When you experience pain, you can use medication if simple measures such as rest or ice are not working.
Pain-relief medications are only one part of controlling pain. The role of medication depends on the type of pain you have.
If you have short term pain (pain that lasts for 3 months or less), you can buy many medications over the counter without a prescription.
If the pain lasts for more than 3 months, it is called chronic pain. Often chronic pain isn’t caused by an injury and has other causes. Pain medications may not continue to work for chronic pain and it can be dangerous to use these medications long term. There are many things you can do other than medicine to try to control chronic pain.
All painkillers have potential side effects, so you need to weigh up the advantages of taking them against the disadvantages. It’s important to review your medications regularly to make sure they are still helping you to function and improving your quality of life.
There are different types of pain medication.
- over-the-counter medication (nonsteroidal anti-inflammatory drugs (NSAIDS), paracetamol, codeine)
- opioids (codeine, morphine, tramadol)
- anti-epileptic medication (pregabalin, gaberpentin, carbamazepine)
- anti-depressants (amitriptyline, duloxetine)
Just because they are available over-the-counter does not mean that they are completely free of side effects and you should always check with your pharmacist or doctor if you are unsure whether these medications are safe for you or not.
If you have allergies, chronic illness or are on any other medicines always check first before taking these medicines. The pharmacist can help in giving medication advice in these cases. Always if your pain persists or you are concerned see your doctor.
Paracetamol (for example Panadol and Panamax) is effective for mild to moderate pain, if used correctly. It is suitable for most people and can help period pain, headaches and some types of low back pain (though you will still need to stay active so you recover more quickly).
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. Arthritis medicines and over-the-counter cold and flu medicines can contain paracetamol.
Paracetamol can be given to children from the age of one month for pain and symptoms of fever. Paracetamol for children can only be bought at pharmacies. Make sure you’ve got the right strength for your child's age and weight as overdosing can be dangerous. Read and follow the directions on the label carefully. If you are not sure, check with your doctor or pharmacist.
Non-steroidal ani-inflammatory drugs (NSAIDS)
Non-steroidal anti-inflammatory (NSAIDs) drugs, such as ibuprofen and aspirin, are effective against mild to moderate pain such as period pain, headache and pain associated with rheumatoid arthritis and osteoarthritis.
Use these at the lowest dose that improves your symptoms and only use them for a short time. These medicines may not be suitable for people with stomach troubles, heart problems, kidney impairment, high blood pressure or asthma. See your doctor if you need to take these medicines for more than one week. The use of oral NSAIDs in older people is usually not recommended.
Ibuprofen can be given for pain and symptoms of fever in children aged 3 months and over who weigh more than 5kg. Ibuprofen for children can only be bought at pharmacies. Make sure you’ve got the right strength for your child's age and weight as overdosing can be dangerous. Read and follow the directions on the label carefully. If you are not sure, check with your doctor or pharmacist. Avoid ibuprofen if your child has asthma, unless advised by your doctor.
Aspirin can be taken for mild to moderate pain such as period pain, headache and migraine. If you have gout, have had a stomach ulcer or are breastfeeding, you should only use aspirin if recommended by your doctor. Do not take aspirin if you have a condition that makes you bleed easily. Don't use aspirin in children under 12 years of age, unless directed by your doctor.
If you need stronger pain relief, you may need opioid medication. Opioids don’t work for all sorts of pain. They can also have serious side effects such as sedation, affecting the breathing and constipation, and they can lead to overdose and dependence.
Opioids may be used to treat chronic pain. Your doctor will usually suggest you start with a low dose to see if it helps.
Codeine is a type of opioid related to morphine. Codeine and codeine-containing medicines are no longer available without a prescription. Visit the TGA website to learn more about the change to codeine access.
The Society of Hospital Pharmacists of Australia does not recommend codeine where pain is mild to moderate and the dose is less than 30mg (below the amount required to offer a therapeutic effect). An alternative medicine may be better in these circumstances. For more information, visit the Choosing Wisely Australia website.
Morphine and morphine-like drugs (for example, oxycodone, fentanyl and buprenorphine) are strong painkillers. They can come in different formulations such as tablets, capsules and patches and will only be prescribed after consultation with your doctor or a pain specialist as part of a long-term plan to manage your pain. The dose and your response will be closely monitored.
Anti-epileptic medication is used to treat nerve pain. Other types of painkillers such as over-the-counter medication and opioids don’t work for this type of pain. However, anti-epileptic medication can be very effective for pain from shingles, diabetic neuropathy, peripheral neuropathy, neuralgia and restless legs syndrome. It is sometimes used in combination with other medication.
Pain from fibromyalgia can also be relieved by antiepileptic medication in some people.
Some medications originally developed to treat depression have also been shown to be useful for nerve pain when taken in very small doses. They can provide pain relief when other painkillers haven’t worked. They are sometimes used in combination with conventional painkillers. They can also improve sleep.
Anti-depressants may be used for people with spinal cord injury, shingles, diabetic neuropathy, irritable bowel syndrome, temperomandibular joint disorder, facial pain, fibromyalgia or nerve pain caused by cancer.
It is important to take this medication exactly as prescribed by your doctor.
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Last reviewed: August 2020