Pain Relievers
Besides topical anesthetics such as benzocaine, there are really only three types of pain reliever: Acetaminophen (example Tylenol, often called "non-aspirin pain reliever" in store brands), anti-inflammatories (ibuprofen, aspirin, naproxen, etc), and narcotics. But if an injury requires narcotics, you need to head for the emergency room. So your choice in over-the-counter medicine is between acetaminophen, which is easy on the stomach but has no anti-inflammatory properties, and the anti-inflammatory agents like aspirin and ibuprofen, with their higher risk of side effects such as ulcers, bleeding, and decreased kidney function.
Acetaminophen is a non-aspirin pain reliever. It is quite well-tolerated by the
stomach, so it's unlikely to cause nausea or abdominal pain. The most well-known brand of
acetaminophen is Tylenol.
Acetaminophen can be used for the pain of insect stings, burns, abrasions, as well as
bruises, and sprains.
Acetaminophen has NO anti-inflammatory activity. It has no anticoagulant effect. It
does not cause ulcers or irritate the stomach.
There's a limit to the amount of pain relief you can get with acetaminophen. Beyond 1000
mg (two extra-strength tablets), no further relief of pain occurs. Because acetaminophen
is poisonous in large doses, it's important not to exceed the recommended dose.
Usual dose: 2 tabs (650 mg) every 4 hours, up to four times daily.
Aspirin is a pain reliever with anti-inflammatory effects. Even at low doses, it
reduces the tendency of the blood to clot, and is therefore useful to prevent heart
attacks and strokes. The anti-clotting effect means aspirin is best avoided in injuries
that tend to bleed. Its anti-inflammatory effects make it useful for tendonitis. The most
well-known brand is Bayer.
Aspirin can irritate the stomach. The pills should be taken with food (if possible) to
prevent stomach upset. Aspirin should be avoided by persons with active ulcers, and by
those on anticoagulants (blood thinners). Aspirin decreases the tendency of the blood to
clot for many days after a single dose.
There's a limit to the amount of pain relief you can get with aspirin. Beyond two tablets
(650 mg), little further relief of pain occurs. Aspirin can easily cause poisoning if
doses are doubled. Do not take higher doses without the advice of your physician.
Usual dose: Two tablets (650 mg) every 4 hours, up to 4 times daily.
Ibuprofen is a pain reliever with anti-inflammatory effects. It is not aspirin, but
some persons with sensitivity or allergy to aspirin may have the same reaction to
ibuprofen. Ibuprofen is especially helpful for the pain of bruises and sprains. Its
anti-inflammatory effects make it useful for tendonitis. Common brands include Advil,
Motrin IB, and Nuprin.
Ibuprofen is usually well-tolerated by the stomach. The pills should be taken with food
(if possible) to prevent stomach upset. Ibuprofen does have some aspirin-like effects on
the stomach, so persons with active ulcers or sensitive stomachs should avoid ibuprofen.
There is a mild anticoagulant (blood thinning) effect lasting a few hours. Medicines of
this class can reduce the effectiveness of some blood pressure medications and diuretics
(water pills). If you're being treated for other health problems, ask your doctor how
often (or if) you can take ibuprofen.
There's a limit to the amount of pain relief you can get with ibuprofen. Beyond 400 mg
(two tablets), little further relief of pain occurs. Do not take higher doses without the
advice of your physician. (The prescription dose of ibuprofen is 800 mg three times a
day.)
Usual dose: 400 mg every 4-6 hours, up to four doses daily.
Ketoprofen is a pain reliever with anti-inflammatory effects. It is not aspirin, but
some persons with sensitivity or allergy to aspirin may have the same reaction to
ketoprofen. Ketoprofen is especially helpful for the pain of bruises and sprains. Its
anti-inflammatory effects make it useful for tendonitis. Common brands include Orudis.
Ketoprofen is usually well-tolerated by the stomach. The pills should be taken with food
(if possible) to prevent stomach upset. Ketoprofen does have some aspirin-like effects on
the stomach, so persons with active ulcers or sensitive stomachs should avoid ketoprofen.
There is a mild anticoagulant (blood thinning) effect lasting a few hours. Medicines of
this class can reduce the effectiveness of some blood pressure medications and diuretics
(water pills). If you're being treated for other health problems, ask your doctor how
often (or if) you can take ketoprofen.
There's a limit to the amount of pain relief you can get with ketoprofen. Beyond 50 mg
(two tablets), little further relief of pain occurs. Do not take higher doses without the
advice of your physician. (The prescription dose of ketoprofen is 75 mg three times a day.)
Usual dose: 25-50 mg every 6 hours.
Naproxen is a pain reliever with anti-inflammatory effects. It is not aspirin, but some
persons with sensitivity or allergy to aspirin may have the same reaction to naproxen.
Naproxen is especially helpful for the pain of bruises and sprains. Its anti-inflammatory
effects make it useful for tendonitis. Common brands include Naprosyn.
Naproxen is usually well-tolerated by the stomach. The pills should be taken with food (if
possible) to prevent stomach upset. Naproxen does have some aspirin-like effects on the
stomach, so persons with active ulcers or sensitive stomachs should avoid naproxen. There
is a mild anticoagulant (blood thinning) effect lasting a few hours. Medicines of this
class can reduce the effectiveness of some blood pressure medications and diuretics (water
pills). If you're being treated for other health problems, ask your doctor how often (or
if) you can take naproxen.
There's a limit to the amount of pain relief you can get with naproxen. Beyond 440 mg (two
tablets), little further relief of pain occurs. Do not take higher doses without the
advice of your physician. (The prescription dose of naproxen is 440 to 500 mg two to three
times a day.)
Usual dose: 220 mg every 8 to 12 hours.
Insect Sting Relief pads contain alcohol and benzocaine. Benzocaine is a topical anesthetic. The pads can relieve the pain of a fresh insect sting.
These pads are also wonderful for stinging nettle! If there's a small area of painful sunburn (like a back shirt-line burn), the anesthetic can give some relief.
Note: If a stinger is present (honey bee sting), remove it. The stinger should be removed by scraping gently (see the section on beesting). Next wipe the sting area with the medicated pad.
Using the sting relief pads on broken skin (such as a scrape) isn't recommended because of the alcohol.