In this Article:
01: What is pain?02: What are the different types of pain? 03: Drug treatment of mild to moderate pain 04: What are the different formulations of pain killers? 05: Non-medicated pain relief
What is pain?
Pain is the body’s way of telling us that something may be wrong. It’s personal and everyone experiences it differently. Pain can be described as an unpleasant sensation that can range from mild discomfort to agony. It can also be described in many other ways, including dull, sharp, aching, burning, and cramping. Pain can affect our body, mood, and our daily life.
By understanding the different types of pain, it can make it easier for you to describe your symptoms so you can find the most suitable treatment to help.
What are the different types of pain?
Acute Pain
Acute pain is short-term pain that comes on suddenly and has a specific cause. Acute pain usually lasts for less than 3 months and will often get better once the issue is resolved.
Acute pain may be the result of Injuries such as pulled muscles, a broken bone, tissue damage, or a wound. It could also be post-surgery pain or acute illness.
Neuropathic pain
Neuropathic pain may result from an injury or illness that damages your nerves. It can occur commonly in patients with cancer, multiple sclerosis, or people with diabetes who suffer with diabetic neuropathy.
Chronic Pain
Chronic pain is pain that persisted for more than 3 months.
Secondary chronic pain – pain that is caused by an underlying condition such as Rheumatoid Arthritis or Cancer, post -operative pain, or a previous injury such as whiplash that may cause ongoing neck or back pain.
Primary chronic pain – is pain that has no real identifiable cause that explains the pain and is not due to any underlying inflammation or damage. Examples include Fibromyalgia.
Sometimes patients can have primary and secondary chronic pain.
Treatment of Pain
Some examples of drug treatments for pain relief
| Examples | How they Help | Time to take Effect |
|---|---|---|
| Paracetamol | Mild pain relief. Often used as first-line treatment. | 30-60mins |
| NSAIDS (e.g. Ibuprofen, Naproxen) | Reduce inflammation and pain (mainly for arthritis or injury-related pain). | Response varies from few hours to days |
| Topical prescription pain relief (Capsaicin cream, Lidocaine patch) | Local pain relief by blocking nerve signals. | Response varies. |
| Triptans for migraine (Sumatriptan, Rizatriptan) | Targets receptors in the brain to stop migraine attacks | 30-60mins |
| Opioids – e.g. Codeine, Morphine, oxycodone | Strong pain relief. Short term use in some specific conditions for severe pain. | 30-60mins |
| Amitriptyline | Neuropathic Pain and migraines, by affecting chemicals in the brain | Response varies and dose adjusted according to response |
| Gabapentin. Pregabalin | Neuropathic pain, calming down overactive nerves in the body | Response varies and dose adjusted according to response |
Drug treatment of mild to moderate pain
Paracetamol
Paracetamol is the most common pain killer and can be very effective for many people if taken at the correct dose. It is available without a prescription. The recommended dose for adults by mouth is 500mg-1g (1 or 2 tablets) every 4 to 6 hours as required (maximum 4g (8 tablets) in 24 hours).
NSAIDs
Non-Steroidal Anti- inflammatory drugs (NSAIDS) such as Ibuprofen can help with lots of types of pain such as joint and muscle pain, headaches, toothache and period pain. You can buy ibuprofen without a prescription. Ibuprofen can cause more side effects than paracetamol so it’s a good idea to try Paracetamol first before taking ibuprofen. To reduce the risk of side effects always take the smallest dose you need for the shortest time you need it, and also speak to a healthcare professional to make sure it is right for you.
Ibuprofen is also available in topical formulations such as gels and cream. The usual oral dose in adults is 200mg -400mg up to 3 times a day ideally with or after food.
Naproxen is also available without a prescription for certain pain conditions such as period pain and muscle and joint pain.
Care should be taken when taking NSAIDs as they are not suitable for everyone and do interact with some other medications. It is best to speak to a healthcare professional to make sure it is right for you. NSAIDS should be taken with or after food.
Mild Opioids
If Paracetamol or Ibuprofen are not achieving the required pain relief, it is possible to take as a combination with a mild opioid such as codeine. Paracetamol combined with codeine (co-codamol, Solpadine plus), and ibuprofen combined with codeine (Nurofen plus) are available without a prescription. It is used to treat mild to moderate pain including period pain, muscle pain, sprains and strains, arthritis and toothache.
Some side effects such as drowsiness, nausea and constipation can occur when taking opioids and it is important that you read the information leaflet to ensure the medication is suitable for you.
What are the different formulations of pain killers?
Medicines for pain relief are available in different formulations. There are lots of options to put you in control of your pain management.
| Formulation | Type | Instruction |
|---|---|---|
| Tablets | Standard Tablets | Swallowed whole with water. Some designed to be easier to swallow . |
| Tablets | Chewable tablets | Chew before swallowing, suitable if struggle with swallowing. |
| Tablets | Effervescent | Dissolve in water, easier to take, faster absorption. |
| Tablets | Enteric coated | Coated to protect the stomach. Can help to reduce stomach side effects. |
| Tablets | Sublingual | Place under the tongue to dissolve. Quick acting. |
| Capsules | Hard capsules | Swallow whole with water. Contain dry ingredients in powder form. |
| Capsules | Soft capsules | Usually hold liquid medication. Often easier to swallow . |
| Liquids | Syrups, suspensions | Commonly used for children and elderly and patients who can’t swallow tablets. Quick acting. |
| Topical | Creams | Water-based and absorbed easily. |
| Topical | Ointments | Oil based, protective barrier on the skin. |
| Topical | Gels | Lightweight, soothing and cooling effect. |
| Topical | Patches | Deliver medication through the skin. Provide slow release over hours or days. Effective for people who find it difficult swallowing . |
Non-medicated pain relief
Sometimes simple nondrug pain relief can help acute and chronic pain management.
Do you know about all the options that are available?
Cold Therapy
Ice packs and sprays: reduce swelling and numbs pain best in the first 48 hours after injury or flare up.
Helps with sprains, strains, bruises, joint inflammation. If using an ice pack always put a cloth between pack and skin. Good for sports kits. Avoid cold treatment on stiff or tight muscles.
Heat Therapy
Warm packs, heat sprays, heating pads, baths, hot water bottles. Helps reduce pain by relaxing and loosening muscles and promote blood and nutrients to speed healing. Can help with most chronic joint conditions. Not to be used during the first few days of acute injuries.
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Tens Machines
Work by blocking pain signals as they pass through the spinal cord on the way to the brain. A mild electrical current is passed through the skin via stick on electrodes.
Some people may find this an alternative to medicines.
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Braces and Supports
Supports can offer some help with stability and pain relief, helping recovery, especially in acute injuries. However, you should always discuss with your doctor whether a support is the best way forward for your condition
Explore braces and supports
Vitamins and Minerals
Most people can get all the nutrients they need from a varied and balanced diet, however sometimes it is difficult. To help support bone health and Osteoporosis we must have 700mg of Calcium which can be obtained from green vegetables dried fruit and dairy. Also, 10micrograms of Vitamin D. It is hard to get enough Vitamin D through your diet so you may consider taking a supplement especially in the winter months.
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Some people have found that nutritional supplements such as glucosamine and chondroitin may help with their painful joints in conditions such as Osteoarthritis. GPs no longer prescribe these nutritional supplements on the NHS.
