What is pain-relief medicine?

Pain-relief medicines are used to manage short-term (acute) or long-term (chronic) pain. They work by either treating the underlying cause of your pain, or by blocking the pain signals that travel through the nerves to the brain.

What are the different types of pain-relief medicines?

Everyone experiences pain differently. Some pain management options suit certain circumstances or health conditions better than others.

There are different types of pain-relief medicines, including:

• non-prescription medicines — paracetamol and some non-steroidal anti-inflammatory drugs (NSAIDs)
• prescription medicines — such as anticonvulsants, antidepressants and opioids

There are also many different formulations of pain-relief medicines, including:

• tablets, capsules and powders
• gels and creams
• liquids
• patches
• inhalations
• suppositories
• injections

Some are taken once a day or once a week. Others are taken several times a day. The formulation that's best in your situation depends on many factors — ask your doctor or pharmacist for advice.

There are also many ways to manage pain that don't involve medicines, such as:

• stress management
• meditation
• acupuncture
• exercise

Over-the-counter (OTC) medicines for pain relief

Over-the-counter (OTC) medicines are medicines that you can buy without a doctor's prescription. Some types of OTC pain-relief medicine are available from a pharmacy and some shops. These are usually suitable for mild-to-moderate pain.

There are 2 common types of OTC pain medicines:

• Paracetamol is often recommended as the first medicine to try for short-term pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of medicines that work by reducing swelling and inflammation and relieving pain. These include aspirin, ibuprofen and diclofenac.

You can also try OTC gels and creams, such as NSAIDs and capsaicin cream, which are absorbed through your skin.

OTC medicines are easier to get than prescription ones, but they still carry risks. They can sometimes cause unwanted side effects. If you take other medicines or substances, OTC pain-relief medicines can affect how your body responds to them. Your doctor or pharmacist can advise you if it is safe to take OTC medicines for pain relief with your other medicines.

Supplements

• Some people find that supplements can help them manage chronic pain. Ask your pharmacist if there is evidence to support taking a supplement for your specific condition.
• For chronic pain caused by osteoarthritis, some people find glucosamine or chondroitin supplements helpful.
• Research also suggests that omega-3 fatty acid supplements can help some types of arthritis pain as well as period (menstrual) pain.

Prescription medicines for pain relief

You need a doctor's prescription to access certain medicines from a pharmacist. Dentists, some authorised nurses and some other registered health professionals can also prescribe some medicines.

Prescription NSAIDs

Some NSAIDs, which you can buy over the counter in low doses, are available in higher strengths on a prescription. These include NSAIDs such as diclofenac and naproxen. Other NSAIDs (such as indometacin) and COX-2 inhibitors (such as meloxicam) are only available with a prescription

These medicines may not be suitable for everyone, including people with:

• some stomach problems
• liver problems
• high blood pressure (hypertension)
• asthma

Opioids

Opioids (such as oxycodone, morphine and codeine) can be used to treat moderate or severe short-term (acute) pain. Your doctor might prescribe them for pain relief after surgery or an injury, or for chronic pain in people with cancer.

Only use opioids that are prescribed for you, and for the pain condition your doctor prescribed them. Never share opioid medicines.

There is no clear evidence that opioids are helpful for chronic non-cancer pain. Opioids can be addictive. They may also cause serious side effects such as life-threatening breathing problems.

Common side effects of opioids include:

• nausea
• vomiting
• constipation
• drowsiness

The longer someone takes opioids, the more likely they are to experience side effects. It's best to use them for the shortest time possible.

Anticonvulsant medicines

The anticonvulsant medicines gabapentin and pregabalin are commonly prescribed medicines for people with nerve pain (neuralgia) or fibromyalgia.

Carbamazepine is another anticonvulsant medicine that can help manage severe facial pain caused by trigeminal neuralgia.

Antidepressants

Antidepressants work by changing the way you experience pain. Some antidepressants, such as amitriptyline and duloxetine, may be prescribed to help manage certain types of chronic pain. For example, they may help treat nerve pain (neuralgia) or pain caused by fibromyalgia.

Topical products

Some pain-relief medicines can be applied directly to the skin at the site of your pain. These are called topical medicines. Examples include gels and creams. They can be helpful for short-term pain relief (for example, in osteoarthritis).

Topical pain medicines often contain NSAID-type medicines such as ibuprofen, diclofenac or piroxicam. They work by decreasing inflammation and swelling.

Capsaicin is an extract from chilli peppers that is also sometimes used in topical pain-relief medicines.

Small amounts of medicine can be absorbed into your blood from topical medicines, so it is important to use the right amount. Always read the instructions on the package before use. You can also talk to your pharmacist or doctor if you have questions.

Other medicines

Other medicines used to help manage pain include the following:

• Corticosteroids like prednisolone or prednisone can help relieve pain caused by inflammation or arthritis.
• Medicinal cannabis may be effective for neuropathic pain, if other medicines have not been helpful. This must be prescribed by a doctor who has specialised training in pain management using medicinal cannabis. Each state and territory in Australia has its own laws about prescribing, administration and storage of medical cannabis.

Is taking long-term pain-relief medicines dangerous?

Regularly taking pain-relief medicines can be important in managing certain health conditions, such as arthritis.

Your doctor or pharmacist can tell you about any side effects associated with long-term use of your specific medicines. They can also recommend ways to help minimise any unwanted effects, for example, taking the medicine at a particular time of day.

Some types of pain and health conditions, such as chronic pain, may be managed together with non-medicine strategies. Talk to your doctor to see if these methods could help you.

Read more on options for managing chronic pain.

Do pain-relief medicines cause side effects?

Most medicines can cause some unwanted effects. You might have side effects even if you take your pain medicines exactly as your doctor prescribes.

Some side effects can resolve after you have been taking the medicine for a while. Speak to your doctor or pharmacist before stopping your medicine or changing the dose, so you understand what to expect.

Opioids can cause serious side effects at any time during their use. This may include potentially life-threatening breathing problems.

If you have side effects that concern you, talk to your doctor or pharmacist as soon as possible. Every medicine has its own list of possible side effects. More information about side effects of each medicine can be found in the Consumer Medicines Information (CMI) leaflet in the package.

Can I become addicted to pain-relief medicines?

Most pain-relief medicines are not addictive. However, the risk of side effects may increase the longer you use them.

Opioid addiction

Pain-relief medicines that contain opioids carry a risk of addiction.

After taking opioid medicines even for a short time, you can become tolerant to the medicine. This means that over time, you need a higher dose to achieve the same level of pain relief. The higher your dose of opioids, the greater your risk of unwanted and potentially dangerous effects.

It is also possible to become dependent on opioid medicines. This means that if you stop taking them, you may get withdrawal symptoms and start craving opioids.

Some people can become addicted to opioids. This means that they feel a compulsion (very strong urge) to take opioids even if the medicine is having a negative effect. Symptoms of addiction include uncontrollable cravings (being unable to control your opioid use), even if it's having a negative effect on personal relationships or finances.

How can I use pain-relief medicines safely?

Here are some tips to help you use your medicines safely:

• Make sure your doctor knows about all the medicines you are taking. This includes any medicines bought over the counter at a pharmacy or prescribed by another health practitioner.
• Make sure you understand how to use your medicines. Always take them as recommended by your doctor. Ask your pharmacist if you are not sure.
• Talk to your doctor if your medicines are not helping you manage your pain, or if you are having problems with side effects.
• Never share your medicines with other people or take another person's medicine. Your doctor will choose prescription medicines that are right for you, based on your circumstances. Medicines can be dangerous if used inappropriately.
• Do not stop taking your prescription pain relief medicine suddenly. Ask your doctor or pharmacist about how to stop or reduce your medicine.
• Keep medicines in a safe place — out of children's reach.
• Return any unused medicines to a pharmacy for safe disposal.

When should I see my doctor?

You should see your doctor if you:

• have been managing short-term pain with OTC medicines without relief
• are unsure how to cope with your pain
• are experiencing side effects from your medicines
• are worried you or someone you know is becoming addicted to pain medicines, or using pain medicines in a way that has not been recommended by their doctor

If you need urgent advice, but your doctor is not available, speak with your local pharmacist.

Resources and support

• Call 1300 MEDICINE (1300 633 424) to talk about the medicines you are taking for your pain.
• Discuss your pain on the Pain Link helpline on 1300 340 357, which is staffed by volunteers with personal experience of chronic pain.
• Go to Painaustralia to find pain services and programs in your area.
• Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

Other languages

The Pain Management Network has translated some of its resources about managing pain into many community languages.

The Alcohol and Drug Foundation has translated their guide to using medicines safely into many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

The Pain Management Network has a collection of resources for Aboriginal and/or Torres Strait Islander people.

Pain Australia has information about services managing chronic pain for Aboriginal and/or Torres Strait Islander people.