine, pheniramine, or chlorpheniramine.


Hydrocodone Bitartrate (anhydrous)


Hydrocodone or dihydrocodeinone is a semi-synthetic opioid derived from two of the naturally occurring opiates, codeine and the baine. Hydrocodone is an orally active narcotic analgesic (pain reliever) and antitussive (cough suppressant). It is commonly available in tablet, capsule, and syrup form, and is often compounded with other analgesics like paracetamol or ibuprofen. Hydrocodone was first synthesized in Germany in 1920[1] and was approved by the Food and Drug Administration on 23 March 1943 for sale in the United States and Canada under the brand name Hycodan.

As a narcotic, hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. It can be taken with or without food as desired. When taken with alcohol, it can intensify drowsiness. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. Studies have shown hydrocodone as stronger than codeine but only one-tenth as potent as morphine at binding to receptors, whereas roughly half as potent as morphine in analgesic properties. However other studies have shown hydrocodone to be anywhere from half as potent to oxycodone (1.5 the potency of morphine) to only 66.6~% the potency of oxycodone (equipotent to morphine). Hydrocodone can be habit-forming, which leads to physical and psychological dependence, but the potential for addiction varies from individual to individual depending on unique biological differences. Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. In the U.S., formulations containing more than 15 mg per dosage unit are considered Schedule II drugs, as would any formulation consisting of just hydrocodone alone. Those containing less than or equal to 15 mg per dosage unit in combination with acetaminophen or another non-controlled drug are called hydrocodone compounds and are considered Schedule III drugs. Hydrocodone is typically found in combination with other drugs such as paracetamol, aspirin, ibuprofen and homatropine methylbromide. One of the major problems today with the illicit use of hydrocodone, especially in younger populations, is that users may not be aware that hydrocodone pills contain acetaminophen. Consuming more than 4,000 milligrams of acetaminophen a day can cause liver damage, jaundice, and even liver failure if the drug is being taken in excessive dosages for an extended period of time. The presence of acetaminophen in hydrocodone-containing products allegedly deters many drug users, at least in theory, from taking excessive amounts. However, some users will get around this by using cold water extraction to extract and dispose of a portion of the acetaminophen, taking advantage of the water-soluble element of the drug. Formal Chemical Name (IUPAC)_4,5a-Epoxy-3-methoxy-17-methylmorphinan-6-on

Arthritis and Narcotic Pain Medication

There are a variety of strong pain relievers, containing narcotic drugs that your doctor may prescribe to help relieve your arthritis pain. Often, these pain relievers are combined with acetaminophen (Tylenol). They include: Tylenol with Codeine, Lorcet, Lortab, Vicodin, Morphin, OxyContin, Roxicodone, Percocet, Darvon, Darvocet. How Do Narcotics Relieve Arthritis Pain? Unlike ibuprofen, Motrin, Aleve, or other NSAID drugs, narcotics do not decrease the inflammation that occurs with arthritis. Narcotic drugs work on pain receptors on nerve cells to relieve pain. If you have pain that isn't relieved by a narcotic drug or NSAID alone, speak to your doctor about combining the two. In some cases, an NSAID/narcotic combination may relieve pain better than either alone.


Pain is a signal from our body that something is not right. It can be due to a physical injury, some kind of disease, or emotional upset. Most types of physical pain can be treated with pain relievers.

Common Pain Conditions

There are many acute and chronic pain conditions, including:

  • Musculoskeletal Pain
  • Back and Leg Pain
  • Neck, Shoulder and Arm Pain
  • "Whiplash" Injuries
  • Motor Vehicle, Work-Related and Sports Injuries
  • Failed Back Surgery and Other Post Surgical Pain Syndromes
  • Pain Due to Arthritis
  • Fibromyalgia

Cancer Pain

Primary and Metastatic Cancer Pain

Medication Side Effect Management

Pain associated with other conditions

  • Vascular Pain
  • Raynaud's Disease
  • Psychogenic Pain
  • Trigeminal Neuralgia
  • Spinal Cord Injury
  • Spasticity
  • Pelvic Pain
  • Pediatric Pain
  • Neuropathic pain
  • Shingles
  • Neuralgia
  • Nerve Injuries
  • Phantom Limb Pain

Common Pain Medications Pain medications (analgesics) are not all the same. Each pain medication has its advantages and risks. Specific types of pain may respond better to one kind of medication than to another kind. Each person may have a slightly different response to a pain medication. Over-the-counter medications are good for many types of pain. Acetaminophen (Tylenol) is good for relieving pain and fever. It is less irritating to the stomach than other over-the-counter pain medications and is safer for children. It can, however, be toxic to the liver if you take more than the recommended dose. Aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin) are examples of non-steroidal anti-inflammatory drugs (NSAIDs). These reduce inflammation caused by injury, arthritis, or fever. NSAIDs also relieve pain associated with menstruation. Take these medications in regular dosing intervals as directed by the manufacturer until the pain is gone.

However, DO NOT give aspirin to children. Reye's syndrome is associated with the use of aspirin to treat children with viral infections, such as chicken pox. This syndrome can cause brain and liver damage. If you have high blood pressure, kidney disease, or a history of gastrointestinal bleeding, you should consult your health care provider before using any over-the-counter NSAID. Prescription medications may be needed for other types of pain. There are specific uses and risks of prescription narcotic and non-narcotic medications. There are alternate methods to help reduce pain that may be helpful instead of, or in addition to, pain medications. These include heat for sore or overworked muscles, ice applied to recent injuries (such as a sprained ankle), massage, resting the affected body part, and biofeedback or relaxation techniques. Consult your doctor if pain lasts longer than a few days, if over-the-counter pain medications are not helping to reduce the pain, or if other symptoms arise. A consultation with a pain clinic or other specialist may be helpful for control of long-term pain.

Leg pain is a common symptom and complaint

  • Foot pain
  • Knee pain
  • Joint pain
  • Hip pain
  • Muscle pain
  • Shin splints
  • Alternative Names
  • Pain - leg; Aches - leg; Cramps - leg


Leg pain can be due to a muscle cramp (also called a charley horse). Common causes of cramps include: Dehydration or low amounts of potassium, sodium, calcium, or magnesium in the blood Medications such as: Diuretics, which can cause you to lose too much fluid or minerals Statins, which lower cholesterol and can cause muscle injury Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time An injury can also cause leg pain from: A torn or overstretched muscle (strain) Hairline crack in the bone (stress fracture) Inflamed tendon (tendinitis)

Shin splints:

Pain in the front of your leg related to overuse or repetitive pounding.

Neck pain

Alternative Names

Pain - neck; Neck stiffness

When your neck is sore, you may have difficulty moving it, especially to one side. Many people describe this as having a stiff neck.

If neck pain involves nerves (for example, significant muscle spasm pinching on a nerve or a slipped disk pressing on a nerve), you may feel numbness, tingling, or weakness in your arm, hand, or elsewhere.

See also:

  • Whiplash
  • Herniated disk
  • Spinal stenosis


A common cause of neck pain is muscle strain or tension. Usually, everyday activities are to blame. Such activities include bending over a desk for hours, having poor posture while watching TV or reading, placing your computer monitor too high or too low, sleeping in an uncomfortable position, or twisting and turning the neck in a jarring manner while exercising.

Traumatic accidents or falls can cause severe neck injuries like vertebral fractures, whiplash, blood vessel injury, and even paralysis.

Other causes include:

  • Other medical conditions, such as fibromyalgia
  • Cervical arthritis or spondylosis
  • Ruptured disk
  • Small fractures to the spine from osteoporosis
  • Spinal stenosis (narrowing of the spinal canal)
  • Infection of the spine (osteomyelitis, diskitis, abscess)
  • What are the common types of arthritis?

There are two major types of arthritis - osteoarthritis, which is the "wear and tear" arthritis, and rheumatoid arthritis, an inflammatory type of arthritis that happens when the body's immune system does not work properly. Gout, which is caused by crystals that collect in the joints, is another common type of arthritis. Psoriatic arthritis, lupus, and septic arthritis are other types of arthritis.

What is osteoarthritis?

Osteoarthritis is also called degenerative joint disease or degenerative arthritis. It affects about 33 million Americans and is the most common chronic joint condition.

What is Raynaud's phenomenon?

Raynaud's (say "ray-NOHZ") phenomenon is a problem with blood flow. Your body doesn't send enough blood to your hands and feet, so they feel very cold and numb. In most cases, this lasts for a short time when your body overreacts to cold temperatures.

There are two kinds of Raynaud's phenomenon. Primary Raynaud's is also known as Raynaud's disease. It occurs on its own and is the most common form. Secondary Raynaud's is also called Raynaud's syndrome. It most often forms as part of another disease. It almost always begins after age 35. Raynaud's is common, but often people don't talk to a doctor about it. For most people, it is more of a nuisance than a disability.

What is degenerative disc disease?

Degenerative disc disease is not really a disease but a term used to describe the normal changes in your spinal discs as you age. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).

How Osteoarthritis Affects Your Knee

In a healthy joint, a rubbery tissue called cartilage cushions the ends of the bones at contact points. A thin, smooth tissue called the synovial membrane covers the other surfaces and releases a fluid that lubricates the knee.

Thigh Bone

The knee is one of the largest joints in the body, and one of the most complex. It is formed by the shin bone (tibia), the thigh bone (femur), and the knee cap (patella).

Knee With Osteoarthritis

Osteoarthritis in the knee begins with the gradual deterioration of cartilage. Without the protective cartilage, the bones begin to rub together, causing pain, loss of mobility, and deformity.

Eroded Cartilage

Cartilage becomes damaged and gradually wears away, allowing bone surfaces to rub together.

What Is Bursitis?

Wherever your bones, tendons, and ligaments move against each other, particularly near joints, the points of contact are cushioned by small fluid-filled sacs called bursae. By reducing friction, each of the more than 150 bursae in your body helps the joints operate smoothly through the full range of natural movement. But when a bursa becomes irritated and swollen, it's called bursitis -- or inflammation of the bursa.

What is Sjõgren's syndrome?

Sjõgren's syndrome (say "SHOW-grins") is a disorder in which the immune system attacks the body's moisture-producing glands, such as the tear glands and the saliva glands. These glands may become scarred and damaged, and extreme dryness in the eyes and mouth (sicca syndrome) may develop. Sjõgren's syndrome may also cause fatigue, pain in the joints, and, in rare cases, problems with the function of vital organs, such as the lungs, kidneys, and nerves. Sjõgren's syndrome is an autoimmune disease, in which a person's immune system attacks its own tissues as though they were foreign substances. Sjõgren's affects over one million people throughout the United States and is most common in white women who are in their 40s and 50s. Women and men of all races may develop this disorder, but nine times more women than men have Sjõgren's syndrome.1

What is juvenile arthritis?

Juvenile arthritis is a disease in which there is inflammation (swelling) of the synovium in children aged 16 or younger. The synovium is the tissue that lines the inside of joints. The inflammation is often accompanied by heat or a rash.

Juvenile arthritis is an autoimmune disease. That means the immune system attacks the body itself. The disease is also idiopathic, which means that no exact cause is known. Researchers believe juvenile arthritis may be related to genetics, certain infections, and the environment.

What are the symptoms of juvenile arthritis?

Children with juvenile arthritis often have no symptoms at all. Symptoms may also vary depending on the type of arthritis.

Symptoms of juvenile arthritis may include:

  • Joint stiffness, especially in the morning
  • Pain, swelling, and tenderness in the joints
  • Limping (In younger children, it may appear that the child is not able to perform motor skills he or she recently learned.)
  • Persistent fever
  • Rash
  • Weight loss
  • Fatigue
  • Irritability
  • Eye redness, eye pain, and/or blurred vision

Hand Osteoarthritis

(Degenerative Arthritis of the Hand)

Arthritis is a general term for inflammation in the joints. Arthritis can occur in numerous forms. The most common is osteoarthritis, a condition in which the cartilage, the protective cushioning between the joints, wears out. When this happens, the bones rub directly against other bones. This causes structural changes that can be seen on X-rays. Bone deposits or bone spurs known as osteophytes may develop on the edges of the joints. The soft tissues that stabilize joints may also show signs of wear.

Arthritis is often painful, but not always. Over time, arthritis can result in joint deformity and can limit the motion and function of joints.

Hip Pain

Hip pain can make it difficult to walk, go up and down stairs, squat, or sleep on the side that hurts. A clicking or snapping feeling or sound around your hip joint (snapping hip) may bother you or cause you to worry. But if your hip is not painful, in many cases the click or snap is nothing to worry about. Home treatment may be all that is needed for minor hip symptoms. To better understand hip problems, it may be helpful to know how the hip works. It is the largest ball-and-socket joint in the body. The thighbone (femur) fits tightly into a cup-shaped socket (acetabulum) in the pelvis. The hip joint is tighter and more stable than the shoulder joint but it does not move as freely. The hip joint is held together by muscles in the buttocks, groin, and spine; tendons; ligaments; and a joint capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint and let the tendons and muscles glide and move smoothly. The largest nerve in the body (sciatic nerve) passes through the pelvis into the leg.

Hip Problems

Hip problems may develop from overuse, bone changes with age, tumors, infection, changes in the blood supply, or a problem that was present from birth (congenital). Oddly enough, a person who has a hip problem often feels pain in the knee or thigh instead of the hip. Hip problems include:

The type of hip pain you have may help your health professional determine the cause of your pain.

Pain when resting does not increase with motion or standing. This type of pain is usually caused by a less severe problem, unless the pain does not go away or awakens you from sleep.

Pain with movement increases when you move the hip or leg but does not increase when you stand or bear weight. This type of pain is most often caused by a muscle injury, inflammation, or infection.

Pain with weight-bearing increases when you stand or walk and may cause you to limp. This type of pain usually means you have a problem with the hip joint itself. Pain that is severe enough to prevent any weight-bearing is more likely to mean a serious bone or joint problem.

Pelvic, groin, thigh, or knee pain (referred pain) may be present along with a sore, painful, or tender hip. Hip pain can have many causes.

What is a migraine headache?

A migraine headache is a form of vascular headache. Migraine headache is caused by vasodilatation (enlargement of blood vessels) that causes the release of chemicals from nerve fibers that coil around the large arteries of the brain. Enlargement of these blood vessels stretches the nerves that coil around them and causes the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the arteries magnifies the pain.

Migraine attacks commonly activate the sympathetic nervous system in the body. The sympathetic nervous system is often thought of as the part of the nervous system that controls primitive responses to stress and pain, the so-called "fight or flight" response, and this activation causes many of the symptoms associated with migraine attacks; for example, the increased sympathetic nervous activity in the intestine causes nausea, vomiting, and diarrhea.

Sympathetic activity also delays emptying of the stomach into the small intestine and thereby prevents oral medications from entering the intestine and being absorbed.

The impaired absorption of oral medications is a common reason for the ineffectiveness of medications taken to treat migraine headaches.

The increased sympathetic activity also decreases the circulation of blood, and this leads to pallor of the skin as well as cold hands and feet.

The increased sympathetic activity also contributes to the sensitivity to light and sound sensitivity as well as blurred vision.

Migraine afflicts 28 million Americans, with females suffering more frequently (17%) than males (6%). Missed work and lost productivity from migraine create a significant public burden. Nevertheless, migraine still remains largely underdiagnosed and undertreated. Less than half of individuals with migraine are diagnosed by their doctors.

What is a headache?

Headache is defined as pain in the head or upper neck. It is one of the most common locations of pain in the body and has many causes.

How are headaches classified?

Headaches have numerous causes, and in 2007 the International Headache Society agreed upon an updated classification system for headache. Because so many people suffer from headaches, and because treatment is sometimes difficult, the new classification system allows health care practitioners to understand a specific diagnosis more completely to provide better and more effective treatment regimens.

There are three major categories of headaches:

Primary headaches, Secondary headaches, and Cranial neuralgias

Facial pain, and other headaches.

What are primary headaches?

Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.

Tension headaches

The most common type of primary headache; as many as 90% of adults have had or will have tension headaches. Tension headaches are more common among women than men.

Migraine headaches

The second most common type of primary headache. An estimated 28 million people in the United States (about 12% of the population) will experience migraine headaches. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. An estimated 6% of men and up to 18% of women will experience a migraine headache.

Cluster headaches

A rare type of primary headache, affecting 0.1% of the population. An estimated 85% of cluster headache sufferers are men. The average age of cluster headache sufferers is 28-30 years of age, although headaches may begin in childhood.

Primary headaches affect quality of life. Some people have occasional headaches that resolve quickly, while others are debilitated. Tension, migraine, and cluster headaches are not life-threatening.

What are secondary headaches?

Secondary headaches are those that are due to an underlying structural problem in the head or neck. There are numerous causes of this type of headache ranging from bleeding in the brain, tumor, or meningitis and encephalitis.

What are cranial neuralgias, facial pain, and other headaches?

Neuralgia means nerve pain (neur= nerve + algia=pain). Cranial neuralgia describes a group of headaches that occur because the nerves in the head and upper neck become inflamed and are the source of the head pain. Facial pain and a variety of other causes for headache are included in this category.

What causes tension headaches?

While tension headaches are the most frequently occurring type of headache, their cause is not known. The most likely cause is contraction of the muscles that cover the skull. When the muscles covering the skull are stressed, they may spasm and cause pain. Common sites include the base of the skull where the trapezius muscles of the neck inserts, the temple where muscles that assist the jaw to move are located, and the forehead. There is little research to confirm the exact cause of tension headaches. Tension headaches occur because of physical or emotional stress placed on the body. Physical stress that may cause tension headaches include difficult and prolonged manual labor, or sitting at a desk or computer for long periods of time Emotional stress may also cause tension headaches by causing the muscles surrounding the skull to contract.

What are the symptoms of tension headaches?

The symptoms of tension headache are:

A pain that begins in the back of the head and upper neck as a band-like tightness or pressure. Described as a band of pressure encircling the head with the most intense pain over the eyebrows. The pain is usually mild (not disabling) and bilateral (affecting both sides of the head). Not associated with an aura (see below) and are not associated with nausea, vomiting, or sensitivity to light and sound. Usually occur sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people. Most people are able to function despite their tension headaches.

How are tension headaches treated? Tension headaches are painful, and often patients are upset that the diagnosis is "only" a tension headache. Though it is not life-threatening, a tension headache can affect daily life activities. Most people successfully treat themselves with over-the-counter (OTC) pain medications to control tension headaches. The following work well for most people:

  • Aspirin
  • Ibuprofen (Motrin, Advil)
  • Acetaminophen (Tylenol)
  • Naproxen (Aleve)

If these fail, other supportive treatments are available. Recurrent headaches should be a signal to seek medical help. Massage, biofeedback, and stress management can all be used as adjuncts to help with headache control. It is important to remember that OTC medications, while safe, are medications and may have side effects and potential interactions with prescription medications. It is always wise to ask your health care practitioner or pharmacist if you have questions about OTC medications and their use. This is especially important with OTC pain medications, because patients use them so frequently. It is important to read the ingredient listing of OTC pain medications. Often an OTC medication is a combination of ingredients, and the second or third ingredient may have the potential for drug interaction or contraindication with medications the patient is currently taking. For example: Some OTC medications include caffeine, which may trigger rapid heartbeats in some patients. In night time preparations, diphenhydramine (Benadryl) may be added. This may cause drowsiness and driving or using heavy machinery may not be appropriate when taking the medication. Other examples were caution should be used include the following: Aspirin should not be used in children and teenagers because of the risk of Reye's Syndrome, a disease where coma, brain damage, and death can occur with a viral like illness and aspirin use. Aspirin and ibuprofen are irritating to the stomach and may cause bleeding. They should be used with caution in patients who have peptic ulcer disease or who take blood thinners like warfarin (Coumadin) and clopidogrel bisulfate (Plavix). Acetaminophen, if used in large amounts, can cause liver damage or failure. It should be used with caution in patients who drink significant amounts of alcohol or who have liver disease. One cause of chronic tension headaches is overuse of medications for pain. When pain medications are used for a prolonged time, headaches can recur as the effects of the medication wear off. Thus, the headache is a symptom of medication withdrawal (rebound headache).

What causes cluster headaches?

The cause of cluster headaches is uncertain. It may be that certain parts of the brain begin to malfunction for an unknown reason. The hypothalamus, an area located at the base of the brain is responsible for the body's biologic clock and may be the part of the brain that is the source for the headaches. When brain scans are performed on patients who are in the midst of a cluster headache, there is abnormal activity in the hypothalamus.

Cluster headaches also:

  • Tend to run in families and this suggests that there may be a genetic role.
  • May be triggered by changes in sleep patterns.
  • May be triggered by medications (for example, nitroglycerin, used for heart disease).
  • If the patient is in a susceptible period for cluster headache, cigarette smoking, alcohol, and some foods (for example, chocolate) can precipitate the headache.

What are the symptoms of cluster headaches?

Cluster headaches are headaches that come in groups (clusters) lasting weeks or months, separated by pain-free periods of months or years. During the period in which the cluster headaches occur, pain typically occurs once or twice daily, but some patients may experience pain more than twice daily. Each episode of pain lasts from 30 minutes to an hour and a half. Attacks tend to occur at about the same time every day and often awaken the patient at night from a sound sleep. The pain typically is excruciating and located around or behind one eye. Some patients describe the pain as feeling like a hot poker in the eye. The affected eye may become red, inflamed, and watery. The nose on the affected side may become congested and runny. Unlike patients with migraine headaches, patients with cluster headaches tend to be restless. They often pace the floor, bang their heads against a wall, and can be driven to desperate measures. Cluster headaches are much more common in males than females.

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