How medicines fit in

Treatment types

Nociceptive pain

Non-steroidal anti-inflammatory drugs, or NSAIDs as this group of drugs are often called, are usually the first treatment you are given to treat your pain.

• Traditional NSAIDs

  There are a number NSAIDs - such as Ibuprofen - that reduce pain by calming inflammation.  NSAIDs work by blocking the activity of the enzyme involved in inflammation, cyclooxygenase, also known as COX.  Traditional NSAIDs are widely prescribed in the UK and are often the first choice for doctors; however, they are linked with stomach-related side effects including indigestion, ulcers as well as other more serious complications.

• COX-2 selective inhibitors

  Studies have shown that there are two forms of COX, simply known as COX-1 and COX-2.  COX-2 is more closely linked with inflammation, where as COX-1 is more closely associated with tissue repair.  By predominantly targeting COX-2, these medications provide pain relief without hindering the actions of COX-1.  As a result, studies have shown that there are less stomach-related side effects associated with COX-2 selective inhibitors compared to NSAIDs.

  There are a number of different NSAIDs available. People's responses to NSAIDs vary, so more than one NSAID may be tried before one that works best for you is found. NSAIDs generally come in tablet or capsule form and are usually taken by mouth.

  Some patients with heart conditions are not suitable for all NSAIDs. Your doctor will consider the benefits versus the risk before recommending a treatment.

Neuropathic pain

If your pain is caused by damage to your nerves, traditional painkillers may not be the most effective treatment for you. Different treatments can be used to reduce this type of pain, including medicines that are otherwise used to treat epilepsy and depression. However, it's important to understand that if your doctor prescribes you one of these medicines, it's in order to treat your pain and not because he or she thinks you're depressed or have epilepsy.

Sometimes damaged nerves can send 'extra' electrical signals throughout the body, stimulating a pain response. These medications are believed to reduce these 'extra' signals and provide significant relief from pain symptoms.

Your doctor is likely to either try different type and dosages of these medications to ensure your pain is managed effectively.

Make a note of what works

Keeping records, possibly in the form of a diary, can be an important part of your ongoing care. Write down how the medicines you take makes you feel, how well they work to reduce your pain, and so on. These are easy to forget if you don't note them down at the time they happen. Your doctor will need this information during your next appointment, so that he or she can give you the best possible help.  

When you visit your doctor, remember to bring your completed pain diary with you for discussion.