Pain is one of the most common reasons people seek medical help. For thousands of years, humans have been searching for ways to relieve pain, and one of the earliest remedies was willow bark, used for over 2,000 years to treat fever and pain. The active ingredient in willow bark, salicylic acid, was harsh on the stomach, leading to the discovery of aspirin in 1897 by German chemist Felix Hoffmann. This marked the beginning of modern pain relief.

Since then, pain management has evolved dramatically, with various painkillers available over the counter and by prescription. Whether you're experiencing short-term pain from an injury or dealing with a chronic condition, understanding how painkillers work can help you make informed choices.

Types of Painkillers and How They Work

Painkillers, also called analgesics, work in different ways to relieve pain and inflammation. Unlike anesthesia, which blocks sensation completely, painkillers allow you to stay alert while managing pain. There are three main types:

1. Paracetamol

  • Used for: Mild to moderate pain and fever.

  • Common forms: Tablets, capsules, liquid, dissolvable tablets.

  • How it works: Blocks pain signals and reduces fever but does not treat inflammation.

  • Caution: Overdose can cause serious liver damage.

  • Example products:

2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

  • Used for: Pain, fever, swelling, and stiffness in joints.

  • Common forms: Pills, liquids, gels, creams.

  • How they work: Reduce inflammation by blocking enzymes responsible for pain and swelling.

  • Side effects: Can cause stomach irritation, bleeding, and cardiovascular risks.

  • Common NSAIDs:

    • Ibuprofen, aspirin, naproxen, diclofenac, ketoprofen.

  • Compound painkillers (containing multiple ingredients):

    • Paracofadal – Contains paracetamol, metamizole sodium, and low-dose codeine (available OTC).

    • Acefein – Combines paracetamol, aspirin, and low-dose codeine (available OTC).

    • Solpadeine – Contains paracetamol and low-dose codeine (available OTC).

    • Lekadol Complex – Contains paracetamol and ibuprofen, available over the counter.

Important Note: If you're taking a daily low-dose aspirin for heart health, take it before NSAIDs to maintain its blood-thinning benefits.

3. Opioids (Narcotic Painkillers)

  • Used for: Moderate to severe pain when other painkillers don’t work.

  • Common forms: Tablets, liquids, patches.

  • How they work: Opioids bind to opioid receptors in the brain and spinal cord, blocking pain signals and altering the perception of pain. This makes them highly effective for severe pain relief, especially in post-surgical or cancer-related pain.

  • Side effects:

    • Nausea, vomiting, drowsiness, constipation, dry mouth.

    • Long-term use can lead to tolerance, dependence, and addiction.

  • Common opioids:

    • Morphine, codeine, oxycodone, tramadol, tapentadol.

  • Caution: Opioids not only dull pain but also trigger the brain’s reward system, increasing the risk of misuse and addiction. Overuse can lead to respiratory depression, which can be fatal.

When Should You Take Painkillers?

Painkillers are used to relieve pain from various conditions, including:

  • After surgery.

  • Injuries (fractures, sprains, cuts, bruises).

  • Headaches, menstrual cramps, muscle soreness.

  • Chronic conditions (arthritis, cancer, back pain).

They come in various forms, including tablets, capsules, powders, liquids, suppositories, patches, and topical creams.

Painkiller Safety Tips

  • Use the lowest effective dose for the shortest possible time.

  • Don’t mix painkillers without medical advice.

  • Avoid alcohol while taking painkillers, especially opioids and NSAIDs.

  • Monitor for side effects like stomach pain, dizziness, or changes in mood.

  • Seek medical help if pain persists beyond 14 days despite medication.

Recognizing Painkiller Addiction

Long-term use of painkillers, especially opioids, can lead to opioid use disorder (OUD), formerly called painkiller addiction. Signs of addiction include:

  • Taking more than prescribed.

  • Inability to stop despite negative effects.

  • Constantly thinking about the medication.

  • Using painkillers in dangerous situations (e.g., driving).

  • Developing tolerance (needing higher doses).

If you or a loved one is showing signs of addiction, seek professional help immediately.

Final Thoughts

Painkillers are essential for managing pain, but they should be used responsibly. Over-the-counter options like paracetamol and NSAIDs are safe for short-term use, while stronger painkillers, including opioids, require close monitoring. Always consult a doctor if pain persists beyond two weeks, and be mindful of the risks of long-term painkiller use.

Your pharmacist’s advice: Opt for generic painkillers—they are just as effective as brand-name versions but more affordable. If in doubt, ask your pharmacist for recommendations based on active ingredients rather than brand names.

By understanding how painkillers work, their benefits, and potential risks, you can make informed choices for safer and more effective pain relief.