Still in Pain? How Ketorolac Works and Medically Approved Next Steps

If you're still in pain despite treatment, you may be wondering whether your medication is working — or whether something more serious is going on. One medication often prescribed for short‑term, moderate to severe pain is ketorolac. Understanding how ketorolac works, what it can (and cannot) do, and when to take the next step medically can help you make informed decisions about your health.

Below is a clear, medically grounded explanation based on trusted clinical guidance.

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What Is Ketorolac?

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID). It is commonly used for:

• Post-surgical pain
• Kidney stone pain
• Severe musculoskeletal injuries
• Acute flare-ups of inflammatory conditions

It is not an opioid, but it is considered a strong NSAID. Because of its potency and potential side effects, ketorolac is typically prescribed for short-term use only (no more than 5 days in most cases).

Ketorolac may be given as:

• An injection (often in hospitals or urgent care)
• An oral tablet (for short-term continuation after injection)
• An eye drop (for certain eye conditions)

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How Ketorolac Works in the Body

Ketorolac reduces pain by blocking enzymes called COX-1 and COX-2. These enzymes help produce substances called prostaglandins, which play a key role in:

• Causing inflammation
• Triggering pain signals
• Promoting fever

By lowering prostaglandin production, ketorolac:

• Reduces inflammation
• Decreases swelling
• Lowers pain intensity

Unlike opioids, ketorolac does not act on the brain's pain receptors in the same way. Instead, it works at the source of inflammation.

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Why You Might Still Be in Pain

If you're taking ketorolac and still hurting, several possibilities exist.

1. The Underlying Cause Hasn't Resolved

Ketorolac treats symptoms — not the root cause. For example:

• A kidney stone may still be passing
• Surgical tissues are still healing
• An infection may need antibiotics
• A fracture may need stabilization

If pain persists beyond the expected recovery period, further evaluation may be needed.

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2. The Pain Type May Not Respond Well to NSAIDs

Ketorolac works best for inflammatory pain. It may be less effective for:

• Nerve pain (burning, tingling, electric sensations)
• Severe structural damage
• Certain cancer-related pain
• Advanced joint degeneration

If pain feels sharp, shooting, or nerve-like, your doctor may consider other medications.

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3. The Dose or Duration May Be Limited

Because ketorolac carries higher risks than many other NSAIDs, doctors limit:

• Duration (usually no more than 5 days total)
• Dosage
• Use in certain populations

It is not meant for chronic, long-term pain management.

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Important Safety Information About Ketorolac

Ketorolac is effective — but it is not risk-free. Understanding the risks helps explain why it's prescribed carefully.

Gastrointestinal Risks

Ketorolac increases the risk of:

• Stomach ulcers
• Bleeding
• Perforation (rare but serious)

Risk is higher in:

• Adults over 65
• People with a history of ulcers
• Those taking blood thinners
• Long-term NSAID users

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Kidney Effects

Ketorolac can reduce blood flow to the kidneys, especially in people with:

• Dehydration
• Heart disease
• Pre-existing kidney disease
• Older age

Kidney injury is uncommon with short-term use in healthy individuals but remains a known risk.

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Cardiovascular Risk

Like other NSAIDs, ketorolac may increase risk of:

• Heart attack
• Stroke

This risk is higher with prolonged use and in people with existing heart disease.

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When Pain May Signal Something More Serious

Persistent or worsening pain should not be ignored.

Seek medical evaluation if you have:

• Pain that worsens despite medication
• Unexplained weight loss
• Night pain that wakes you from sleep
• Swelling that does not improve
• Fever with pain
• Blood in stool or vomit
• Severe abdominal pain

If your pain feels deep, constant, and unexplained — especially if it is worsening — it's important to rule out serious causes.

In some cases, persistent pain that doesn't respond to standard medications may be related to underlying serious conditions. If you're experiencing unexplained or worsening pain and are unsure whether it requires urgent attention, Ubie's free AI-powered Cancer Pain symptom checker can help you understand your symptoms and determine whether you should seek medical evaluation right away.

This tool is not a diagnosis, but it can help you decide whether to seek medical care.

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Medically Approved Next Steps If Ketorolac Isn't Enough

If your pain continues, doctors may consider several evidence-based strategies.

1. Reassess the Diagnosis

Your provider may:

• Repeat imaging (X-ray, CT, MRI)
• Order blood work
• Evaluate for infection
• Refer you to a specialist

Correct diagnosis is essential for proper treatment.

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2. Adjust Medications

Depending on your condition, your doctor may consider:

• Switching to another NSAID
• Adding acetaminophen (if appropriate)
• Prescribing a short course of opioids (in select cases)
• Using nerve-targeting medications (gabapentin, duloxetine)
• Prescribing muscle relaxants
• Using corticosteroids for inflammatory conditions

Medication plans are individualized.

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3. Add Non-Drug Therapies

Evidence supports combining medication with:

• Physical therapy
• Ice or heat therapy
• Gentle movement
• Massage
• Cognitive behavioral therapy for chronic pain
• Guided exercise programs

These approaches can significantly improve outcomes.

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4. Evaluate for Chronic Pain

If pain lasts more than 3 months, it may be considered chronic. Chronic pain often requires:

• Multidisciplinary management
• Lifestyle adjustments
• Sleep optimization
• Mental health support
• Long-term care planning

Short-term drugs like ketorolac are not appropriate for chronic use.

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Who Should Avoid Ketorolac?

Ketorolac is generally avoided in:

• Pregnant individuals (especially third trimester)
• People with active stomach ulcers
• Those with significant kidney disease
• Patients with recent gastrointestinal bleeding
• Individuals undergoing coronary artery bypass surgery
• People allergic to NSAIDs

Always inform your doctor about:

• Blood thinners
• Steroids
• High blood pressure
• Heart disease
• Prior ulcer history

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Signs You Need Immediate Medical Attention

Call emergency services or seek urgent care if you experience:

• Black or tarry stools
• Vomiting blood
• Severe chest pain
• Sudden shortness of breath
• Sudden weakness or numbness
• Severe allergic reaction (swelling, hives, difficulty breathing)
• Severe abdominal pain

These symptoms may indicate serious complications.

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Practical Tips While Taking Ketorolac

To reduce risk:

• Take exactly as prescribed
• Do not exceed 5 days of use unless specifically directed
• Avoid combining with other NSAIDs (ibuprofen, naproxen)
• Limit alcohol
• Stay well hydrated
• Take with food if using oral tablets

Never self-extend the treatment period.

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The Bottom Line

Ketorolac is a powerful, short-term pain reliever that works by reducing inflammation. It can be highly effective for acute pain, especially after surgery or injury. However:

• It does not treat the underlying cause of pain.
• It is not safe for long-term use.
• Persistent pain deserves reevaluation.

If your pain is not improving, worsening, or accompanied by concerning symptoms, do not delay medical care. In some cases, serious conditions — including infections, internal injury, or cancer — must be ruled out.

If you are uncertain about what your symptoms mean, consider using Ubie's free AI-powered Cancer Pain symptom checker to better understand your risk and guide your next step.

Most importantly, speak to a doctor about any pain that is severe, persistent, or associated with alarming symptoms. Some causes of pain can be life-threatening if left untreated, and early medical evaluation makes a real difference.

You deserve answers — and effective relief.