If you have a body ache or pain,such as back,
neck or knee pain, what pain medication should you use?
Pain Medication Options
There are many types of pain medication. In general all pain medications are referred to as ‘analgesics’. Some analgesics are better for a particular problem then another. With all these different types of pain medication it can be difficult to know what medication works the best for a particular condition.
Therefore this blog will give some general advice about the most common analgesic and what they are used for. This blog is not giving medical recommendations, rather it is providing general information. Medication is only one way to manage pain and usually can be enhanced by using physical and/or cognitive therapy.
Analgesic Pain Medications
So one of the most common analgesic is Paracetamol (eg. Panadol, panama etc). This medication has been shown to be effective for mild to moderate pain. It is typically used for headache and generalised pain. It also has a fever reducing capability. Paracetamol works by reducing the nerve signals sent to the brain.
Opiods are a stronger form of analgesic (eg. Vicodin, Oxcycodone, Codeine). These drugs are typically used for moderate to severe pain. Opioids work by binding to opioid receptors in the brain and spinal cord. Our bodies can also form its own natural opiods, called endorphins. Opiods reduce pain by reducing the nerve signals to brain. They also effect the regions of the brain that control emotion.
The body can develop a dependence on opioids in just a few weeks. Opioids have significant side effects including sedation, and reduced breathing rate. Because of these factors opiods are a prescription medication that are given cautiously and need to be taken under medical advice.
Anti-inflammatory Pain Medications
NSAIDs (Non-steroidal anti-inflammatory) are commonly used to manage pain relating to inflammation. Therefore these medications work by changing the body’s response to swelling and pain at a local tissue level. These drugs are effective for muscle strains, and sprains, arthritis, and back or neck pain.
There are many types of NSAIDs. Common NSAIDs include aspirin, voltaren, nurofen and ibuprofen, which are available over the counter at Pharmacies. Your GP can also supply prescription anti-inflammatories such as Mobic, celebrex, naproxen or stronger voltaren or brufen tablets.
NSAIDs are generally safe in short periods. However, long term use may cause issues with your stomach and liver. Most importantly, NSAIDs should always be taken under the direction of your GP.
Nerve Pain Pain Medications
Nerve pain (also called neuropathic pain) is different from other types of pain. It is typically a result of damage to the peripheral or central nervous system. Common conditions where people experience nerve pain include shingles, diabetes, stroke, and HIV. Typical pain medication has little effect, however, low doses of medication that are used to treat depression and epilepsy have been shown to be effective. Typically a combination of medication is used.
Anti-depressants are normally used when other analgesic have not been effective. They work by reducing pain signals sent to the brain. They also correct the imbalance of chemicals in the brain (noradrenaline and serotonin). Amitriptyline (eg. Endep), a type of anti-depressant, has been demonstrated to be effective at reducing pain for diabetic neuropathy, facial pain and postherpetic neuralgia.
Pregabalin (Lyrica) is a type of anti-epileptic. It is used to treat damaged nerves in conditions such as diabetic neuropathy, stroke, spinal cord injury and multiple sclerosis. It has been shown to improve pain and sleep in some patients with diabetic neuropathy or herpetic neuralgia.
The take home message
Medication can be a useful tool to manage pain. However, it is only one way to manage pain and can usually be improved by using physical and/or cognitive therapy.
Taking the right type of medication is important to provide the best pain relief. This means that before taking any medication it is important to consult your GP.
This blog was written by Neal Fitton, myPhysioSA Physiotherapist at our Mount Barker clinics.