This advice is sourced from Dr Ros Taylor a senior palliative physician
There are many different medicines that can be used to treat pain. All of them have benefits and risks. Some work better for certain types of pain than others. Some work well in combination. Some should not be taken together.
This is why choosing the right type of pain relief depends on the cause of your pain, other health conditions and personal preferences. Do feedback to your doctor how your pain medicine works for you. Side effects can usually be treated effectively.
Please seek medical advice if you have a new pain or a rapidly changing pain as there may be a treatable cause for this.
This table is a simple overview of the main types of pain medications:
|
Type of pain relief
|
Example |
Use |
Side effects and issues to consider |
|
Paracetamol |
An effective painkiller which is used to treat pain and fever |
Paracetamol can improve the effect of other painkillers Doses need reducing in people with liver disease |
|
|
Non steroidal anti inflammatory drugs (NSAIDs) |
Ibuprofen (nurofen), Naproxen, Aspirin, Diclofenac, Celecoxib |
These are used for pain, inflammation and fever Because they treat inflammation NSAIDs are very effective for certain types of pain such as bone pain or soft tissue pain caused by infection, wounds or cancer |
Can cause irritation or bleeding from the stomach or bowel and often are prescribed with medicines to protect the stomach lining (e.g. omeprazole, lansoprazole) NSAIDs can also affect kidney function |
|
Weak Opioids |
Codeine, Co-dydramol, Co-codamol, Tramadol |
Depending on the level of pain the right strength opioid in the right dose will be prescribed by your doctor. Opioids can be effective for all types of pain |
Nausea and drowsiness often settle after the first few doses Constipation may need regular laxatives Please see our information on opioid concerns. |
|
Strong Opioids |
Oxycodone, Morphine, Fentanyl |
Depending on level of pain the right strength opioid in the right dose will be prescribed by your doctor. Opioids can be effective for all types of pain |
Nausea and drowsiness often settle after the first few doses Constipation may need regular laxatives Please see our information on opioid concerns Can be given orally, via a patch on the skin or by injection |
Other medications which enhance pain relief
Certain medications which are not well known as 'painkillers' can be very effective for certain types of pain. For example certain antidepressants (e.g. amitriptylline, duloxetine) and some anticonvulsants (e.g. gabapentin, pregabalin) can be very effective for nerve pain. Anti-spasm medication (e.g. buscopan) can be used for crampy pain. Steroids can be very effective for pains caused by swelling.
Mouthcare can be very effective for sore mouths.
Important issues to consider
- Liver and kidney function affects what doses you can safely take
- Do not stop pain medications suddenly as this may cause withdrawal effects. Doses may need slowly reducing down before stopping
- Remember some medications already contain paracetamol (e.g. Co-codamol, Co-dydramol)
Marie Curie have comprehensive resources on Pain relief and common side effects.