Anti-inflammatory and pain relief medications

What is Pain?

Pain is something everyone experiences at some point in life. Sometimes pain has physical causes, at other times pain can have psychological causes.

Pain, particularly chronic pain, can effect a person’s wellbeing and quality of life.

In the article below we’ve explored causes of pain, types of pain, treatments for pain and some general pain management tips.

Pain is an unpleasant sensory or emotional experience. Physical pain is often linked to tissue damage, however emotional pain has more complex causes.

Pain can be either acute (short-term) or chronic (lasting more than 12 weeks.)

Managing pain requires a holistic approach, however there are several types of medication which can form part of an effective treatment plan. Medications that treat pain are known as analgesics.

These can include paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, topical pain relivers and anti-depressants.

Different Types Of Anti Inflammatories Medications

There are a few types of anti-inflammatory medications.

There are topical analgesics such as deep heat or deep freeze, which help temporarily relieve muscle pain by increasing blood flow to the area.

But when people are talking about ‘anti-inflammatories’ in most instances, they’ll be referring to non-steroidal anti inflammatories (NSAIDs.)

NSAIDs are medications that are widely used for pain management. They help to reduce pain, reduce inflammation and reduce temperature.

NSAIDs:

  • Ibuprofen: Ibuprofen (commonly sold under the brand Nurofen) is a pain killer used to treat muscular pain, period pain, tooth aches, colds and flu and inflammation such as strains or arthritis.
  • Naproxen: Naproxen is a prescription only NSAID medication typically used for rheumatoid arthritis, osteoarthritis, strains and sprains and gout.
  • Diclofenac: Is a prescription only NSAID which is used to treat arthritis, sprains and sprains, back pain and other ailments. Diclofenac is available in tablet form or as a pain relief gel sold under Voltarol gel or other brands

NSAID are useful tool due to their wide therapeutic index. Most NSAIDs are well tolerated, however patients should familiarise themselves with side effects ans use the medications in their recommended doses to minimise side effects.

Corticosteroids:

Corticosteroids are another type of anti-inflammatory medication. Corticosteroids are found in beclomethasone inhalers, nasal sprays and creams or lotions containing steroids.

Corticosteroids are typically used to treat conditions like Asthma and COPD, eczema, pain in the joints and muscles and several other conditions.

Over-the-Counter Pain Relief Treatments

There is a wide range of over-the-counter pain killers available in the United Kingdom.

If you have mild-to-moderate pain, paracetamol is often a good first line treatment. However, for pain associated with inflammation such as strains and sprains ibuprofen and other NSAIDs may be more effective.

Common Over-the-Counter Pain Killers Include:

  • Paracetamol: A widely available over-the-counter pain killer, sold as a generic medication or under brands such as Panadol.
  • NSAIDs: NSAIDs are anti-inflammatory pain killers. These include ibuprofen, naproxen, diclofenac and low DOSE aspirin. NSAIDs particularly effective at relieving pain associated with inflammation. NSAIDs are available as tablets, capsules, gels or as an anti inflammatory cream
  • Weak Opioid Pain Killers: There are several brands of NSAID or paracetamol + codeine available in the UK. The dual effects work effectively to treat lots of types of pain. Common brands include Solpadeine or Paramol.

Prescription Medications For Pain Relief:

There are wide range of prescription medications available for pain relief.

The spectrum ranges from NSAIDs such as naproxen or Diclofenac (which are typically used for minor inflammation or strains), through to anaesthetics used during surgeries.

Prescription pain relief medications also come in various different formulations including tablets, gels, capsules and pain relief patches.  

We’ve looked at some of the prescription medication pain medications below:

Prescription NSAIDs

Common prescription-only NSAIDs include Naproxen and Diclofenac. NSAIDs work by inhibiting production of a chemicals called prostaglandins.

Prostaglandins cause inflammation and pain in the body. By reducing prostaglandin production NSAIDs effectively treat pain and swelling.

Some NSAIDs such as Ibuprofen are available over the counter.

Prescription Opioid Analgesics

Opioids are strong pain relief medications usually used to relieve moderate to severe pain. However, due to risks of addiction, they should be used extremely cautiously.

Some weaker opioid analgesics are available over the counter. Some brands include Solpadeine, Paramol and Nurofen Plus. These medications often combine several active ingredients. Typically, paracetamol or ibuprofen and then a low dosage of codeine.

Higher dose codeine phosphate is a prescription only medication. Prescription codeine is indicated in doses of 30-60 mg for the short-term treatment of acute pain.

Prescription Benzodiazepines

Benzodiazepines such as diazepam (Valium) or Alprazolam (Xanax) have several uses including helping to treat general anxiety disorder, other mental health conditions, sedation.

Diazepam can particularly be effective for pain management when patients are experiencing muscle spasms.

Pregnancy and Breast Feeding:  

As with all medications, pregnant and breast-feeding women should be especially cautious when taking pain killers or anti inflammatories tablets.

Medication Over-The-Counter Safe When Pregnant?* Safe When Breastfeeding?*
Paracetamol Yes Yes Yes
Ibuprofen Yes No Yes
Codeine Phosphate Yes No No

*Please note, the above table assumes patients are using medication at the recommended dosage.

Paracetamol is safe to use when pregnant and breast feeding.

Ibuprofen is not recommended in pregnant, especially after 20 weeks as it can interfere with a baby’s heart and kidney development. Paracetamol is a safer alternative.

Codeine phosphate should be avoided during pregnancy and when breastfeeding due to the risk of the medication being passed through breast milk or to the unborn baby.

Contraindications For Anti Inflammatories

A contraindication is a reason why a certain treatment or procedure should not be used because it can be harmful to a patient.

Contraindications can be absolute (extremely serious and avoided in all circumstances), or relative (acceptable in certain circumstances if the benefits outweigh the risks).

The most widely used anti-inflammatories are Ibuprofen, Naproxen and Diclofenac. These medications are known as NSAIDs.

Some key contraindications for NSAIDs include (but are not limited to):

  • Pregnancy– NSAIDs should be avoided in pregnant women, especially after week 20. Paracetamol is considered a safer alternative.
  • Gastro-intestinal bleeding– NSAIDs should be avoided in patients with a history of gastro-intestinal bleeding.

Where Can I Buy Pain Relief Medications In The UK?

At Meds for Less we stock a range of meds for pain relief and anti-inflammatory treatments.

You can buy paracetamol, ibuprofen and aspirin and have them delivered to your door, next day.

We also stock a range of over the counter and prescription lines.

At Meds for Less you can buy Solpadeine, Paramol and other weaker opioid analgesics after you fill a short health questionnaire.

Our prescription lines include Naproxen and Diclofenac.

When purchasing prescription items at Meds for Less, you’ll be asked a few simple questions regarding your symptoms during checkout.

This information will be submitted to a doctor, who’ll then write a prescription for you (if appropriate.) Your medication will be shipped thereafter.

What is the strongest over the counter painkiller you can buy in the UK?

The strongest over the counter painkiller in the UK is co-codamol, an opioid analgesic containing codeine and paracetamol.

Co-codamol is available as a generic medication or under brands such as Solpadeine or Migraleve.

Other opioid analgesics such as Nurofen Plus are over the counter in the United Kingdom. Nurofen Plus contains ibuprofen and codeine, rather than paracetamol and codeine.

Codeine is available in these medications up to 8mg. Codeine containing medications above 8mg are prescription only.

Can you get pain meds over the counter?

Over the counter pain medication is pain medication you can buy without a prescription from a doctor.

Several types of pain killer are available over the counter, including paracetamol, ibuprofen, low-dose codeine (co-codamol), low-dose dihydrocodeine (sold under brands such as Paramol) and aspirin.

For stronger pain medications or strong anti inflammatories, a prescription is required. For any medications containing codeine, anything in dosage above 8mg will require a prescription.

What is the safest pain medication for long-term use?

Long-term pain (known as chronic pain) is a serious health condition which can seriously impact a person’s quality of life.

For patients suffering from chronic pain prescription NSAIDs such as (diclofenac, naproxen, ibuprofen and aspirin) can form part of an effective treatment plan. However, when using these medications long-term it’s paramount there is medical supervision to avoid risks to the liver, kidneys and stomach.

However NSAIDs are available as cream pain relief or as gel pain relief medications, which may help mitigate some of the side effects and might be more suitable for long term use.

Paracetamol is a good option for pain management, however if taken in higher doses or with alcohol it can lead to liver damage. Using paracetamol long term also has implications, regular use of paracetamol can cause damage to the kidney and liver.

Opioid analgesics can be effective tools in pain management but there is a risk of addiction with these medications if used long term.

Ultimately when managing chronic pain, you should work with a professional to develop an effective treatment plan which incorporates medication and non-pharmacological treatments.

There is no ‘safest’ option, the best option will vary person to person depending on age, overall health status and other medications a person. 

What can I take for all over pain?

To effectively manage pain, it’s important to understand the root cause.

Understanding the root cause will allow development of specific and effective pain management strategies incorporating both pharmacological and non-pharmacological treatments.

However, generally the following medications have been proven effective at fighting pain all over the body:

  • NSAIDs – NSAIDs such as aspirin, ibuprofen, naproxen and diclofenac help inhibit the production of prostaglandins. Prostaglandins are chemicals that promote swelling and pain in the body. NSAIDs are available as tablets, capsules, gels or as an anti inflammatory cream (sold under brands such as Phorpain or Voltarol)
  • Paracetamol – Paracetamol works in a similar way to NSAIDs but is not helpful with swelling, however paracetamol generally has less side-effects than NSAIDs (especially fewer stomach related side effects.) Paracetamol can be bought alone, or in branded products such as Panadol or Lemsip.
  • Opioid Analgesics – Opioid analgesics are highly effective pain management medications. They target opioid receptors in the brain to block pain signals. However, there is a risk of addiction with these medications.
What to do when chronic pain is unbearable?

Chronic pain can be debilitating, however, if possible, it’s best to stay active through exercises such as walking, swimming or yoga. You should also continue to work if possible. Resting too much can lead to weakened muscles, poor sleep and more intense pain.

Additional strategies such as physical therapy or work with occupational therapists can also help with pain management.

There are also medications which can help relieve chronic pain. Medicines such as paracetamol and ibuprofen can be used to manage pain. So can over the counter opioid analgesics such as co-codamol.

There are also prescription options, including prescription strength NSAIDs which have a wide therapeutic index.

Is Co-Codamol an opioid?

Yes, co-codamol (including brands of co-codamol such as Solpadeine or Migraleve) contain codeine. Which means they’re opioids.

They’re lower dosage over-the-counter opioids however they are still opioids.

What is the strongest drug for nerve pain?

Many of the medications used to treat nerve pain are prescription medications. These include:

  •       Gabapentin – A prescription only medication commonly used for nerve pain relief.
  •       Pregablin – Similar to gabapentin, but often prescribed for neuropathic pain.
  •       Amitriptyline – A tricyclic anti-depressant used for nerve pain or migraine prophylaxis.
  •       Tramadol – A prescription strength opioid sometimes used to treat severe nerve pain.

All of these medications for pain relief are prescription only and should only be used when directed by a doctor.

Gabapentin, Pregablin and Tramadol are also controlled drugs in the UK. Meaning they’re subject to tighter controls than other prescription medications.

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