Painful Times

Everyone has pain sometimes. Almost any injury or illness can affect the tissues and nerves, and cause pain. Nerves carry the feeling of pain from where the pain is to the brain, which tells us we are 'hurting'.

The International Association for the Study of Pain defines pain as 'an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage'.

Pain is extremely difficult to measure - what some people find agonising, others may consider bearable.

Types of Pain

Short-term pain, sometimes called acute pain, can be caused by a number of things, such as a burn, a sprained ankle or toothache, and tells the body that something is wrong. It can be severe but it doesn't last very long. Words used to describe short-term pain include 'sharp', 'stabbing', 'burning' and 'sore'. If this pain persists you should consult your doctor.

Long-term pain, sometimes known as chronic pain, happens every day or comes and goes. It can be caused by many conditions including arthritis, pain joint or nerve problems in the lower back, angina, leg ulcers or stomach ulcers. Chronic pain can often affect your quality of life. Words associated with long-term pain include 'dull', 'throbbing', and 'deep'.

Pain is classified as being mild, moderate or severe. Most common aches and pains, such as headaches, migraine, period pains, toothache, sore throat, muscle spasms, some nerve pain (neuralgia) and fever are in the short-term mild to moderate category. You can buy pain relievers (analgesics) that will help to reduce short-term or acute pain 'over the counter' (sometimes shortened to OTC) from your pharmacy. This means you don't need a doctor's prescription to get them. However you should only use them for a few days at a time. If the pain continues for more than that, you should go back to the pharmacist or see your doctor.

Beating Pain

When you know what is causing pain, you should try to relieve it. Wanting pain relief is not a sign of weakness, it means you can get on with the rest of your life! There are several practical things you can do to relieve pain. You can:

• have a hot bath to help muscular pains, stiffness, stomach-ache and period pains;
• use cold compresses or ice packs for headaches and sprains; and
• get someone to give you a massage for headaches or tense shoulders.

But sometimes we need the extra help that pain relievers can give. These work in different ways and it is important to take the right one for your symptoms. Different pain relievers suit different people. What suits your family and friends may not suit you. If you are not sure which pain reliever you should be using, please ask your pharmacist.

You can get two types of pain relievers over the counter: those you take by mouth (oral pain relievers) and those you apply to the skin where the pain is (topical pain relievers). You can also get pain relief products that you put up your back passage (rectally) if you find it difficult to swallow. These are called suppositories and your pharmacist is the best person to tell you about these.

Oral Pain Relief

Oral pain relievers are available as tablets (you can get some that will dissolve), capsules or liquids. They may contain one or more active ingredients such as:

• a non-steroidal anti-inflammatory drug (sometimes called an NSAID for short) such as aspirin or ibuprofen;
  
• or paracetamol.

They are convenient to take and can give pain relief from a variety
of conditions.

Aspirin, ibuprofen and paracetamol are good all-round pain relievers and can all help to reduce a high temperature. Ibuprofen can also reduce inflammation and swelling.

Pain relievers are sometimes combined with opioids such as codeine or dihydrocodeine to improve the pain relief effect. Your pharmacist will be able to advise you which ones are available over the counter. However these combinations may make you drowsy. If you are planning to use machinery or drive, please ask your pharmacist to recommend the most suitable product.

You can get pain relievers combined with other products to relieve symptoms such as sickness that can be caused by migraine, and the nasal congestion that can be caused by colds and flu.

Aspirin, ibuprofen, paracetamol and opioid pain relievers are all effective medicines for treating short- term pain and are safe when you follow the instructions.

Topical Pain Relief

Topical pain relievers are available as creams, rubs, ointments, gels, liniments, mousses or sprays. They can be particularly useful if you cannot take oral pain relievers.

Local anaesthetics in the form of topical liquids or gels help reduce the pain caused by mouth ulcers and teething, when you put them where the pain is. Muscular pain relievers that you rub onto the skin where the pain is help with sprains and strains, rheumatic, muscular and mild arthritic pain.

Childhood Pain

Apart from the usual bumps and scrapes that happen to all children, there are a number of conditions that can cause children pain. These include
any illness that causes a high temperature, such as colds and flu, or chickenpox. You can get suppositories for children who can't swallow, but please ask your pharmacist for advice.

You can get ibuprofen and paracetamol as a liquid (called a suspension) in different flavours for children. You can use them to relieve the flu-like aches, pain and fever of measles, the facial swelling of mumps, and the discomfort and fever of chickenpox. You can give children's medicine that contains ibuprofen or paracetamol to babies that are suffering from post-immunisation fever, but please get advice from a health professional such as your doctor, practice nurse or pharmacist first.

What OTC pain reliever to use and when to use it

Precautions and side-effects

As with all medicines, pain relievers are safe and effective when you use them correctly and follow the instructions on the label or patient information leaflet inside the pack.

You should not give aspirin to children under 16, because there is a link between aspirin and Reye's syndrome in children with viral infections. Reye's syndrome is a rare but serious condition that affects the liver and the brain. The child may become unconscious and, in the most serious cases, may die.

You should get advice from a health professional before you take any pain relief if you:

• have asthma;
• have a stomach ulcer or colitis (inflammation of the colon);
• have kidney or liver damage;
• are taking prescription medicines, or alternative medicines, including herbal remedies;
• are pregnant or breastfeeding; or
• are buying it for someone else, for example, a child or an older person.
  

If the pain carries on or gets worse, you should ask your pharmacist for advice or go to your general practice.

If you have any questions about taking an OTC medicine, ask your local pharmacist or phone NHS Direct on 0845 4647 (where available).