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Which painkiller for which problem?
Picking the best painkiller makes all the difference
Chronic toothache
In acute pain, take the maximum dose of the strongest two different types of painkiller you have, at the recommended time intervals, for as long as it takes the dentist or antibiotics to start making a difference.
Period pain
The pain is caused by hormone-like chemicals called prostaglandins in the womb lining, released in the second half of your cycle. Painkillers that have an anti-prostaglandin action - like the non-steroidal, anti-inflammatory drugs (NSAIDs) naproxen (Naprosyn), mefenamic acid (Ponstan) and ibuprofen - work best. Paracetamol has little or no effect.
Headache
Treat one-off headaches with ibuprofen, but daily use of painkillers can be a cause of ‘rebound' headaches. Regular tension headaches should be treated with alternative methods of pain relief, such as relaxation techniques or acupuncture. Click here for more information on headache causes and cures.
Knee pain from osteoarthritis
A mixed approach to pain is best. Topical analgesics, such as ibuprofen gel, are best for older people. Slow-release NSAIDs are useful at night. Alternatively, put a wrung-out, wet hand towel in the microwave and heat. Check the towel isn't too hot, then wrap it around the affected joint, cover it with clingfilm and leave it on for 30 minutes.
Nerve pain
Typically experienced by people with disc problems and by diabetics, the most effective relief comes from anti-epilepsy drugs gabapentin (Neurontin) or pregabalin (Lyrica), which slow down transmission of nerve signals.
Shingles
Pain after shingles - post-herpetic neuralgia - is caused by damage to nerve endings and can be acute. Gabapentin (Neurontin) works well for this, and a capsaicin cream that contains pepper (Axsain, Zacin) is also very good, but the burning sensation on application can be off-putting for some.
Heartburn
This pain, caused by excess acid in the stomach, can be very severe. Don't take aspirin or any other NSAIDs as they'll make it worse. The pain of heartburn is immediately relieved by using an antacid, but if you don't have any to hand, a large glass of water or milk may help. Prevent it happening with an over-the-counter preparation that reduces acid secretion and by watching your diet. Don't continue to treat the condition yourself, though - make an appointment to see your GP.
Never treat pain yourself for more than a few weeks without seeking medical attention.
The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk
