Pharmacy2U By Published:

We all have the odd ache or pain from time to time and when used correctly, there is no harm in reaching for pain relief, as long as you do not exceed the recommended dose or use them on a regular basis without checking with your doctor.

Common problems such as headaches, period pain or toothache can often be treated with over-the-counter pain relief when required.

Ongoing pain should always be discussed with your GP, to help you plan pain management strategies, even if the cause seems reasonably simple – like a headache.

Being in pain can make even the simplest of tasks feel challenging. Pain management is best thought of as a ladder, the more severe the pain, the higher up the ladder you need to go and as pain settles, work back down the rungs.

Types of pain relief

There are three main types of pain relief available without prescription from most high street and online pharmacies; paracetamol and anti-inflammatories.

It is worth starting with simple pain relief such as paracetamol. Don’t be tempted to take more than the recommended dosage, as this could lead to serious side effects including liver failure. If the pain lasts for more than three days, it is best to get it checked out with your doctor.

In addition to paracetamol there are painkillers called NSAIDs – non-steroidal anti-inflammatories. These can be used with or without paracetamol. Ibuprofen is the most widely used over-the-counter NSAID.

Naproxen is another, but is only available on prescription. These are seen to be most effective when there is clear evidence of an inflammatory cause, such as arthritis or an injury.

Use with caution

You shouldn’t use NSAIDs for a long time without discussing with your GP. They can cause irritation to the stomach lining and can contribute to acid reflux and ulcer issues. If you do require them regularly, your doctor may recommend an additional treatment to protect your stomach. Anti-inflammatories should also be used in caution in patients with asthma.

Aspirin also falls into the NSAID category, but shouldn’t be given to children under 16. They are not as effective for pain as ibuprofen and are more likely to be prescribed for people with long-term cardiovascular illness.

Paracetamol and NSAIDs make up the first rung of the pain ladder.

The next step on the pain ladder are treatments such as co-codamol. This can be bought as a low dose (each tablet containing 8mg of codeine and 500mg paracetamol) over-the-counter or higher doses on prescription. These should only be used short-term, as it’s easy to form a dependency to them, unless guided by your GP. Similar prescription-only pain relief includes tramadol and dihydrocodeine.

Severe pain relief

For more severe pain relief your doctor might discuss trying morphine based treatments, available as tablets, liquids, patches or lozenges.

In terms of children, paracetamol and ibuprofen are safe and effective, but it’s important to follow the manufacturer’s instructions. Many manufacturers provide age-appropriate treatments to make it easier to give your child the right dose.

Dr Alexandra Phelan is a working NHS GP and member of the Pharmacy2U Online Doctor service team. Visit for further information. Read the blog by Dr Nitin Shori to find out more about managing pain.