Pain can be caused by various factors, from arthritis and inflammation to headaches and cancer. Although prescription pain relievers are widely available, it is essential to try safer alternatives before resorting to narcotic or other problematic pain relievers. This article provides an overview of some safe and effective medication options for short-term pain control, starting with over-the-counter (OTC) and topical formulations.
Non-prescription pain relief
You can find several effective non-prescription pain relievers, including:
- Acetaminophen (e.g., Tylenol®) is harmless at typical doses but can affect your liver at high sustained dosing over weeks.
- Motrin and Aleve: Non-steroidal anti-inflammatory drugs (NSAIDs) help with mild to moderate pain. These are useful for the first 3-5 days after an injury to slow inflammation but should be discontinued as soon as possible to promote healing. Note that NSAIDs increase the risk of stomach acid and, potentially, stomach bleeding. They can also be problematic for individuals with heart conditions.
- Arnica (Arnica montana): This herbal pain reliever can be used in cream, ointment, salve, or tincture form to soothe muscle aches, reduce inflammation, and help heal skin wounds. Its medicinal use dates back to the 1500s.
- White willow bark (Salix alba): This plant-derived product contains salicin, which is similar to the acetylsalicylic acid found in Aspirin, as well as polyphenols and flavonoids that provide antioxidant, fever-reducing, antiseptic, and immune-boosting effects.
- Turmeric (Curcuma longa): High doses have been found to be safe and effective for relieving various sources of pain (joint, head, and more). Studies have shown it to be as effective as Ibuprofen for arthritis pain while being gentler on the stomach. It can be taken in capsules or incorporated into food, like golden milk.
Safe, effective topical prescriptions
Prescription topical pain relievers provide stronger pain relief and are relatively safe because only 2-3% of the medicine enters the bloodstream. A pharmacist specially trained in compounding must prepare these treatments in their lab, so they are not available at typical pharmacy chain stores.
Topical pain relief ingredients may include one or more of the following:
- Ketoprofen, Diclofenac, or Ibuprofen: When used in creams, these provide pain relief and anti-inflammatory effects for sprains, strains, and overuse injuries, similar to oral NSAIDs.
- Lidocaine: This well-known topical anesthetic can be highly effective, even on deep tissues, when used in 5%-10% concentrations.
- Ketamine: When applied to the skin, it absorbs into the bloodstream and reduces pain through central nervous system sensitization and peripheral nerve action at opioid and sodium-potassium channels.
- Gabapentin: A nerve modulator that blunts pain, also known as Neurontin.
- Clonidine: Trials have shown that 0.1% topical clonidine gel applied three times daily for 12 weeks significantly reduces foot pain in patients with painful diabetic neuropathy.
- Capsaicin: At 8%, this topical cream has been compared closely to Lyrica for neuropathy pain relief. A March 2016 report found that the 8% capsaicin patch and the 5% topical lidocaine patch were significantly more effective than oral gabapentin, opioid narcotics, Lyrica®, and tricyclic antidepressants for post-herpetic neuralgia.
- Tramadol: Research has shown that Tramadol is equally effective as ketamine for post-surgical mouth/throat pain.
- Amitriptyline: In a small 21-subject study, it was found that using 2% topical amitriptyline plus 1% ketamine cream was safe and effective for neuropathy pain relief.
It is important to remember that severe pain is usually short-lasting; however, there is a universal psychology that develops with chronic pain. In cases of severe or prolonged pain relief management, it is crucial to explore different treatment options and take into account the new opioid guidelines from the CDC (Centers for Disease Control).
