Medication and Nonmedicine Pain Options: A Shared-Decision Worksheet

By the Pain Care Questions Team

A shared-decision worksheet helps you compare medication and nonmedicine pain options with your clinician by writing down your goals, what the evidence says, what is still unknown, and the safety questions that matter for you. It does not pick a treatment for you. It helps you and your care team make that choice together, using the same information.

A worksheet is for planned conversations. If your pain is sudden and severe, or comes with symptoms that feel like an emergency, contact local emergency services now. Do not wait to fill out a form.

By Pain Care Questions Editorial Team. Updated September 23, 2026.

New to this site? Our Start Here page explains what Pain Care Questions covers and what it does not.

Why Your Own Goals Belong in Pain Decisions

The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”

IASP’s notes on that definition show why pain choices are personal:

Pain is always personal. IASP says it is influenced “to varying degrees by biological, psychological, and social factors.”
Pain and nociception are different. IASP defines nociception as “the neural process of encoding noxious stimuli,” meaning stimuli that damage or threaten to damage normal tissue. IASP notes that pain “cannot be inferred solely from activity in sensory neurons.”
Your report matters. IASP states that “a person’s report of an experience as pain should be respected.”
Pain can affect more than the body. IASP notes it may have adverse effects “on function and social and psychological well-being.”

This worksheet is built on that idea. Your experience, goals, and limits are part of the information your care team needs.

Three Pain Terms You May Hear

Your clinician may use one of these IASP terms. Knowing them can help you ask sharper questions. Only a clinician can say which one, if any, applies to you.

Nociceptive pain: pain from actual or threatened damage to tissue that is not nerve tissue, through activation of nociceptors (sensory receptors that respond to stimuli that damage or threaten to damage tissue).
Neuropathic pain: pain caused by a lesion or disease of the somatosensory nervous system. IASP explains that “somatosensory” refers to information about the body itself, including internal organs, rather than information about the outside world such as vision or hearing.
Nociplastic pain: pain from altered nociception without clear evidence of tissue damage or nerve disease causing it.

The Evidence Ladder: How to Read What Research Says

Evidence summaries use careful words. “Strongly recommends” and “may be helpful” do not mean the same thing. This ladder uses real examples from the National Center for Complementary and Integrative Health (NCCIH) summary of complementary approaches for chronic pain, from strongest support down to recommendations against.

Top rung: a guideline strongly recommends it. Example: NCCIH reports that the guideline from the American College of Rheumatology and the Arthritis Foundation strongly recommends tai chi for managing osteoarthritis of the knee or hip.
Moderate-quality evidence, but a small benefit. Example: NCCIH reports that mindfulness-based stress reduction is associated with a small improvement in chronic low-back pain, and that the American College of Physicians (ACP) guideline recommends it as an option based on moderate-quality evidence.
Low-to-moderate or weak evidence. Example: NCCIH describes low-to-moderate quality evidence that spinal manipulation can reduce pain and improve function in chronic nonspecific neck pain, and only weak evidence that massage may help low-back pain.
Unclear. Example: for fibromyalgia, NCCIH says the effectiveness of biofeedback, mindfulness, movement therapies, and relaxation-based therapies is unclear because the evidence quality is low.
Bottom rung: a guideline recommends against it. Example: NCCIH reports that the American College of Rheumatology and Arthritis Foundation guideline strongly recommends against glucosamine for osteoarthritis of the hand, hip, or knee, because studies with the lowest risk of bias have not shown it works better than a placebo.

Two points matter when you use this ladder:

Evidence depends on the condition. The same approach can rank differently for different kinds of pain. NCCIH reports that a large review found acupuncture more effective than no treatment or sham acupuncture for back or neck pain, while the evidence suggests it is no more effective than sham acupuncture for irritable bowel syndrome symptoms, though it may help when used in addition to other treatment.
Benefit and safety are separate questions. A high rung for benefit does not mean an option is safe for you. Ask about both.

Want to know how we choose and check sources like these? See How We Research and Use Sources.

Known Versus Unknown: What This Page Can and Cannot Tell You

What the sources support

NCCIH reports that, based on the 2019 National Health Interview Survey, about 20.4 percent of U.S. adults had chronic pain (pain on most days or every day in the past 3 months), and about 7.4 percent had high-impact chronic pain.
NCCIH says psychological and physical complementary approaches, such as acupuncture, massage, mindfulness, spinal manipulation, tai chi, and yoga, are generally safe for healthy people when performed appropriately, but people with medical conditions and people who are pregnant may need to modify or avoid some of them.
NCCIH notes that movement-based practices such as tai chi and yoga can cause sore muscles and may involve some risk of injury.
NCCIH warns that “natural” does not always mean safe. Some dietary supplements may have side effects and may interact with medicines.
NCCIH reports that the U.S. Food and Drug Administration has warned the public about several supplements promoted for arthritis or pain that were tainted with prescription drugs.

What stays unknown until you talk with your clinician

Which type of pain you have, and what is causing it.
Which medicines are appropriate for you. The NCCIH page used here focuses on complementary approaches. It does not grade prescription or over-the-counter pain medicines, so this worksheet gives you questions about medicines, not answers.
How any option might interact with your current medicines, supplements, or health conditions.
Whether an option will help you. Ask how the research findings apply to someone with your condition and health history.

The Shared-Decision Worksheet

Copy these prompts onto paper or into a notes app. Fill in what you can before your visit. Leave blanks for what you want to ask.

Part 1: My pain in my own words

Where I feel pain, and how long I have had it:
Words that describe it (for example, aching, burning, sharp, or throbbing):
What makes it better or worse:
How it affects sleep, work, mood, movement, and time with others:

Part 2: My goals

One daily activity I want to do more easily:
What matters most to me right now (for example, less pain, better function, fewer side effects, or less time and cost):
What I am not willing to trade off:

Part 3: Everything I currently use

Prescription medicines, with doses:
Over-the-counter medicines:
Dietary supplements, herbs, and cannabis products:
Nonmedicine approaches I use or have tried (for example, exercise, yoga, massage, or relaxation techniques), and how they went:

Bring the full list. NCCIH advises telling the health care providers you see for chronic pain about any product or practice you are considering.

Part 4: Options to discuss

For each option your clinician raises, or that you want to ask about, write down:

Option name, and whether it is a medicine or a nonmedicine approach:
Where it sits on the evidence ladder for my kind of pain:
Possible benefits, in plain words:
Possible side effects, risks, or interactions:
Time, effort, travel, and cost involved:
How we will judge whether it is helping, and when we will check:

Part 5: Questions about medicines

What is this medicine meant to do for my pain?
What side effects should I watch for, and which ones mean I should call you?
Does it interact with anything on my Part 3 list?
How long before we know whether it is helping?
If I want to change or stop it later, what is the safe way to plan that with you?

Part 6: Questions about nonmedicine approaches

What does the research say about this approach for my specific kind of pain?
Do I need to modify or avoid it because of a health condition or pregnancy?
Could it be used alongside my current care?
If it involves a practitioner, what training and experience should I look for? NCCIH suggests asking a trusted source, such as your health care provider or a nearby hospital, to recommend a practitioner.
If it is a supplement, could it interact with my medicines?

Next-Step Checklist

Fill in Parts 1 through 3 before your appointment.
Circle your top one or two goals from Part 2.
Bring your complete medicine and supplement list, or the bottles themselves.
Ask where each option sits on the evidence ladder for your condition.
Ask about benefit and safety as two separate questions.
Write down the plan, who to contact with concerns, and when you will review progress.
Do not start, stop, or change any medicine or supplement without talking with your clinician first.

Sources

International Association for the Study of Pain. Terminology.
National Center for Complementary and Integrative Health. Chronic Pain and Complementary Health Approaches: Usefulness and Safety. Last updated January 2023.

About This Page

This article is general educational information, not medical advice. It does not diagnose conditions, recommend treatments, or replace care from a qualified health professional. Talk with your clinician before making any change to your pain care.

Pain Care Questions is an independent educational publication. It is not a pain clinic, treatment center, health care provider, or referral service, and it is not connected to any business that previously used this web address.