Let’s face it: When it comes to managing those annoying aches and pains, the solution is not one-size-fits-all. While you can sometimes safely manage pain without a visit to the doctor’s office, using over-the-counter medications correctly can be confusing.
How do you know what’s best — and safest — for the pain you’re experiencing? For example, should you chose aspirin, acetaminophen or ibuprofen? So, before you reach for that pill, get to know how and when to self-treat your pain.
3 Main Categories of OTC Pain Products
In order to understand how to choose and use OTC pain medications correctly, you must first understand the different categories. Over-the-counter medications for pain generally fall into three basic categories, explains Dr. Hersh Patel, chief of the division of Pain Medicine at ChristianaCare in Newark, Delaware.
— Nonsteroidal anti-inflammatory drugs (NSAIDs).
— Acetaminophen (Tylenol).
— Natural supplements for pain.
[Read: Tips for Chronic Pain Relief.]
Nonsteroidal Anti-inflammatory Drugs
NSAIDs include painkillers like aspirin, ibuprofen (Motrin, Advil) and naproxen (Aleve). These drugs work by interfering with the body’s ability to produce chemicals that cause pain and inflammation.
According to Patel, NSAIDs tend to do a better job of relieving injuries that involve inflammation than other OTC options. If you’re healthy overall with no kidney, stomach or heart issues, aspirin is a fast-acting go-to for pain that doesn’t last very long — like a headache.
However, if you have heart failure, you should avoid NSAIDs because they can make this condition worse. Also, NSAIDs can sometimes enhance the effects of blood thinners, so double check your medications and talk to your health care provider before giving them a try.
Acetaminophen
Acetaminophen (Tylenol) is your best bet for when NSAIDs are not an option — for example, if you have peptic ulcer disease, are allergic to aspirin and related drugs or have bronchial asthma. It also makes a good choice for children less than 12 years old and women who are pregnant or breastfeeding. Patel says that acetaminophen is a great option for elderly patients, people who have kidney problems and people who use blood thinners.
Believe it or not, nobody really knew how acetaminophen worked for more than 100 years after it was discovered. Like NSAIDs, it can reduce fever and soothe aches and pains, but it has no effect on inflammation. And while there’s now a better understanding of how it works, scientists are still figuring out how it acts on certain parts of the brain to ease those woes.
A few points of caution with acetaminophen: You’re better off taking an NSAID if you’re looking for pain relief within six hours of drinking, and it’s always a good idea to review your entire medication list before taking acetaminophen — whether prescription or over the counter. That’s because many OTC medications — like those for cough and cold — contain acetaminophen in combination with other drugs, as do many prescription painkillers.
Natural Supplements for Pain
This category usually refers to OTC products the U.S. Food and Drug Administration classifies as dietary health supplements. Examples are magnesium, arnica and turmeric. The good thing about natural supplements is that you can consume many of these products and reap their benefits by eating an anti-inflammatory diet.
Studies indicate that magnesium can help your body feel less sensitive to pain, but how much to take and the best form — spray, pill, powder, tablet, etc. — depends on the individual and the reason you need it. For example, ingesting too much of certain magnesium supplements can cause diarrhea.
Turmeric is popular for supporting an appropriate inflammatory response but may enhance the effects of blood thinners.
Arnica has been used traditionally in herbal and homeopathic medicine for hundreds of years, and now you can find arnica creams, gels, ointments and tablets for pain. Studies show that arnica reduces inflammation and can help with pain from rheumatoid arthritis, osteoarthritis and lower back pain, to name a few. While there are arnica teas, it’s generally not recommended to take arnica as a tea.
Before using any natural product, please speak to your pharmacist to help you make an informed decision.
[READ: New Treatments for Knee Pain.]
Read the Label
Experts agree that examining the label is the single most important thing when choosing an OTC product to ease those bothersome aches.
“Read the drug product labeling specifically for the sections on the purpose, uses, warnings and directions for use,” says Rania El-Desoky, a clinical assistant professor at the University of Houston College of Pharmacy in Houston. Reading the drug product labeling will also provide information on ages appropriate for use, dosing and quantities of use.
But reading the label is just one part of the equation. You should make sure you fully understand what it says too, Patel says. Perhaps it warns you not to take the drug if you have a certain health condition or are taking certain medications. For example, after reading the label, you should understand how much to take at one time, the maximum amount that’s safe to take at one time and how often you can take the medication.
The label gives very specific directions about taking medication regarding the amount, frequency and duration. It also points out the circumstances under which it’s not safe to take a particular medication — like if you have certain health conditions.
“Kidney problems, breathing difficulties, blood pressure problems and gastrointestinal tract discomfort are health issues that can be adversely impacted by the effects of the over-the-counter medication,” Patel explains.
So, if any of the above apply to you, consider asking your doctor or pharmacist to help you select the right OTC medication. “All medications and supplements come with potential side effects,” Patel warns. “For that reason, it is important to know your health and profile.” You should also talk with your doctor or pharmacist before initiating any OTC medication long term to determine if it’s safe for you.
[See: On a Scale From 1 to 10: Most Painful Medical Conditions.]
Recognize When You Should See a Doctor
According to El-Desoky, understanding when to see a doctor or other qualified medical professional is the biggest pitfall in OTC pain management. “You need to know when to get in contact with a health care provider because there are many exclusions when self-treating pain,” she explains.
A headache that lasts for more than 10 days, being pregnant and in pain or showing signs of infection, such as fever, are just a few examples of when you should check with your pharmacist or doctor before using aspirin or another pain medication to to help relieve your pain.
El-Desoky also highly encourages patients to speak with their pharmacists regarding their pain, medical history, whether they smoke or drink and their current medications to ensure they are eligible for OTC self-treatment.
Don’t Take More OTCs for Longer Than Necessary
For Patel, the biggest concern with OTC medications is taking medication longer than the label or their medical professional recommends. “Most medications for pain attempt to treat the symptom, but these medications generally do a poor job of treating the actual injury,” Patel explains.
Your best bet for long-term relief? When taking OTC pain meds, talk with your doctor or pharmacist about using them combined with other treatments such as exercise, stress reduction and weight loss.
One of the best things Patel says you can do is see a pain management specialist to diagnose your injury and create a multi-pronged plan for pain relief.
OTC Warnings
The saying that less is more doesn’t just apply to makeup. The same holds true for medications, which means you should never take more than the recommended amount.
Acetaminophen is a classic example. If your liver is healthy, you shouldn’t take any more than 4 grams, or 4,000 milligrams, a day. But if you have liver damage, you should not take more than 2 grams, or 2,000 milligrams, a day, and this should be under the guidance of your doctor.
Also, alcohol and acetaminophen don’t mix, so be sure to avoid acetaminophen altogether if you plan on drinking in the near future. An aspirin overdose can be fatal, and children under 12 years of age should avoid taking the drug altogether.
“At times, a patient will overutilize OTC pain in medication hoping to alleviate it, but pain that doesn’t subside is likely a sign they should seek medical attention,” El-Desoky cautions.
One way to avoid overdoing it is by periodically reevaluating your pain to see if it’s getting better. “You should reassess your pain every so often to avoid taking more medication for longer than you actually need it,” El-Desoky says.
Is Any Class of OTC Pain Medications Better?
The answer? It depends. The type of pain, location and specific factors, including your current medical history and medications, all affect which type of OTC medication is your best bet. For example, NSAIDs may be ideal for patients associated with inflammation, but they can worsen kidney problems and blood pressure if you have severe kidney impairment.
“All medications and supplements come with potential side effects,” Patel says. “For that reason, it’s important to know your health profile and to select the medication that works best for you when you’re suffering from pain.”
This also includes seeking the advice of a medical professional to find the optimal medication for you. At the end of the day, sometimes, it takes a team effort to find the best answer.
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Questions to Ask Your Doctor for Nerve Pain
On a Scale From 1 to 10: Most Painful Medical Conditions
Pain and OTC Medications: Which Is Best? originally appeared on usnews.com
Correction 02/02/22: A previous version of this story incorrectly stated Dr. Hersh Patel’s title.
Update 04/12/23: This piece was previously published at an earlier date and has been updated with new information.
