MANAGING CHRONIC PAIN: OVER THE COUNTER MEDICINES

Chronic pain — what can I do?

Chronic or persistent pain is when pain occurs most days of the week, for at least a three month period. About 1 in 5 Australians suffer from chronic pain and it most commonly occurs in older people.

People experience pain differently and will have different responses to pain treatment. There are many ways to manage pain. You need to find the one that works best for you.

Managing pain involves strategies that help you reduce the impact of pain on your daily activities. It may include individually tailored exercises, performing activities that are within your pain tolerance and using pain relief medicines.

If you need a pain relief medicine, you may purchase it over the counter or get a prescription from your doctor. It is important to see your doctor, who can review your medicines, recommend options and help you decide what is best for you.

Using over-the-counter medicines

There are a range of pain relief medicines that can be bought without prescription as over-the-counter pain relievers, including paracetamol and aspirin. One of the most commonly used is paracetamol, which is effective for mild to moderate pain, if used correctly. When you take paracetamol, check that none of your other medicines contain the same active ingredient, as it can cause serious liver damage if taken in larger doses than recommended.

Speak to your doctor or pharmacist about the best options for you before buying any over-the-counter medicines. This is particularly important if you suffer from any other medical conditions, such as stomach, kidney, liver or heart problems.

To ensure the safest and most effective pain management from these medicines, talk to your doctor or pharmacist about:

• the location of the pain and how long you have had it
• possible side effects
• whether a particular pain management approach is right for you
• whether the medicine will interact with any other medicines you are taking.

When pain is caused by osteoarthritis, some people use glucosamine and/or chondroitin. However, the long-term benefits are unclear. If you use an over-the-counter medicine you should tell your doctor and pharmacist as it may affect other medicines you are taking. Add it to your Medicines List to help you keep track of your medicines. You can print the Medicines List form from our website. A consumer medicine information (CMI) leaflet gives you important facts to know before, during and after taking your medicine. Ask your pharmacist or doctor for the CMI for your medicine.

Using other pain relief medicines

• Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, should be used at the lowest dose that improves your symptoms and only be used for a short time. These medicines may not be suitable for people with stomach troubles, heart problems, kidney impairment, high blood pressure or asthma.
• Combination pain relievers contain more than one active ingredient. Examples include Nurofen Plus, which is a combination of ibuprofen and codeine; Aspalgin, which is a combination of aspirin and codeine; or Codalgin that is a combination of paracetamol and codeine. Check with your doctor or pharmacist before using these.
• Opioids include buprenorphine, codeine, fentanyl, morphine, oxycodone and tramadol. These medicines may be addictive and may have side effects such as nausea and vomiting. Due to their sedative effect, your driving abilities might be impaired. Never mix alcohol with opioids. For some people opioids are effective in controlling pain but others may not be able to tolerate them. 

Your checklist for pain management medicines

There are a number of important things to talk to your doctor or pharmacist about when working out the best pain medicine for your individual circumstances and preferences:

• Should I take this medicine at regular intervals or only when I feel pain?
• How long will it take to work?
• Is it safe to use in the long term?
• How will this medicine benefit me?
• Will this medicine make me feel drowsy?
• What side effects should I expect or watch out for?
• What can I do to minimise any side effects?
• How will this medicine interact with my other medicines?
• Could I become addicted to this medicine?
• What should I do if the pain doesn’t go away?
• What alternative kinds of pain medicine or management could I consider?

Non-medicine treatments

You need to find the right treatment for your individual needs. You may consider seeing a physiotherapist, chiropractor or other allied healthcare professional who may be able to help reduce and/or manage the pain. Keeping active may prevent or reduce the likelihood of further pain. You may find it useful to participate in support or self-help groups, where you can share experiences and learn about ways to manage pain from others in similar situations.

Talk to your doctor about a pain management plan.