Registering pain is one of our body’s most fundamental and important systems. It alerts us to injuries and warns us of potentially dangerous medical conditions. Effective pain management is an integral part of maintaining our quality of life, whether after an injury or as we get older.

Options and approaches for pain relief and management are as many and varied as the causes of pain itself. That’s good news, as there is likely to be a solution for each individual’s needs. The challenge, however, is knowing what is safe and appropriate for those needs.

How Are Pain Meds Classified?

Broadly speaking, the phenomenon of pain can be addressed with two fundamental levels of medication: over-the-counter and prescription. Of particular concern in the last category, as we’ve all heard in the news, is the use of medications containing opioids.

Some pain medications are designed to treat inflammation associated with conditions like headache, arthritis or an injury. Others are intended to address discomfort caused by sensitive or damaged nerves. All should be taken only as directed by a pharmacist, physician or product label.

We often seek relief from routine pain with over-the-counter medications. In general there are two types:

• NSAIDs (nonsteroidal anti-inflammatory drugs) inhibit certain enzymes in the body to treat pain and swelling. Typical indications include menstrual cramps and muscle soreness.
• Analgesics affect the heat center in the brain to reduce fever and work on the central nervous system to reduce pain. These are often applied to headache or arthritis.

Stronger measures, like opioids, require a physician’s authorization.

If you’re not sure what’s right for you, or what may be causing your pain, the most important first step is to see your doctor. That way, you’ll have the best chance of finding the medication that works best and which pain relievers are the safest for you.

What Are My Choices?

Let’s take a quick look at some alternatives to help you decide how to pick the best painkiller for your situation.

Ibuprofen

An NSAID typically used for pain, fever and swelling. Taking effect in 30-60 minutes, they should be taken with food to avoid an upset stomach. Taking ibuprofen for a long period of time can lead to bleeding as well as heart and kidney issues.

Naproxen

Another NSAID used to treat similar conditions. It should be avoided by people with kidney problems and not taken together with aspirin. Another NSAID is diclofenac.

Aspirin

An NSAID typically used to treat fever and not as effective as other NSAIDs for pain. As a blood thinner, it should be considered carefully if there is any potential for internal bleeding in your health profile. It should not be given to children under the age of 16 without a doctor’s prescription.

Acetaminophen

An anti-inflammatory medication that is very effective for pain relief and fever. It takes about an hour to start working. Taking too much, either in a single medication or as part of several, can lead to severe liver damage.

Paracetamol

Another medication for headache and other types of non-nerve-based pain. Taking too much can be dangerous, so increasing a dosage should only be done under professional guidance. This medication may be recommended as an alternative to ibuprofen for women who are pregnant.

Solubles

In the form of effervescent solutions, these are often high in salt. Since too much salt can increase blood pressure, leading to heart disease and stroke, you may want to consult your doctor or avoid these altogether.

Amitriptyline and Gabapentin

Primarily used for depression or epilepsy, respectively, but sometimes for pain due to nerve sensitivity or damage. Conditions involved can include shingles, diabetes and sciatica. Both require a prescription.

Codeine

Typically most effective when combined with paracetamol and available in low-dose form over the counter. Higher doses require physician authorization. Primary risk is dependency if taken over a longer period of time.

Morphine

This is the top of the chain in terms of strength for pain relief along with similar medications such as fentanyl, oxycodone and buprenorphine. They can be administered by injection, patch or self-controlled pump. These substances can be highly effective, but have some significant risk factors like overdose and addiction.

Overall, regardless of the medication, it’s advisable to start with the lowest dosage and see if that does the job. If not, you can increase the dosage per the instructions for the medication or talk to your physician for further advice.

You can also usually switch safely to another medication to see if that helps. And it’s OK, for a day or two, to alternate between an NSAID and acetaminophen.

When Should I See My Doctor?

Although the perception of pain can be highly personal, there are some guidelines for when you should consider seeing a professional to help you manage the discomfort in a healthy way. Here are some situations to consider:

• Your pain continues for more than two or three days
• You seem to need for more medication to get relief than you did before
• You have trouble cutting back on the medication
• You find yourself needing pain relief on a regular basis
• Your pain just seems more severe than it should be

The key is to determine exactly what is causing the pain, then determine the right approach. Simply downing more pain meds won’t fix the situation for the long term and may have significant risks.

Also, several health factors may indicate that you should consult your doctor about using any pain medications and which ones are right for you. Those conditions can include:

• Kidney disease or cirrhosis of the liver
• Heart disease or high blood pressure 
• Gastrointestinal upset or peptic ulcer disease 

Unfortunately, pain is an inescapable fact of life. But, with the right information and advice, we can maintain healthy choices and quality of life.