Tips for Choosing the Right Pain Relief Medicines

Everyone has certainly experienced pain at least once in life. Pain can be caused by a variety of things, from minor incidents to serious illnesses that require medical attention. In this article, we will discuss pain and tips for choosing the right pain relief medicines.

Types of Pain

According to the International Association for the Study of Pain (IASP), pain is a sensory and emotional discomfort associated with, or resembling that associated with, tissue damage that has been confirmed or is a possibility. The definition of pain is supplemented by six key notes and the etymology of the word pain to provide further context which can be seen on the IASP website.

There are several types of pain that can be distinguished based on the duration, the source, the intensity, and the location. 

According to the duration

• Acute pain: felt for less than three months, occurs suddenly. For example, if you cut your fingers with a knife while cutting an onion or if your feet trip over a stone while walking.
• Chronic pain: lasts more than three months, comes and goes or is persistent. For example, rheumatic pain, migraine, and back pain.

According to the source

• Nociceptive pain: appears due to the response to tissue damage. For example, sports injuries.
• Neuropathic pain: occurs due to nerve damage or problems. For example, in people with diabetes and herpes zoster.
• Deep somatic: pain comes from the muscles, dull, and poorly located. For example, post-operative pain and bone pain.
• Visceral: derived from internal organs such as the pancreas, gallbladder, and intestines.
• Psychogenic: the source of the pain is unknown.

According to the intensity

• Mild
• Moderate
• Severe

This intensity can be measured by a simple descriptive scale using facial images that show a variety of expressions, from sad to happy, to express pain, or on a numerical scale from 0 to 10.

According to the location

• Peripheral: consists of superficial pain, deep pain, and referred pain (pain felt at a location other than the site of the painful stimulus)
• Central: originates from stimulation of the central nervous system, brainstem, or spinal cord
• Ghost: pain that seems to be felt from a part of the body that is no longer there, for example in the case of amputation
• Radiating: pain that feels widespread in a large area

Types of Pain Relief Medicines

Pain can be relieved with medication. There are various medicines that can be used to relieve pain. In Indonesia, the classification of drugs is regulated in the Regulation of the Minister of Health Number 949/Menkes/Per/VI/2000. It explained that there are classes of over-the-counter drugs, limited over-the-counter drugs, mandatory pharmacies, hard drugs, psychotropics, and narcotics. 

Meanwhile, in general, the category of pain medicines can be simplified into three types: over-the-counter, prescription, and topical drugs.

Over-the-counter drugs

Over-the-counter drugs that can be purchased without a doctor’s prescription at pharmacies or drugstores are usually used to treat mild to moderate pain. The drug is easy to obtain, but there is a risk of side effects and other impacts when used together with other drugs. There are two types of over-the-counter drugs commonly used for pain:

• Paracetamol: it is usually advised as the first treatment for acute pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): this group of drugs works by reducing swelling and inflammation while relieving pain. For instance, aspirin, ibuprofen, and diclofenac.

Prescription drugs

You need a doctor’s prescription to obtain this kind of drugs. These drugs are generally available in pharmacies. There are at least four types of prescription pain drugs reliever:

Nonsteroidal anti-inflammatory drugs with a prescription

Besides over-the-counter drugs, there are nonsteroidal anti-inflammatory drugs that can be obtained by prescription when the dosage is higher. There are also some NSAIDs that can only be used with a doctor’s prescription, such as meloxicam and celecoxib.

Opioid

The opioid pain medicine class is usually used to treat moderate to severe acute pain or chronic pain experienced by cancer patients. For example, morphine.

Anti-epileptic

Anti-epileptic drugs such as gabapentin and pregabalin are commonly prescribed to patients with nerve pain or widespread musculoskeletal pain (fibromyalgia).

Antidepressant

This drug can relieve pain, for example for nerve pain and fibromyalgia.

Topical drugs

Topical drugs are drugs that are applied directly to the skin at the source of the pain. These drugs may contain types of NSAIDs such as ibuprofen or piroxicam.

Different Ways to Give Pain Relief Medicines

There are several ways to give pain relief medicines, including:

• Buccal: drugs are placed between the gums and the inside of the cheek
• Epidural: injected through the lower back
• Intramuscular injection: by injection into the muscle
• Intranasal: through the nose, usually by sprayer
• Intravenous: into the vein
• Oral: ingested orally
• Rectum: inserted through the rectum
• Subcutaneous: injected under the skin
• Under the tongue: placed or sprayed under the tongue
• Topical: applied to the skin
• Transdermal: absorbed into the skin using a medical patch
• Transmucosal: through the mucous layer

How to Choose the Right Pain Relief Medicines?

Since there is a wide variety of pains, the selection of right medications depends on the characteristics of the pain felt. Typically, paracetamol is a pain medicine that is first used to relieve mild to moderate pain because this over-the-counter drug is easy to be obtained. For moderate to severe pain, chronic pain, or if you are not sure which pain relievers to choose, you should first consult a doctor. The doctor will give tips on choosing the right pain relief medicines or prescribing medications according to the results of the examination.

How to Prevent Pain Medication Dependence?

Pain medications are known to cause psychological dependence. The most addictive types of pain relief medicines are opioids, such as morphine. To prevent dependence, be sure to choose the right pain medicines by prescription. The doctor can help find a solution if the patients feel dependent on medication to relieve their pain. For example, by changing drugs or limiting the frequency of use and dosage of drugs.

Pain Therapy without Drugs

Pain does not always have to be treated with medication. There is an option in the form of pain therapy without medication. For example, mind and body therapy with relaxation techniques, meditation, hypnosis, and guided imagery. This therapy is also said to be able to overcome the dependence of opioid drugs such as morphine to relieve pain. Other therapies include acupuncture, massage, as well as adjustments to diet. Therapy with alternative medicines such as herbal medicine can also be an option, but you should first consult a doctor to ensure its safety.