HealtH spotligHt
10 drug-free optionsParacetamol is no longer recommended
for back pain. Dr Melanie Wynne-Jones
explains when pain relief works best
and what you need to know about itP
ain’s job is to warn and
protect us, but it can
feel more like the
enemy. As well as producing
unpleasant sensations
(musculoskeletal, dull or
cramping internal organ
pain and nerve damage), its
severity can vary depending
on activity, posture,
digestion or stress levels.
Weighing up the pros and
cons can help you find the
best solution – whether it’s
tablets, liquid, patches or
injections – or whether it’s a
non-drug option (see below).
If you’re pregnant or
planning a pregnancy, if1Find the underlying^
cause. Getting a diagnosis^
may lead to a cure, such
as surgery.2Ride it out – but only if
the cause isn’t serious
or progressive and you can^
manage with an occasional^
dose of painkillers.3Keep a pain diary of what^
helps. How your pain is^
affected by food, activity,
sleep and mood can give^
hints as to the best way to^
prevent or relieve pain.4To relieve an acute^
injury, try rest, an
ice pack, a support^
bandage and elevating^
the affected part.5A TENS (which stands for^
transcutaneous
electrical nerve stimulation)
machine, which delivers^
electrical impulses via pads^
on the skin, can bring relief.6Anaesthetic injections
(such as an epidural for^
back pain) or nerve blocks
for cancer pain may help.7Exercise boosts feelgood^
endorphins, while^
physiotherapy can help^
strengthensupportive tissues and^
relieve musculoskeletal pain,^
including arthritis.8Heat – via a warm bath,^
hot-water bottle or heat^
pad – can block nerve signals,^
but do be very careful not to
burn yourself.9Relaxation techniques,
such as mindfulness,
CBT (cognitive behavioural^
therapy), a pain management^
programme or joining a^
support group can reduce^
the impact of pain.10For more
information
advice and
support at british^
pain s o ciet y.o r g.you’re on other medicines
or have other conditions
(including heart/lung/
kidney/liver disease,
indigestion or raised blood
pressure), check with your
GP or pharmacist before
taking new medication.Over-the-counter/
prescription drugs
Paracetamol reduces fever
and many types of pain,
such as tension or migraine
headaches, strains, sprains,
toothache, period pain,
arthritis or post-operative
pain, although NICE, the
National Institute for Healthand Care Excellence, no
longer recommends it for
back pain. It’s often combined
with other painkillers, caffeine
or cold remedies. It can be
dangerous if taken incorrectly,
though, so always stick to the
recommended dose for your
age and size, as even a small
overdose can be fatal.
Non-steroidal anti-
inflammatory drugs (NSAIDs,
such as ibuprofen, are a good
option, but can cause stomach
irritation, wheezing or kidney
damage, and have been
linked to a higher risk of
cardiac arrest, so seek
medical advice if you need
them for more than two orthree days consecutively.
NSAID rub-in gels often work
well with fewer side effects.Prescription-only
painkillers
Codeine and tramadol are
both morphine-derived
painkillers that can be
prescribed alone or with
NSAIDs/paracetamol. They
can be effective for moderate
to severe pain, but can cause
drowsiness, constipation,
nausea or dizziness.
Morphine and similar-
strength drugs, such as
fentanyl and oxycodone, are
used for severe pain, such
as broken bones. Their
side-effects are stronger –
and, like codeine and
tramadol, they can be
addictive – but they’re safe to
take if monitored carefully.Neuralgia
This is caused by nerve
damage or malfunction, such
as a trapped nerve (sciatica),
or after shingles, an injury or
surgery, or by conditions such
as trigeminal neuralgia –
spasms of facial pain. Regular
doses of the antidepressant
amitriptyline, or epilepsy
drugs such as carbamazepine
and gabapentin, can block
pain signals so the brain
doesn’t feel them, as can
capsaicin cream, which is
derived from chilli peppers.go away!
PaiN, PaiN,
photos (posed by models): getty