OTC Medications for Everyday Pain

Pain and love have a great deal in common. They are both remarkably small and compact words whose meanings are manifold and complex in their range and interpretation. At some basic level, we all know what pain is; yet it is a uniquely personal experience that, despite one's best attempts at empathy, remains the province of the individual sufferer.

There is no objective test to measure pain that reduces it to a quantifiable and understandable commodity. The source of one's pain can be the result of physical injury, but its expression and effects can be intensified by depression, fatigue, and stress. As one of my professors in medical school once said, "If someone tells me that they're in pain, then they're in pain."

When dealing with pain, it is first useful to characterize it. Is your pain sharp or dull, aching or throbbing, or continuous or intermittent? Where is it located, what makes it worse, what makes it better, is there a time of the day that is most difficult?

Some health care professionals label pain as "The Fifth Vital Sign" (after blood pressure, temperature, pulse and respiration) and ask patients to use a scale of 1 to 10 or a series of 5 diagrams, based on the happy face symbol, to describe their pain level.

Deep and traumatic injuries or debilitating diseases often require medications that are able to target specific symptoms with powerful pain relief, but for most of the everyday discomforts that afflict us all, over-the-counter medications (OTCs) will usually provide the help we need. (Drugs you can commonly buy in a store are often called OTCs as a way of distinguishing them from drugs that require a prescription.)

Most OTC medications contain either acetaminophen or non-steroidal inflammatory drugs (NSAIDS).

The NSAIDS, which include aspirin, ibuprofen, and naprosyn, have three qualities: they are analgesic (relieve pain), antipyretic (reduce fever) and anti-inflammatory (reduce inflammation). If there is an inflammatory aspect to your pain, it's best to use an NSAID.

Acetaminophen has only analgesic and antipyretic abilities. If you don't have inflammation with your pain, consider taking acetaminophen.

Many people fail to get relief because they do not take OTC medications in the correct dose, the correct frequency, or long enough to benefit. Most healthy adults can use the following amounts:

• Acetaminophen (including brand names such as Tylenol) comes in 325mg and 500mg doses. Adults can safely ingest as much as 1000mg (two 500mg tablets) four times per day.
• Most forms of aspirin come in 325mg and 500mg doses. Adults can take two of either tablet four times per day with a maximum amount of 4000mg in 24 hours. Be careful, as some brands of aspirin (like Excedrin) also have caffeine in them.
• Ibuprofen (including brand names such as Advil or Motrin) comes in 200mg tablets. Most adults could safely take 2 to 3 of these tablets three times per day.
• Naproxen Sodium (including brand names such as Aleve or Naprosyn) comes in 200mg tablets. Most adults can take at least two of these twice a day.

The dosing I've suggested for ibuprofen and naproxen sodium is similar to the strength prescribed by a physician and likely different than the directions on the label. For this and other reasons, make sure that your doctor is aware if you are using any of these medications on a regular basis.

There are some risks that need to be considered. NSAIDS can cause nausea, irritation of the stomach lining (which can lead to an ulcer), and in rare cases, kidney failure. Because they keep blood from clotting, NSAIDS prolong bleeding times, which can be beneficial for some people but dangerous to others.

Acetaminophen can be harmful to those who have pre-existing liver disease, or to people who are unknowingly ingesting it in more than one form. (It is the only ingredient in Tylenol and is present in all OTC meds with the Tylenol brand.)

If you are taking any prescription medications, talk with your doctor or pharmacist to avoid any dangerous drug interactions.

Again, I want to emphasize that these are medications and doses for adults. Aspirin should never be given to children; call your child's doctor before using any of the other medications for a child.

With a little bit of planning and careful understanding, OTC medications can substantially reduce levels of pain and allow you to function as normally as possible - and often at considerably less expense than prescription medications.

"Your Health" provides easy-to-understand information about common health conditions.