I spend an inordinate time in practice telling patients how and why they should take their prescribed pain medication. Many believe that they “won’t work” or will only “mask” their symptoms so don’t give them a chance. I thought I would write a user’s guide to different sorts of pain medication.

1. Non-opioid analgesics.
Painkillers pure and simple these are most commonly represented by paracetamol. Paracetamol is a wonderful drug when used correctly and has relatively few side-effects. It is very helpful in the management of chronic conditions like osteo-arthritis but has the disadvantage of having to be taken several times a day.

2. Non-steroidal anti-inflammatory drugs (NSAID’s)
These include Ibuprofen (Nurofen), Diclofenac, Naproxen. These drugs kill pain and also reduce inflammation (swelling and heat). They are used to damp down the body’s natural response to damage. Often used for injuries or arthritis they are best taken REGULARLY AT THE PRESCRIBED DOSE for a limited period. They can irritate the stomach lining so aren’t suitable for those with gastric problems and some asthmatics can’t take them either so check with your doctor or pharmacist. Please don’t take them at the same time as using heat packs as they will have the opposite effect!

3. Opioid Analgesics
These include Codeine phosphate, paracetamol– and- codeine mixtures like Co-codamol and Tramadol. These are strong painkillers for severe pain like sciatica and you’ll probably need them to make your life bearable. They are derived from opium and so are related to drugs like morphine and heroin. They can be addictive when taken for long periods and will tend to make you a bit sleepy and constipated but for short periods they can be essential.

4. Gels and rubs
These include Deep Heat, Ibuleve and Movelat. Some are purely soothing and work by warming the skin which ‘distracts’ your brain from the pain and others have a local anti-inflammatory effect. Can be useful for those who can’t (or won’t) take pills but work best on superficial problems (muscular strains or joint pain).

5. Anti-depressants
Some patients are unlucky enough to develop chronic pain and they may be prescribed tri-cyclic antidepressants like Amitriptyline. This is not because they are depressed but because these drugs are safer and more effective when taken long-term than opioids or NSAID’s. For the first few days they can make you VERY sleepy but this side-effect does wear off quite quickly.

6. Muscle Relaxants
These include Diazepam and are old-fashioned tranquillisers which are used for their ability to relax spasmed muscles. Yes they’re very addictive but worry not, you won’t be prescribed them for long enough to get hooked! Very useful in small doses.

Please bear in mind that most drugs are designed to work at their best after about 5 doses so don’t give up on them after just one try. There’s nothing noble about refusing painkillers-they were invented for a reason and no-one’s going to give you an award for bravery, so if you’re in pain take them! Contrary to popular belief, you’re usually better off taking the drugs and staying as active as you can rather than being confined to bed in agony.

© Justine Knowles 2012