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It doesn't hurt to ask

Monday 21st July

If you find the wide array of pain-relief options on the market bewildering, your pharmacist should have all the answers.

When you need pain relief fast, a pharmacist can provide helpful advice on the best over-the-counter (OTC) remedy for you. Your local pharmacy is in fact a good source of support on a number of health matters – from giving advice on how best to lose weight or quit smoking to providing blood pressure checks, flu jabs and holiday vaccinations.

“Choosing the right OTC option depends on your individual requirements and requires a closer look at your symptoms,” says Brian Deal, a community pharmacist at Ashwell Pharmacy in Hertfordshire. “You also need to take into account contraindications (factors making a specific drug unsuitable for you), such as allergies, any other medical conditions and medication you’re already on.”

Headaches

Symptoms: tension headaches are the most common type. Their symptoms include a dull, aching, bilateral pain – ie, on both sides of the head – or one that strikes across the front. You may also experience a tightening sensation across the head. Migraine symptoms differ and these include a throbbing sensation, usually on one side of the head. Nausea, vomiting, oversensitivity to light and visual disturbances can also occur.

Options: “Analgesics such as paracetamol, ibuprofen and aspirin are good pain-relief options for headaches,” says Zartasha Arshid, a locum community pharmacist in Manchester and member of the National Pharmacy Association. “Paracetamol is very effective in treating mild to moderate pain caused by headaches. If this fails to ease the pain, a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen can be taken. If the pain continues, you can safely take both types together, although it is better to stagger the doses.”

How they work: paracetamol helps to block the nerves that transmit the pain impulse to the brain. NSAIDs such as ibuprofen and aspirin work by reducing the level of prostaglandins, hormone-like substances that irritate the nerve endings and cause the feeling of pain.

Take with caution: never exceed the recommended dose with paracetamol. The drug may also be harmful for anyone with a disease of the liver or kidneys. Before taking NSAIDs, pregnant women and anyone with asthma, hypertension, renal impairment or peptic ulcers should ask their pharmacist for advice.

Period pain

Symptoms: lower abdominal pain, cramps, heavy bleeding, headaches, bloating, nausea.

Options: “NSAIDs such as ibuprofen are the best option, as they have the anti-inflammatory action that can often ease period pain,” Deal says. “This group of drugs works on reducing the production of prostaglandins and there is evidence to show that they help to reduce the heaviness of a period.” Arshid adds: “If pain persists, ibuprofen can be combined with paracetamol by staggering the doses. Hyoscine can also be taken to ease cramps.”

How they work: ibuprofen and paracetamol are effective against mild to moderate pain. NSAIDs also help to control the body’s temperature.

Take with caution: pregnant women or people with asthma, hypertension, kidney problems or stomach ulcers should take NSAIDs only after seeking medical advice. See previous advice for paracetamol.

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Joint pain

Symptoms: stiffness, reduced movement, pain in and around the joint, swelling. Joint pain may be caused by rheumatoid arthritis or osteoarthritis.

Options: “NSAIDs – for example, ibuprofen or diclofenac, available as a cream, spray or oral painkiller – are the best option for treating joint pain,” Arshid says. “Applying a topical preparation to the skin will help to increase blood flow and stimulate nerves in the affected joint.”

How they work: NSAIDs can help to ease musculoskeletal pain and reduce inflammation in affected joints by speeding up the healing process.

Take with caution: for anyone sensitive to NSAIDs, taking the drug via a topical preparation can make it safe to use, but always check first with your pharmacist.

Stomach upsets

Symptoms: bloating, trapped wind, griping pain, diarrhoea, heartburn, indigestion.

Options: “Simeticone is an OTC anti-flatulent that helps to relieve the symptoms associated with trapped gas,” Arshid says. “Loperamide can help to reduce the duration of diarrhoea. Antacids or alginates can help to relieve indigestion symptoms. H2 receptor antagonists such as ranitidine and proton-pump inhibitors such as omeprazole also help to ease indigestion discomfort by suppressing acid secretion in the stomach.”

How they work: Simeticone is an anti-foaming agent that enables trapped gas to be expelled more easily. It is not absorbed by the body and can be taken by infants and adults. Alginates form a “raft” in the stomach to prevent acid reflux and heartburn.

Take with caution: antacids contain sodium bicarbonate and should be avoided by people with restricted sodium intake, hypertension or heart problems. Alginates can impair absorption of other medicines and should be taken separately. Ranitidine is unsuitable for children aged under 16 and pregnant or breastfeeding women. Omeprazole is not recommended for pregnant or breastfeeding women, either. Loperamide is unsuitable for children aged under 12.

Seasonal aches and pains

Sunburn: if you find your skin going pinker than planned, taking paracetamol or one of the NSAIDs can help to minimise any mild discomfort. If there are associated signs of heatstroke or burns, especially in babies and children, seek medical help.

Insect bites: applying a topical antihistamine cream can relieve their redness and itchiness. For additional pain relief, paracetamol is the best option.

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