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Ask a Physio: Why don’t painkillers work?

03 December 2018

Good question!

We don’t get much benefit from our painkillers because of two main reasons:

1.Taking the wrong type

Broadly speaking, painkillers fall into two types:

  • Pain blockers : these have the letters -ol in their name eg. paracetamol, codydramol, tramadol
  • Anti- inflammatories: these have the letters -fen in their name, ibuprofen, neurofen, diclofenac sodium

Pain blockers work best when there is no inflammation associated with the pain and anti-inflammatories (also known as NSAIDs) work best when there is inflammation. Signs of inflammation can be night pain, early morning stiffness, heat and swelling (you don’t have to have all of these to
have inflammation). So make sure you are taking the right type of painkillers for your pain.

2.Taking them at the wrong time

What I mean by this is leaving it too late before you take them. Most people don’t like to take painkillers and that not a bad thing. However, a common
scenario would be: You’ve had a mild pain for a while, perhaps on a scale of 0 - 10, 0 = no pain 10 = worst pain ever, your pain is a 2-3, you can function normally no pain killers necessary. However, it starts getting worse going up to a 5-6, you chose to ignore it but try and carry on - tasks are a bit more tricky and take a bit longer to achieve, then your pain reaches a 7 and you finally submit to taking a couple of painkillers. Half an hour later there’s no significant change, now your worried, it’s 4-6 hours before you can take some more tablets, you don’t sleep well and the pain is getting a grip.

Why didn’t they work?

Waiting for your pain to become unbearable then taking painkillers is like trying to put a fire out with a cup of water. You are better off taking your medication when the pain gets to a 4 or 5 so it never reaches 6,7,8… ultimately you will take less medication. Of course there will always be exceptions to this, but if you want to give your pain medication the best chance of working, take the right type at the right time. Always talk to your pharmacist before taking a new medication.

Alison Hodges - Physiotherapy Manager, Spire London East

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