Overview of adjuvants for pain management

Adjuvants are drugs with analgesic properties, although pain is not their primary indication. They reduce pain by either inhibiting pain transmission (eg inhibiting noradrenaline reuptake reduces neuropathic pain), or modulating central sensitisation. There is evidence for the use of adjuvants for neuropathic pain and as a component of multimodal analgesia following surgery or trauma (where they work by reducing central sensitisation). There is limited evidence for their use for nociplastic pain—they provide limited analgesic benefit and efficacy varies according to the condition (eg chronic low back pain, fibromyalgia). Always combine adjuvants with nonpharmacological approaches.

See here for commonly used adjuvants in pain management. Specialist input is often required for less commonly used adjuvants, and adjuvant use in children.