Easy-to-read information about pain relief medications.
Medications for pain or pain relievers can be grouped into different categories, depending on how they work. The following is a summary of the common pain relievers.
Types of pain relievers
|Paracetamol||Paracetamol is used to treat mild-to-moderate pain.
|| NSAIDs are used to reduce pain and inflammation (swelling).
|| These are a type of NSAID.
|Opioids||Opioids are effective in treating moderate-to-severe pain.
Other types of medicines used to relieve pain
There are other medicines that are used to relieve pain. They may be used when the standard painkillers above are not effective alone or are not suitable. For example, antidepressants and anti-epileptics can be used for nerve pain. Steroids are used to reduce swelling and inflammation. These may be given as tablets or an injection directly into a painful joint.
- Antidepressants: amitriptyline, nortriptyline
- Anti-epileptics: gabapentin, carbamazepine, sodium valproate
- Steroids: prednisone, triamcinolone
Which pain reliever?
The choice of pain relief medication can depend on many factors, such as the type, severity and cause of your pain, any medications you may already be taking and any allergies you may have.
Type of pain
Acute pain is usually related to an obvious injury, such as dental infection, bone fracture or surgery. This pain can be severe but mostly gets better quickly, within days or weeks. Treatments usually only need to be given for a short time while healing of the injury begins.
- Paracetamol and NSAIDs are commonly used.
- Opioids are useful and usually only need to be given for a period of a few days. The dose of opioid should be reduced as healing occurs.
- Read more about acute pain.
Chronic pain sometimes begins with an injury but the pain doesn’t get better as expected. Common examples of chronic pain include lower back pain and pain related to arthritis. Unlike acute pain, chronic pain is difficult to treat with most types of treatment helping less than a third of patients. Medicines generally, and opioids in particular, are often not very effective for chronic pain. Other non-medicine treatments may be used, such as electrical stimulating techniques (TENS machine), acupuncture, advice about activity and increasing physical fitness, and psychological treatments such as cognitive behaviour therapy. Most treatments aim to help you self-manage your pain and improve what you can do.Read more about chronic pain.
Nerve pain is a type of chronic pain associated with injury to your nerves or nervous system. Types of nerve pain include sciatica following disc prolapse, nerve injury following spinal surgery, pain after infection such as shingles, pain associated with diabetes, pain after amputation (phantom limb pain or stump pain) and pain associated with multiple sclerosis or stroke. Medicines used to treat nerve pain include antidepressants and anti-epileptics. Read more about nerve pain.
Severity of the pain
Pain severity is usually grouped into mild pain, moderate pain or severe pain. The step-wise or ladder approach to managing pain is based on the intensity of your pain. It is a 3-step approach.
Step 1: Mild-to-moderate pain
This type of pain is treated with paracetamol, ibuprofen and other NSAIDs.
Step 2: Moderate-to-severe pain
More intense pain is treated with mild opioid pain relievers such as codeine and tramadol. These may be used together with paracetamol or NSAIDs.
Step 3: Severe pain
Severe pain is treated with strong opioids such as morphine and oxycodone. These may be used together with paracetamol or NSAIDs.
Cause of the pain
Depending on the cause and location of your pain, you may need to use different treatments to ease the discomfort or pain.
- Muscle sprain may be relieved by R.I.C.E. (rest, ice, compression and elevation).
- Pain caused by indigestion may be relieved by antacids.
- People with migraine headache may need to take triptan medicines, which are a specific painkiller for migraine headaches. They're thought to work by reversing the changes in the brain that may cause migraine headaches.
Read more: where’s your pain?
Some types of pain medication can worsen some medical conditions and should be avoided. For example, NSAIDS can make stomach ulcers worse and if you have a history of stomach ulcers, you should avoid them. They must also be used with caution by older adults, and people with heart disease, type 2 diabetes or kidney problems.
Medications you are taking
Before taking medication for pain relief, it is important to consider if these may interact with medications that you are already taking for another condition.If you are unsure about potential interactions, check with your doctor or pharmacist.
Some allergies may prevent you from taking certain types of pain relief medicines. For example, NSAIDs can cause allergic reactions in some people. Soon after taking the medicine, you may develop symptoms such as flushing, itchy rashes (hives), blocked and runny nose and asthma (sometimes severe). If you have had hives (urticaria), nasal polyps or asthma, your risk of NSAID allergy is much higher compared to people without these conditions.
What can I do to make sure I'm taking my pain reliever safely and effectively?
In general, advice given by your prescribing doctor or pharmacist, or on the packaging of over-the-counter medications, can be relied upon to reduce the risks associated with taking these medications. You an also compare the benefits and risks of the common used painkillers.