Thursday, March 13, 2008

Painful, Inflamed or Both? What medications to use.

Are pain medications the same with anti-inflammatory medications? Should one be used instead of the other? Can they be used interchangeably? Can they be used at the same time?

First off, pain medications get a bad publicity both in the media and in the movies. You usually see stars or news on patients getting addicted to it. This is a sad faith for such useful medications. In reality, there are many types of pain medications, it is generally classified as “Analgesics” but from it stems various subtypes with each specific effect. This will range from the very basic such as acetaminophen or what we call paracetamol to the more advanced medications such as opiods. The opiods are the “addicting” medications portrayed in the media. If used accordingly and through a physician’s guidance, its medical importance is undeniable.

However, in most cases patients get pain medications mixed up with another subtype or kind, the anti-inflammatory medications or NSAID (non-steroidal anti-inflammatory drugs). From the term itself, anti-inflammatory medications are used on a condition that warrants control and abating inflammatory processes. In my previous article, acute inflammation is “usually” obvious to the naked eye. This is not the case if the inflammatory process is found deep within. Muscle, nerves or even ligaments or bone that are found in the inner layers of the limb may still be inflamed even if there is no warmth nor swelling outside. The patient only notices pain on certain positions or movements. One added benefit of anti-inflammatory medications is that it has a pain reliever effect too.

When patients tell their medication history, it is often only pain relievers. The pain goes away but after the effect of the medication subsides, they complain again. So they usually state that the medication is not working or useless. It is actually working but the cause of the pain is not addressed. Anti-inflammatory medications should then be used instead.

These are the common generic “Over the Counter” (OTC) pain medications in the Philippine drugstore:
1. paracetamol or acetaminophen
2. Mefenamic acid.
Brands such as Tylenol or Biogesic are Paracetamol base while Ponstan is mefenamic acid.

The anti-inflammatory medications that are over the counter are Ibuprofen found in Advil, or in the US, it is Motrin. Another one that recently became OTC is Flanax or Naproxen its generic name.

Some combine the two (Ibuprofen+paracetamol) such as Alaxan and Restolax. Its purpose is to combine the effect of removing the inflammation at the same time further relieve the pain while minimizing the usual side effect of gastric (stomach) irritation peculiar for anti-inflammatory medications.

So can your physician combine the two? Generally yes especially if the pain is too much. However, if your physician feels it can be taken care off by only one, then that would be 1 less medication to take.

Unfortunately, here in the Philippines, most of us like to take the advice given by a “friend” or “neighbor” who used this certain medication for his painful joint. Please be careful on such recommendations. This might not be the best drug for you and might end up making it worse. Consult your physician please.


Pain medications address only the pain and not the cause. If it is inflamed then,
anti-inflammatory medication should be used.

If over the counter (OTC) drugs such as those mentioned above do not work after a day or two, consult your nearest physical medicine and rehabilitation specialist.

Do NOT self medicate
based on the advise of a non-physician.

Combining both (pain and anti-inflammatory) medications can be done especially if the pain is too much to handle by the patient.

1 comment:

  1. Thank you for posting this, I found it helpful and informative. I was searching for safe OTC anti-inflammatory pain relievers aside from ibuprofen, which I am allergic to. I'm not sure if I'm allergic to mefenamic acid, so I think I will check first with a doctor before self-medicating.


If you find the articles helpful or like to give suggestions please post your comments.
I also welcome questions on the articles.