Pain Relief Medications
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.
Pain Relief Medications
Types of pain relievers
Common pain relievers | Description |
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Paracetamol | Paracetamol is used to treat mild-to-moderate pain.
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Non-steroidal anti-inflammatories
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NSAIDs are used to reduce mild-to-moderate pain and inflammation (swelling).
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COX-2 inhibitors
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COX-2 inhibitors are a type of NSAID.
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Opioids
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Opioids can be used for moderate-to-severe short-term pain such as after an injury or surgery, or for ongoing pain due to cancer.
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Steroids
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Some steroids are used for pain relief by reducing swelling and inflammation when other pain relievers are not effective alone or are not suitable.
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Antidepressants
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Tricyclic antidepressants are usually used to treat depression but low doses can relieve some types of chronic pain such as nerve pain. They have also been found to improve sleep and help with relaxation.
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Gabapentinoids
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Which pain reliever?
The choice of pain relief medication can depend on many things, such as the type, severity and cause of your pain, other medications you may already be taking, any allergies you may have and other conditions you may have.
Type of pain
Acute pain
Acute pain usually occurs because of surgery, injury or infection, such as a dental infection or bone fracture (break). It often comes on quickly, lasts for a short time and goes away as the underlying cause resolves. Treatments usually only need to be given for a short time while the injury is healing.
- Paracetamol and NSAIDs are commonly used.
- Opioids are useful and usually only need to be given for a few days. The dose of opioid should be reduced as healing occurs.
- Read more about acute pain.
Chronic pain
Chronic pain, also called persistent pain or long-term pain, is pain that lasts longer than 3 months. It is often described as pain that does not go away as expected after an injury or illness.
- Chronic pain is thought to occur when nerves become over-sensitive and send warning messages to your brain even when there is no injury, or the original injury causing pain has healed. In other words, the fire has been put out, but the fire alarm is still going off.
- Chronic pain is complex and can be difficult to treat. The aim of treatment is to find ways to support you and reduce the impact of the pain on your life.
- Medicines generally, and opioids in particular, are often not very effective for chronic pain because they do not greatly improve chronic pain levels or help you to be able to do the things you want to do. However, medication can be used in some situations alongside other strategies, such as physiotherapy, exercise, diet, relaxation, different ways of thinking and responding to pain (mindfulness and cognitive behaviour therapy), or other non-medicine treatments such as electrical stimulating techniques (TENS machine) and acupuncture.
- Read more about chronic pain and medicines for chronic pain.
Nerve pain
Nerve pain is a type of chronic pain from an injury to your nerves or nervous system. Types of nerve pain include sciatica from disc prolapse, nerve injury after spinal surgery, pain after infection such as shingles, pain with diabetes, pain after amputation (phantom limb pain or stump pain) and pain with multiple sclerosis or stroke.
- Medicines used to treat nerve pain include tricyclic antidepressants (amitriptyline, nortriptyline) and gabapentinoids (gabapentin, pregabalin).
- If these medicines help your pain, you can continue to take them for as long as you need to. If you do not feel any improvement in your pain after 6–8 weeks, speak to your doctor.
- Read more about nerve pain.
Severity of the pain
Pain is usually grouped into mild pain, moderate pain or severe pain. The step-wise or ladder approach to managing pain is based on the severity of your pain. It is a 3-step approach.
- Step 1: Mild-to-moderate pain
This type of pain is best treated with paracetamol, ibuprofen and other NSAIDs. Read more about paracetamol and 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. Read more about opioids.
Cause of the pain
Depending on the cause and site of your pain, you may need to use other things to ease the 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.
- If you have migraine headaches, you may need to take triptan medicines, a special type of painkiller for migraine headaches. They’re thought to work by reversing the changes in the brain that may cause migraine headaches.
Medical conditions
Some types of pain medication can worsen some medical conditions and should be avoided. For example, NSAIDS can make stomach ulcers worse, so if you have a history of stomach ulcers, you should avoid them. NSAIDs 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 ask if these may interact with medications that you are already taking for another condition. If you are unsure, check with your doctor or pharmacist.
Allergies
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 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 relief medication safely and effectively?
Ask your doctor or pharmacist for advice or read the packaging of over-the-counter medicines. This will help to reduce the risks of taking these medications. You can also compare the benefits and risks of commonly used painkillers.
Pain Relief Medications
References
- The principles of managing acute pain in primary care BPAC, NZ, 2018
- Prescribing gabapentin and pregabalin: upcoming subsidy changes BPAC, NZ, 2018
- Managing patient with neuropathic pain BPAC, NZ, 2018
- Helping patients cope with chronic non-malignant pain: it’s not about opioids BPAC, NZ, 2014
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Codeine Phosphate 60 mg Tablets
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Fentanyl Citrate Injection
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Fentanyl Oral Transmucosal Citrate 200 mcg
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Fentanyl Oral Transmucosal Citrate 400 mcg
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Fentanyl Patches
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- MIXED PHARMACEUTICAL DRUGS CATEGORY, Pain Relief Medications
Oxycodone Oral Tablets Extended Release
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Vicodin Oral Tablet
- 1.00$ tablets
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