You are in pain. Which over-the-counter pain medicine is best for you?
Over-the-counter (OTC) products can often help with pain, and no prescription is necessary. Oral medicines fall into two general categories: Acetaminophen and NSAIDs. Some types of pain respond better to one than to the other, and each has its own set of benefits and risks.
Acetaminophen (Tylenol, Paracetamol, Panadol) helps with fever, headaches, and other aches and pains. It does not upset the stomach. Even though it does not treat inflammation, it is often recommended for arthritis pain because it has fewer side effects than do other oral pain medicines.
Acetaminophen is generally considered to be very safe. Note, however, that although the body breaks it down and eliminates most of it in the urine, some is converted into a toxic byproduct. Taking too much at one time, or too much over a period of days, can build up more toxins than we can handle. Alcohol causes the liver to convert even more of it into toxic byproducts, so while taking acetaminophen, men should not consume more than two drinks per day, and women one. More than 3,000 mg per day can damage the liver, and those with liver disease should check with a physician before using any. Be aware that prescription pain medicines may already contain acetaminophen.
NSAID stands for non-steroidal anti-inflammatory drug, and includes aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). NSAIDs relieve pain and fever, and, as the name indicates, reduce swelling from arthritis or muscle strain or sprain. When taken for a short time (no longer than ten days) they are safe for most of us. However, they can cause stomach upset, ulcers and can harm the kidneys. Some NSAIDs can be bought over the counter, and others are available only by prescription.
Those under 18 should not take aspirin, due to the risk of Reye syndrome. In addition, be cautious with NSAIDs if you have heart disease, high blood pressure, kidney disease, liver disease, stomach or digestive tract bleeding, or take blood thinners. Note that prescription pain medicines may already contain NSAIDs.
Topical NSAIDs, in the form of pain lotions and gels directly applied to the skin, provide relief from injuries and sore muscles and joints. They are generally safer than oral medication and have fewer side effects, but avoid them if you are already taking oral NSAIDs.
What about simple heat and cold? Hot and cold packs can provide relief for sore muscles and joints. Cold is usually most helpful during the first three days of a new injury, and reduces inflammation by constricting blood flow to the injured area. It is especially useful for the pain and swelling of an arthritis flare, sprain, or strain. Heat dilates the blood vessels, sending more oxygen and blood to the area. It relaxes the muscles and decreases pain sensation. Note that a heating pad is not recommended while using topical over-the-counter pain relievers, as that can cause too much of the medicine to be absorbed at once.
So, back to the question: which is best: acetaminophen or an NSAID? NSAIDs offer pain treatment and are anti-inflammatory, while acetaminophen can help relieve pain and fevers. Acetaminophen is metabolized in the liver, and is safer (and easier on the stomach) unless you have liver disease or have more than one or two alcoholic drinks per day. NSAIDs are metabolized in the kidneys, so, if you have or are at risk for liver disease, an NSAID is a safer choice. However, NSAIDs are risky for those with chronic kidney disease or gastrointestinal disease.
Remember to always carefully read labels, and to not hesitate to consult with your health care professional in order to find the most effective and safest pain reliever for you.
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