Which painkiller to use and when to use that analgesic?
Below are the most common questions asked online about pain and types of pains
What is pain?
The first indication of an unseen malady within the body is usually pain. Pain is therefore a natural early warning system. Pain can be of great benefit to the body. This agonising and unpleasant sensation afflicts all people at some time as a result of injury, disease or emotional disorder. Pain tells the body to take avoiding action against whatever is causing pain. This is usually an involuntary action as when a hand jerks away when pricked by a pin or when you touch something very hot. Pain prevents further injury.
Pain is difficult to describe even though it though the sufferer finds pain too real. Continuous and throbbing pain indicates swelling or inflammation in a restricted space. Intermittent stabbing pain results from the stretching or swelling or a tube-like part of the body like intestines. Continuous severe pain can indicate disruption of blood flow as in angina and gangrene. Burning pain is felt when heat, friction or chemicals destroy body tissues. A dull continuous pain can signal strained muscles and ligaments.
It is important to know exact spot of the pain to assist making the correct diagnosis. It is important to know that pain not always felt at the site of injury or disease. For example, pain from heart muscle damage can be felt down the left arm and fingers. This pain is called referred pain. Pain from a slipped spine disc may radiate down the leg. Referred pain from the heart is called angina and referred pain from the spine is called sciatica.
The pain threshold
Pain threshold is the point at which the pain is first felt during the painful stimulus. It roughly the same among all ordinary healthy people. What varies greatly is the pain tolerance point, when pain becomes unpleasant. Several factors other than the immediate cause of pain can influence the pain threshold. Illness, hunger, extremes of temperature and pain caused by another condition will all lower the threshold giving greater pain. For example, people with arthritis find their pain worse in seasons when temperature swings. Psychological conditions like worry, fear, anxiety, fatigue, stress, depression and insomnia all lower the pain threshold. There are other psychological factors that increase the pain threshold and ease the pain. When you believe strongly that pain will get better, it often does. Faith in your doctor or a particular treatment reduces the pain. Happiness and excitement also increase the pain threshold.
Killing pain the natural way
The body produces its own powerful painkillers. Examples are endorphins and encephalins which are proteins occurring naturally in the brain which have similar effects to those induced by strong pain killers like opiates. The body synthesises these natural painkillers from amino acids in the proteins in your diet. Other similar proteins are dopamine and stress hormones like adrenalin and noradrenaline. Their release is triggered by stress and exercise and are powerful natural pain killers as seen in sports injuries which are only felt hours after the game and the adrenaline rush has faded. Dopamine and the hormones are produced by the body from the amino acid phenylalanine. The body cannot synthesise this amino acid. It is an essential amino acid that must be provided by the diet. Examples of dietary sources are cheese, nuts, avocados, bananas, beans, herrings, sesame and pumpkin seeds, etc.
Types of analgesics and painkillers and when to use the OTC pain relievers
The type of medicines that you need to treat your pain depend on what type of pain you have. For pain associated with inflammation, such as back pain or headaches, paracetamol and anti-inflammatory painkillers work best. If the pain is caused by sensitive or damaged nerves, as is the case with shingles or sciatica, it's usually treated with tablets that change the way the central nervous system works. The aim of taking medication is to improve your quality of life. All painkillers have potential side effects, so you need to weigh up the advantages of taking them against the disadvantages.
Paracetamol is used to treat headaches and most non-nerve pains. Two 500mg tablets of paracetamol up to 4 times a day is a safe dose for adults. You must never take more than 8 tablets in a 24-hour period. Overdosing on paracetamol can cause serious side effects, however, so do not be tempted to increase the dose if your pain is severe. If the pain lasts for more than 3 days, see your doctor.
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac and naproxen, work better when there's clear evidence of an inflammatory cause, such as arthritis or an injury. They should not be used for long periods unless you have discussed it with your doctor. If you take them for long periods, there's an increased risk of stomach upset, including bleeding and kidney and heart problems. Do not take more than the recommended dose, as this will increase the risk of serious side effects. Pregnant women should not take ibuprofen unless a doctor recommends and prescribes it. Paracetamol is the recommended alternative in pregnancy.
Aspirin is another type of NSAID. It produces the same kind of side effects as other NSAIDs, but is not as effective as a painkiller, which means it's not usually prescribed for pain. Never give aspirin to a child younger than 16 unless their doctor prescribes it. There's a possible link between aspirin and Reye's syndrome in children.
Codeine does not work very well on its own. It works better when combined with paracetamol in a single pill. You can buy combination paracetamol and low-dose codeine over the counter. Higher-dose codeine has to be prescribed. It's not recommended to take codeine or other medium-strength prescribed painkillers on a long-term basis as this could lead to you becoming dependent on them. This could then make it difficult for you to stop taking them. If you're worried that you may have become dependent on painkillers, contact your doctor or another healthcare professional for advice.
Effervescent painkillers are high in salt, containing up to 1g per tablet. Too much salt can raise your blood pressure, which puts you at increased risk of health problems like heart disease and stroke. You may want to consider switching to a non-effervescent painkiller, especially if you have been advised to watch or reduce your salt intake.
Amitriptyline and gabapentin
Amitriptyline is a drug for depression and gabapentin is a drug for epilepsy. Each of these medicines can also be used to treat pain caused by nerve sensitivity or nerve damage such as shingles, diabetes, nerve pain and sciatica. You do not have to have depression or epilepsy for these tablets to help your nerve pain. Amitriptyline and gabapentin both have to be prescribed by a doctor. Side effects include drowsiness and dizziness.
Morphine and morphine-like drugs (such as oxycodone, fentanyl and buprenorphine) are the strongest painkillers there are. Depending on your individual circumstances, these types of painkiller may be prescribed as a patch, an injection, or sometimes in a pump you control yourself. But they all work in similar ways and should only be used for severe pain. They'll only be prescribed after consultation with a doctor or a pain specialist. The dose and your response will be closely monitored. These drugs should only be used as part of a long-term plan to manage your pain.
Over-the-counter analgesics and painkillers
Click on the links below for the best-selling and most popular painkillers online.
- Tylenol 500mg Acetaminophen Rapid Release Gels, 290 ct. x2 AS
- Leader Extra Strength Acetaminophen 500 mg, 100 Gelcaps (Pack of 2)
- Basic Care Junior Strength Ibuprofen Tablets, 100mg, 24 Count
- Basic Care Naproxen Sodium Tablets, 300 Count
- Basic Care Ibuprofen Tablets, 500 Count
- Children's Motrin Pain Reliever/Fever Reducer Liquid - Ibuprofen (Pack of 2)
- Equate Junior Strength Ibuprofen, Grape, 24 Chewable Tablets (Pack of 2)
Topical analgesics and when to use these painkillers
Oral analgesics are commonly prescribed for the treatment of acute and chronic pain, but these agents often produce adverse systemic effects, which are sometimes severe. Topical analgesics offer the potential to provide the same analgesic relief provided by oral analgesics but with minimal adverse systemic effects. The most commonly used topical analgesics are nonsteroidal anti-inflammatory drugs, followed by lidocaine, capsaicin, amitriptyline, glyceryl trinitrate, opioids, menthol, pimecrolimus and phenytoin. The most common indications are acute soft tissue injuries, followed by neuropathic pain, experimental pain, osteoarthritis and other chronic joint-related conditions, skin or leg ulcers and chronic knee pain. Doctors prefer the use of topical diclofenac and topical ibuprofen in the treatment of acute soft tissue injuries or chronic joint-related conditions, such as osteoarthritis. Evidence also supports the use of topical lidocaine in the treatment of postherpetic neuralgia and diabetic neuropathy. In acute pain conditions, such as strains and sprains, two topical NSAID products, a diclofenac gel and a ketoprofen gel produced good pain relief.
Patients will often use OTC topical analgesics for the treatment and management of musculoskeletal injuries and disorders. These products may have local analgesic, anaesthetic, antipruritic and counterirritant effects. Counterirritants are approved for the topical treatment of minor aches and pains of muscles and joints. They are often employed for the treatment of acute musculoskeletal injuries and as an adjunct therapy in the treatment of chronic musculoskeletal disorders. Counterirritants differ from other external analgesics in that pain relief results more from nerve stimulation than depression. Topical analgesics for musculoskeletal pain can be used alone or in conjunction with oral analgesics when appropriate and warranted. External analgesic products may contain or more of the following ingredients: methyl salicylate, camphor, menthol, methyl nicotinate, capsicum, and trolamine salicylate.
Topical analgesic products are available in a variety of formulations, including gels, ointments, creams, lotions, and patches in single-entity or combination formulations. Topical heat therapy patches, such as ThermaCare, are also available in various sizes for treating joint and muscle pain and provide 8 to 12 hours of continual, portable heat therapy. Products new to this OTC category include Icy Hot Spray and Icy Hot Powder Gel, Salonpas Pain Relief Patch and Bengay Pain Relief + Massage. OTC topical analgesics are intended to be used for mild-to-moderate pain for no longer than 7 days, unless otherwise directed by a doctor.
Patients on anticoagulation therapy should be advised not to use topical products that contain salicylates, because concomitant use has been associated with prolonged prothrombin time. Patients should be advised to use these products as directed and to apply topical products only to intact skin. Areas treated with counterirritants should not be covered with tight bandages or occlusive dressings. The use of these products should be discontinued if the patient experiences excessive redness or blistering of the skin. Patients should also be advised not to use heating devices in conjunction with topical counterirritants. Patients must seek medical care from their primary health care provider if pain worsens or persists after 7 days of self-treatment.
Click on the links below to view the best-selling and most popular analgesic topical painkillers.
- BENGAY Ultra Strength Pain Relieving Patches Large Size 4 Each (Pack of 3)
- Bengay Ultra Strength Bengay Cream, 3Pack (2 x 4 Oz Each ) Cmklsa
- BENGAY Ultra Strength Pain Relief Patch for Muscle Pain On-The-Go, Large 3.9 x 7.9 inches, 1 ea (Pack of 3)
- Icy Hot Extra Strength Medicated Patch, Large, 5-Count Box (Pack of 3) Temporarily Relieves Minor Pain Associated with Arthritis, Simple Backache, Muscle Strains, Sprains, Bruises, and Cramps
Published by an experienced medical doctor for painkiller.life
Dr BA Mabaso, MB ChB, MPhil, MBA, DHSM