How To Choose The Right Pain Relief: Reduce The Pain, Choose The Right Painkiller

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Pain management aims to reduce its intensity, prevent the risk of becoming chronic and improve quality of life. The choice of treatment depends in particular on the intensity of the pain, as well as its mechanism (pain from excess noniception, neurogenic pain etc) , its location, its context and the patient. Paracetamol, ibuprofen, or aspirin.

How Do I Choose The Right Painkiller? Which Medicine Is Best For Pain Relief?

Choosing the right over-the-counter pain medicine can be overwhelming, but the most suitable option depends on the type of pain and your health. Most nonprescription pain medicines effectively reduce pain as a symptom when taken for short periods, but caution should be exercised when using them.

Choose The Right Painkiller

You should know how to choose the right painkiller. To relieve fever, headache, dental pain, inflammatory pain, migraine, painful period, aches, burns. You have the choice between paracetamol, ibuprofen or aspirin.

Paracetamol

It is a level I painkiller like ibuprofen and aspirin, it is the most used and has the lowest benefit risk . In case of a painful condition or feverishness, it is the first to be taken because it reduces fever, relieves headache, period pain, and dental pain. However, for doliprane, efferalgan or dafalgan, it is essential to respect the doses recommended on the instruction, namely, from 500 mg to 1 g per dose, spaced at least four hours apart, it is recommended not to exceed 3 g per day, but the daily dose can possibly go up to 4 grams.

Aspirin

It is an analgesic and anti-inflammatory that can be taken in cases of fever, pain, sprains, tendinitis, migraine, its maximum dosage is 1 gram every 8 hours or 3 grams per day, and it should not be combined with another anti-inflammatory. Furthermore, it has a major disadvantage, its harmfulness to the stomach, indeed, it can cause ulcers, gastritis, and it thins the blood. It is prohibited for pregnant women from the 6th month, to avoid giving it to children.

Level II analgesic

Others, so called level II analgesics are intended for pain not relieved by level I analgesics. These are codeine, dihydrocodeine and tramadol. They are available on prescription. It is the doctor who will prescribe the dosage to follow if your state of health allows it because they are contraindicated in cases of renal insufficiency, respiratory insufficiency, pregnancy, breastfeeding and in children.

Our advice

Always ask your pharmacist or doctor for advice before taking medication, even if taking it seems harmless to you. If you are unsure between several painkillers, tell them the other medication you are taking because they may already contain paracetamol, for example, and if you are under treatment for a Long-Term Condition (ALD) never take painkillers as  self medication.

As a general rule, you should not take more than one over the counter pain reliever at the same time, especially two NSAIDs (including aspirin) due to the increased risk of side effects. If your pain is not relieved with the counter products, it is best to consult a doctor.

Pain medication can cause various adverse effects depending on the substances used: nausea, balance problems, drowsiness, constipation, etc. The doctor may possibly prescribe medication to prevent some of these side effects (laxatives for example).

Take Your Painkillers Carefully

In the case of chronic pain (arthritis for example) taking analgesic at regular intervals helps to calm  the pain  more effectively than taking them on demand (when it hurts). It is recommended not to use painkillers for more than five days without medical advice. It is better not to take opiate painkillers (codeine and morphine derivatives) without the advice of your doctor. This type of medication can delay a diagnosis by masking pain.

Take Your Painkillers Carefully

Medications Other Than Analgesics Used For Pain

Other substances are also used to combat pain:

Local anesthetics (such as lidocaine, procaine, bupivacaine etc), antispasmodics (for visceral pain such as renal colic, colitis, etc), certain antidepressants (anafranil and its generic, laroxyl, tofranil, cymbalta) for the treatment of neuropathic pain, but their adverse effects sometimes limit their use.

Muscle relaxants ( thiocolchicoside, methocarbamol) can be used in chronic back pain (low back pain) for their muscle relaxing effects. They should not be used for periods of more than two weeks.

Antiepileptics: carbamazepine (tegretol and its generic) and phenytoin are used in the treatment intractable facial neuralgia and neuropathic pain

Gabapentin (neurontin and its generic) is used in the treatment of pain following shingles in adults.

Pregabalin (Lyrica) is indicated for the treatment of neuropathic pain 

Non Drug Treatment

Drug treatment is not the only answer to relieving pain, non drug techniques exist and are often considered effective, it could be physical manipulation and rehabilitation exercises (such as Physiotherapy, osteopathy), or mind-body methods such as tai chi or qigong, massage and therapeutic touch, Physiotherapy methods ( acupuncture, and electroacupuncture).

Cognitive and behavioral therapies, including relaxation, sophrology and hypnosis, surgery or neurostimulation.

Besides Taking A Pain Reliever, What Can I Do To Relieve My Pain?

Pain that is swollen and recent can best be relieved by applying ice to the point, not directly, but should be wrapped possibly in a towel before application on the spot for about ten minutes. Again, never apply ice directly to the skin. You must place the ice in a bag and surround it with a thin towel. If the injury is on a limb (an arm or a leg), it is recommended to keep it elevated and rest it for a few days.

An elastic bandage can be placed around the injury to stabilize it, ask your pharmacist for advice, they will explain how to do it correctly. If you suffer from chronic pain, a little heat can help relax the sore area. You can use a hot magic bag, or a heating pad, but be careful of burns.

Taking A Pain Reliever

Wrap-up

Finally, painkillers are intended to relieve mild to moderate pain. Many medications are available without a prescription and each has its advantages and disadvantages. The choice of molecules varies depending on the pain, its  intensity and your state of health.

It is important to know the properties of each to select the one to take at the right time. If the chosen products contain other ingredients in addition to the analgesic, you need to make sure that they all suit you. Read the precautions on the packaging carefully. If in doubt, consult the pharmacist.

References:

  1. Parthipan A, Banerjee I, Humphreys K, Asch SM, Curtin C, Carroll I. Predicting inadequate postoperative pain management in depressed patients: A machine learning approach. (https://pubmed.ncbi.nlm.nih.gov/30726237/) PlosOne. 2019. Accessed 4/2/2021.
  2. Arthritis Foundation. Taking Acetaminophen Safely. (https://www.arthritis.org/drug-guide/medication-topics/taking-acetaminophen-safely) Accessed 4/2/2021.
  3. American Academy of Family Physicians. Pain Relievers: Understanding Your OTC Options. (https://familydoctor.org/pain-relievers-understanding-your-otc-options/) Accessed 4/2/2021.

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Dr. David G Kiely is a distinguished Medical Reviewer and former General Medicine Consultant with a wealth of experience in the field. Dr. Kiely's notable career as a General Medicine Consultant highlights his significant contributions to the medical field.

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