Pain Medicines and Kidney Disease
Your Kidneys & Liver Remove Drug Wastes
When you take medicines, your body breaks them down as they are used, and wastes are created. These wastes must be removed from your blood or they could build up to unsafe levels. Your liver and your kidneys remove drug wastes. Which organ does the work depends on the drug. This is true for pain medicines, too.
If you take a pain medicine like morphine that is removed by your kidneys, harmful wastes may build up in your blood if your kidneys don’t work well. Each pill may last longer. But, to avoid harm, your doctor may need to change your dose or your medicine. This is true even if you have been taking the same pain medicine for a long time.
Talk with your doctor about your pain control with kidney disease. For mild pain that you just have once in a while, ask your doctor if over-the-counter acetaminophen is a good choice.
Non-steroidal anti-inflammatory pain pills, or NSAIDS, are a rare cause of kidney failure—most often if they are taken daily for a year or more. Most NSAIDS are over-the-counter, like naproxen and ibuprofen. Avoid NSAIDS as much as you can.
Some NSAIDS are prescribed by a doctor. These prescription NSAIDs include:
Talk to your care team about pain treatment that’s safe for you to use and won’t hurt your kidneys.
NSAIDs can cause chronic kidney disease (CKD) or make it get worse faster. If you have CKD, it’s best for your kidneys if you don’t take these for daily pain relief. Talk to your care team about other options to manage your pain.
Pain Management with Heat and Cold
Some types of pain can be helped with heat, cold, or switching between the two. Never use heat for more than 20 minutes at a time—it could cause nerve damage.
Keep ice in a bag or towel so it does not touch your skin. Never use ice for more than 15 or 20 minutes at a time—you could get frostbite.
Don’t use the hottest setting of a heating pad if you have diabetes. If you are not sure how to use ice or heat safely to help relieve pain, talk to your care team.
Pain Management at the VA
The VA is a leader in pain control. The health psychology and pain management departments have many ways to help manage pain. Learn more about VA pain management services. They may be able to help you reduce the dose or numbers of medications you need, and help you to feel more in control.
Transcutaneous Electrical Nerve Stimulation (TENS)
A TENS unit can be used to stimulate nerves through the skin and block pain. Sometimes medicine can be given through the skin using the electrode pads. It can be helpful for chronic pain and for nerve pain in some people. If you have a pacemaker, using TENS may not be wise. Talk to your care team to learn whether TENS might help your pain.
Biofeedback May Help You Control Pain
You may be able to learn how to control the process that leads to your pain—so you have less pain. How? Through biofeedback.
First, you learn to be aware of what is going on in your body that leads to the pain. This can be done by using sensors to measure your heart rate, breathing rate, and skin temperature. You will get feedback in your patterns through a noise or a computer screen. Then, you can learn to change the patterns by watching the feedback. In time, you will be able to change your patterns without needing the feedback.
Biofeedback may help chronic pain, headaches, low back pain, anxiety, and many other problems. Talk with your VA care team if you think biofeedback might be helpful for you.
Treating Pain with Acupuncture
It may sound odd, but acupuncture and acupressure have helped people with many kinds of health problems, including pain. Acupuncture is a type of traditional Chinese medicine. Its aim is to affect the flow of energy or “Qi” (“chi”) in the body. It has been used for thousands of years and studies have found that it can help pain and nausea.
When you have a kidney problem, don’t take Chinese herbs—they can contain products that can damage your kidneys or liver. The VA can help you get acupuncture—talk to your VA care team if this is something that you think might help you.
Having chronic kidney disease may mean that you need a change in your pain medications:
Not scored If your pain medication is broken down and removed from your body by your kidneys, it could build up in your blood to unsafe levels. You may need a lower dose or a different drug.
Medications are broken down by your:
Not scored Either the kidneys, liver, or both break down medications.
You only need to tell your care team about prescription pain pills you take:
Not scored It’s vital to tell your care team about ALL medications you take. This means herbal products, folk remedies, and over the counter drugs, too.
Some other ways that can help manage pain besides medications include:
Not scored Pain relief does not always have to come out of a prescription bottle. The VA has pain clinics that can help you. Talk with your care team if you need help with pain.
It’s safest to avoid Chinese herbs, because they could harm your kidneys:
Not scored Chinese herbs may contain products that could damage your kidneys. Don’t risk it.