It Doesn’t Have to Hurt: 10 Ways to Help Relieve Pain

2. Healing with ‘MEAT’

You’ve probably heard of RICE — rest, ice, compression and elevation — and may have even used it to treat a strained muscle or painful bruise. Recently, though, a growing consensus suggests the better option is to replace RICE with MEAT, which stands for movement, exercise, analgesia and treatment.

Here’s why. The downside of RICE is that it tamps down short-term inflammation. Normally, we think of inflammation as a bad thing — and that’s true, when we’re talking about chronic inflammation. 

Chronic inflammation, which occurs throughout the body, can cause pain directly by attacking the tissues — for example, in the case of arthritis, a painful condition associated with chronic inflammation — and it can also lead to diseases, from heart disease to cancer, that can inflict pain on us. 

But acute inflammation — meaning the swelling and redness that occur at the site of an injury — is actually beneficial to our healing process. While dialing down inflammation may initially ease pain, it also can delay or inhibit long-term tissue healing. 

Given what we now know, RICE should no longer be the blanket recommendation for pain management. Instead, the emphasis is now on these four steps:

• Movement: Mild movement or exercise improves blood flow and circulation of healing agents to the injured area, stimulating muscle, tendons, ligaments and other tissue.
• Exercise: For a muscle injury, this would involve gentle moves designed to slowly restore function and flexibility. For other types of soft tissue that are bruised or swollen from, for example, surgery or trauma, mild exercise further improves circulation.
• Analgesia: Cautious use of pain relievers or natural anti-inflammatories such as turmeric or capsaicin, which may inhibit healing for the reasons already described. Also consider topical anesthetics and analgesic patches.
• Treatment: This might include physical therapy, massage, acupuncture or less-familiar therapies such as “dry needling,” myofascial release (and other techniques using targeted massage to release tension in a specific muscle area) and joint mobilization (to improve range of motion).

3. Temperature therapy

Heat and cold can both help relieve pain, though they work in different ways and are best for different situations.

Cold therapy, such as an ice pack, is best for short-term pain, applied within the first 72 hours to counter swelling. Keep in mind that while cold temperature slows blood flow, which can help reduce pain from sprains, strains and other acute injuries, it may also decrease inflammation, slow healing and increase the likelihood of chronic pain.

Heat therapy, such as a heating pad, is best for long-standing muscle pain, stiffness and chronic pain conditions. Because it boosts blood flow, which can help relax muscles and ease aching joints, heat therapy is often recommended before exercise or stretching or to ease morning stiffness.

4. Supplements

People are turning increasingly to dietary supplements, seeking out substances they perceive as natural. Unfortunately, because there are very few good, randomized trials, it’s hard to find solid evidence of the benefits of this approach. Still, here are a few supplements worth considering:

• Coenzyme Q10, or CoQ10: There is evidence that this coenzyme can improve mitochondrial function within cells, thereby boosting cellular energy, and also act as an anti-inflammatory. It may also effectively lower systolic blood pressure.
• Magnesium: Evidence exists that this simple mineral, which is found in all our bones, can help with pain, particularly in the lower back. By blocking calcium from entering cells, magnesium may reduce the excitability of your muscles, allowing them to relax and reduce spasm, especially after exercise.
• Turmeric: The active ingredient, curcumin, is thought to be a potent anti-inflammatory and may be effective for osteoarthritis of the knees. It has been found to help reduce the symptoms of irritable bowel syndrome. In lab experiments, however, turmeric inhibited some chemotherapy drugs from working against breast cancer cells and also increased the risk of kidney stones, so check with your doctor before taking it.
• Willow bark: The active ingredient in willow bark is salicin, which is similar to aspirin. It is broken down into salicylic acid in the body, which helps decrease pain and fever but, like aspirin, may have side effects such as upset stomach and bleeding problems.

5. Nonopioid analgesic medications

Let’s take a look in your medicine cabinet and get a real sense of what’s on hand.

Acetaminophen (paracetamol), found in Tylenol, FeverAll, Panadol: An analgesic medication that works in the brain to increase the body’s pain threshold and change the way the body senses pain. It also works to bring down fever and regulate body temperature.

• Best for: Headaches, muscle aches, sore throat, toothaches, backaches, sprains and strains. Best painkiller for people with gastrointestinal issues.
• Don’t use for: Nerve pain or inflammatory conditions.
• Avoid if: You are a heavy drinker or have existing liver issues. Take no more than 1,000 milligrams (mg) at a time, and no more than 4,000 mg over a 24-hour period, to avoid liver issues.

Ibuprofen (Advil, Motrin, Midol), Naproxen (Aleve, Naprosyn, Naprelan): Nonsteroidal anti-inflammatories (NSAIDs) that reduce fever and block prostaglandins — compounds that cause pain and inflammation. Consult your doctor to determine the dosage and frequency of use that is best for you.

• Best for: Headaches, musculoskeletal pain, arthritis, toothaches, backaches and sunburn. These may be safer choices than aspirin for those with bleeding risk but are still associated with gastrointestinal issues.
• Don’t use for: Nerve pain.
• Avoid if: You take blood thinners or have uncontrolled high blood pressure, heart failure, ulcers, or liver or kidney disease.

Aspirin: An NSAID that stops the production of prostaglandins, which cause pain and inflammation. It also reduces fever and blood clotting.

• Best for: Headaches, arthritis, toothaches, muscle aches, sprains, strains.
• Don’t use for: Wounds or bruises (aspirin may promote bleeding) or nerve pain.
• Avoid if: You take blood thinners or have uncontrolled high blood pressure, kidney disease, ulcers or other bleeding risks.

Topical pain relievers: Analgesics that temporarily relieve pain at the skin’s surface. A topical NSAID called diclofenac sodium topical gel 1 percent (Voltaren, and over the counter as a generic drug) can be effective for joint pain.

• Best for: Nerve pain and soft-tissue injuries.
• Don’t use for: Wounds or open sores.
• Avoid if: You are allergic to lidocaine, aspirin or NSAIDs, or if you have liver or heart issues.

An important reminder: Always tell your doctor about any supplements you’re taking, as even over-the-counter products might cause concerning drug interactions.

6. Nonopioid prescriptions

We’ve seen remarkable progress since the days when opioids and steroids were used to treat most pain maladies. For example:

Sodium channel blockers: Just this year, the FDA approved Journavx, the first drug in a new class of nonopioid pain medicines. While opioids primarily work by dulling sensations in the brain, the new drug, in 50 mg oral tablets, is reported to reduce pain by targeting a pain-signaling pathway in the peripheral nervous system, before the pain signals reach the brain.

The discovery of this drug has a fascinating backstory. More than two decades ago, researchers learned about a boy in Pakistan who could walk on hot coals without flinching. Researchers found and examined three families from the same region with offspring who could not feel pain. 

It wasn’t that they were numb. Rather it was just the pain-conducting nerves that were affected. That observation led to further investigation, the identification of a gene mutation unique to these families, and ultimately helped inspire the development of the new medication.

Gabapentin: Originally developed as an anticonvulsant, it helps manage neuropathic pain by regulating how pain messages travel from the brain through the spinal cord and reducing the excitability of nerve cells in the brain. Gabapentin (sold under the brand names Horizant, Gralise and Neurontin) was approved for treatment of neuropathic pain more than 20 years ago, but it is far from a perfect drug. It works best for postherpetic neuralgia (a complication of shingles); evidence for other types of neuropathic pain is very limited.

Antidepressants: It’s not clear why they help relieve pain for some people. What is clear is that they take a long time to work, sometimes up to several weeks, and even then, not every drug works for every issue. A 2023 meta-analysis concluded that “the only antidepressant we are certain about for the treatment of chronic pain is duloxetine [Cymbalta]. Duloxetine was moderately efficacious across all outcomes at standard dose.”

7. Medical interventions and medication management

The following are some of the many available options for pain relief and management:

Neuromodulation, including spinal cord stimulation, an implanted device that sends low levels of electricity directly into the spinal cord to relieve pain; deep brain stimulation; and local (external) electrical stimulation, applying brief pulses of electricity to nerve endings under the skin to provide pain relief (Scrambler Therapy, TENS).

Injection therapies, in which medication is injected directly into the site of the discomfort. These include epidural steroid injections, nerve blocks, joint injections and trigger point injections.

Dry needling, which can be initially painful, involves placing thin, sharp needles through the skin and into what are known as “trigger points,” areas of muscle that have become knotted and tender. The needling can decrease tightness, improve blood flow and reduce pain. It’s called “dry” because there are no medications in the needle.

Non-painkiller injections. They may include:

• Botox
• Gel injections (hyaluronic acid to mimic cushioning fluid in joints), often used for knee pain, such as mild to moderate arthritis
• Prolotherapy injections (concentrated sugar water to relieve pain in joints, ligaments and tendons)
• Regenerative medicine (orthobiologics): a newer category, including injectables made from your own blood or tissue, or application of dressings using biomaterials (such as placenta), used to restore tissue in skin grafts and other wound or surgical sites
• Platelet-rich plasma injections and cell therapy: PRP injections involve taking the patient’s blood, isolating and concentrating the platelets, and injecting billions of them into the joint, ligament or tendon. Some newer injectables, called cell therapies, collect cells and tissues from bone marrow or fat tissue. The cells are collected, cleansed and injected into the patient’s joint, ligament or tendon.

8. Psychological approaches

Clinical hypnosis (with a trained therapist), self-hypnosis, mindfulness-based pain management and other mind-body approaches are among several techniques that have been shown to help some people not only manage pain but also improve sleep, eating habits, exercise choices to support a more active lifestyle, and relationship dynamics. The most frequently applied therapy approaches include:

• Cognitive behavioral therapy for chronic pain
• Acceptance and commitment therapy
• Pain reprocessing therapy
• Emotional awareness and expression therapy

Options for psychological services are growing dramatically as the medical community has awakened to their value and the need to make them more accessible for patients. In addition to one-on-one therapy and group therapy, other options are programs or sessions by telehealth, online, apps and other digital platforms.

9. Cannabis and ketamine

In some treatment areas — including certain types of epilepsy, symptoms of multiple sclerosis, nausea and opioid use disorder — cannabis may be effective. 

When it comes to pain, however, the data is less compelling. And of course, cannabis is not legal for use everywhere. 

After reviewing several randomized controlled trials, here’s how I’d summarize the findings: Some studies suggest cannabis use may provide some relief for chronic pain; however, results are mixed. There were other benefits, such as patients opting for smaller doses of opiates, suggesting a synergistic effect of cannabis with other pain meds. Wherever you come down on the idea of cannabis use for pain, you should talk with your doctor about it.

Ketamine is not a new drug, even if you’ve just started hearing about it. In the 1970s, it was used as a battlefield anesthetic during the Vietnam War. In recent years, however, there has been research into using ketamine as a possible treatment for depression, post-traumatic stress disorder and chronic pain. 

In 2019, researchers published a systematic review and meta-analysis of randomized controlled trials evaluating the effectiveness of intravenous ketamine for those with chronic pain. The conclusion was that while ketamine provides significant short-term analgesic benefit in these patients, larger, multicenter studies with longer follow-ups were needed.

10. Acupuncture, yoga, meditation and more

Complementary and integrative health options round out your toolbox. These health approaches are not just for pain. They’re used to improve sleep, stress management, general wellness, energy and immune health — all of which play a role in pain. 

Think of it as engaging the body’s own resources, from our naturally occurring endogenous opioids to the brain’s learning processes, as well as therapies and practices that engage those processes on command — our personal command.

We need to continue to frame pain management and prevention in the context of our own biological and behavioral arsenal, rather than solely on the conventional focus on pills, patches, needles and procedures.

Adapted from It Doesn’t Have to Hurt: Your Smart Guide to a Pain-Free Life by Sanjay Gupta, M.D. Copyright © 2025 by Sanjay Gupta, M.D. Reprinted by permission of Simon & Schuster, Inc. All rights reserved.