Medication
Do you need medication to help control your pain? Physiotherapists are not currently allowed to give tailored pharmaceutical advice, so you should always speak to your GP or pharmacist for specific advice. Here’s some general info about the different types of pain-relieving medications:
Paracetamol. Reduces pain, potentially by activating serotonin and cannabinoid receptors. Not a large anti-inflammatory role. Possible side effects include a rash, and kidney/liver damage if overdosed.
The preferred first line pharmaceutical option for pain relief.
Non-steroidal anti-inflammatory drugs (NSAIDs): voltaren, nurofen, celebrex, mobic. Blocks the production of prostaglandins that play a major role in the production of inflammation. Side effects: nausea, ulcers, headaches, high blood pressure, fluid retention.
Should not be used for acute injuries due to anti-platelet effect causing increased bleeding. Some recent research also suggests inflammation may play a key role in the resolution of acute pain! Therefore, avoiding anti-inflammatories could be wise to reduce the likelihood of an episode of acute pain developing into chronic pain.
Corticosteroids: prednisone, cortisone, prednisolone. Suppress the immune system and subsequently the inflammatory response. Side effects include fluid retention, salt imbalance, kidney and adrenal damage, growth irregularities, muscle wasting, increased infections, ulcers, impaired wound healing, reduced bone density.
Pain is an immune response, less immune function can mean less pain, but voluntarily impairing your immune function has obvious issues. This is why these are not a first line treatment.
Opioids: codeine, fentanyl, oxycodone, morphine. Block incoming nociception messages (which may result in an experience of pain) in the spinal cord and brain. Highly addictive and side effects include: sleepiness, constipation, nausea, shallow breathing, slowed heart rate, loss of consciousness.
Some very serious side effects and addiction make these best to avoid unless absolutely necessary. Often only prescribed for high levels of acute pain, intended for very short-term use.
Summary: Pain relief via heat or ice, movement, modifying your activity (doing less of the things that hurt), improving sleep will affect the same physiological mechanisms that the above drugs do, without all of the nasty potential side effects. Maybe it will be slower, maybe it will take some trial and error, but is usually a better option.
Having said that, medication can be a very helpful part of a well-rounded treatment plan, so if you can’t get on top of your pain, speak with your GP or pharmacist about the best option for you.