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Pain Medicines and Kidney Disease

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man standing with difficulty


Treating Pain

If you take medications for pain, having kidney disease, too, may mean that your doctor will need to make changes to your pain management.

location of kidneys and liver in the body


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.

bottle of NSAIDs with flashing warning symbol


Avoid NSAIDs

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:

  • Indomethacin
  • Piroxicam
  • Nabumetone
  • Celecoxib

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.

hot or cold water bag


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.

smiley face, frown face


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.

woman getting back massage


Pain Relief with Massage

Therapeutic massage can help problems like neck and back pain. Studies have found that people who get massage treatments for these problems have less pain and more function than those who don’t. Massage is just one type of pain treatment the VA can offer you if you need it.

nerve stimulator hooked on a mans arm


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.

man with biofeedback monitors attached to forehead


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.

acupuncture needles


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.


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