Medication Choices for ‘Everyday’ Pain

Do you ever have pain when you wake up?   Do you have pain when you sit too long?

Does your back bother you on a long car ride?  Do you get a headache when the weather changes?  Do your muscles hurt the next day when you overdo it?

What do you do about this ‘everyday’ sort of pain? 

You have many choices.  Walk in to any pharmacy, grocery store, or super store and you will find several shelves of options.  You will find brand name pain medications next to generic, or store, versions of the same medication.

Which ones do you pick?  Do you have a ‘stand by’ favorite or do you like to keep switching to try something new?  I have had many clients with either of these philosophies.

Here are a few things I want you to know about these options so you can make an informed decision.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are medications such as ibuprofen (brand names Motrin and Advil), naproxen (brand name Aleve), and aspirin (brand names Bayer, Excedrin, Bufferin).  These can relieve pain, fever, and inflammation.  The over-the-counter doses are lower than the prescription doses.

There are three big risks associated with these that I want you to know about:

  1. They can be hard on your kidneys. Be sure your doctor and your pharmacist know that you take these, how much you take, and which ones you take.  They will monitor your kidney function and likely ask you to stop taking them if your kidneys show signs of injury.

  2. They can be hard on your stomach. Your risk of stomach ulcer goes up when you take these.  ALWAYS take them with FOOD.  If you develop stomach pain, more indigestion, reflux, or burning, tell you doctor.

  3. They can raise your blood pressure. This in turn can increase the stress on your heart.  If you have high blood pressure or a heart condition, talk with your doctor and pharmacist BEFORE choosing to take an NSAID.

Another important tip is to make sure your doctor and your pharmacist know you are taking any NSAID and how much.  There are many of these available by prescription.  I have seen many people who are taking a prescription and an over-the-counter NSAID at the same time.  They had no idea because the names are different.  So, share all of your medications – prescribed and self-selected – with your healthcare team.  Too much NSAID makes the three risks stated above worse.

Acetaminophen

Acetaminophen (brand name Tylenol®) is similar to the NSAIDs without the anti-inflammatory part.  Acetaminophen can relieve pain and fever.  Studies have found it is just as effective as NSAIDs for relieving pain not associated with inflammation.

There are two primary risks with acetaminophen:

  1. Too much can hurt your liver. The current guideline is to take no more than 3 grams (3,000 mg) per day.

    1. Drinking alcohol can make the damage to your liver even worse.

    2. If you already have liver problems, talk with your doctor and pharmacist BEFORE taking acetaminophen.

  2. It can increase the blood thinning effects of warfarin.

    1. If you are on a blood thinner, talk with your doctor and pharmacist about taking acetaminophen.

Note, acetaminophen can be found in many combination products.  Please look for it in your headache, cold, flu, sinus, and prescription pain medications.  The TOTAL amount for the entire day should be 3,000 mg or less.

Some other options

Sometimes there are simple things you can do that will relieve the pain without the use of medication.  Here are just a few:

  • Stretching – for sore muscles and back pain

  • Icing – for sprained or strained muscles

  • Applying heat – for back pain

  • Drinking plenty of water – for headache

  • Closing the eyes and covering with warm compress – for headache

  • Exercising – even a stroll can help with some muscle and back pain and relieve tension related headaches

Your physical therapist is a wealth of information about stretches and exercises to relieve many types of pain.  In many states, you can call and make an appointment with your physical therapist without a referral.

 

Submitted by Michelle Fritsch, Pharm.D., CGP, BCACP    MSRN Member

410-472-3870  or EMAIL: michelle@medsmash.com