Painkillers- How do painkillers work and how many types of painkillers exist

Painkillers are used as part of a pain management strategy for either short-term (acute) or long-term (chronic) pain. They act by either addressing the source of pain or lowering the sensation of pain. There are some painkillers that can be purchased ‘over the counter’ (OTC), which means you don’t need a prescription from a doctor in order to get access to them. Then there are prescription painkillers which are powerful medications that block the nervous system from transmitting the nerve signals that we sense as pain.

What are the different types of pain-relief medicines?

Because everyone's pain is different, different approaches to pain management are required. There are two broad categories under which painkillers fall into. These are:

• Over-the-counter medicine (OTC)
• Prescription medicine

1) Over-the-counter (OTC) Medicine

Some pain relievers can be bought over the counter to help with mild to severe pain. These are called over-the-counter medicines. There are two common types of OTC painkillers which include Paracetamol, often recommended as the first drug to try if you experience short term pain and Nonsteroidal anti-inflammatory drugs (NSAIDs) which is a class of drugs that reduce swelling and inflammation while also easing pain. Aspirin, ibuprofen, and diclofenac are examples.

While over-the-counter drugs are more accessible, they nevertheless pose danger. These medications can occasionally have unfavorable side effects.

2) Prescription Medicines

There are certain painkillers which require a doctor’s prescription in order to get access to them. These are called prescription medicines. These painkillers provide stronger pain relief and treat severe or chronic pain. They include:

• Anti-epileptic medicines such as pregabalin, gabapentin or carbamazepine
• Anti-depressants such as amitriptyline or duloxetine
• Opioids, for example codeine, morphine or tramadol

How do painkillers work?

Our body is full of nerve endings and tissues. Some of these nerve endings can sense pain. When cells in our body are injured or damaged, they release a chemical called Prostaglandin. This chemical is extremely sensitive to the pain-sensing nerves. When prostaglandin is released, nerve endings respond by picking up and relaying pain and injury messages to the brain via the neurological system.

When you take a painkiller like ibuprofen, it prevents injured or damaged cells from producing and releasing prostaglandin. As the cells can not release it, the brain fails to receive the pain alarm. Thus, pain reduces and slowly stops.

Do Painkillers cause side-effects?

Pain relievers, both over-the-counter (OTC) and prescription, can assist relieve discomfort and physical distress, but they can also have negative effects. These side-effects could be mild, limited or severe. The side effects include allergic reactions, constipation, headaches and nausea. Medicines such as Opioids can cause serious side-effects which include depression and addiction. Every medicine has its own list of possible side-effects. Therefore, if these side-effects concern you, you should see a doctor as soon as possible.

Can you become addicted to painkillers?

Opioid-based pain relievers have the potential to be addictive. The higher the dose of opioids you take, the more likely you are to experience unpleasant and potential side effects. It is possible to become addicted to opioid medications, which means that if you stop taking them, you can experience withdrawal symptoms and develop a yearning for them. You may feel a compulsion to take opioids even if the medicine is having negative effects. Uncontrollable urges and an inability to control opiate consumption are signs of addiction.

If you have been managing short term pain with OTC medicines but the pain still persists or you are not very sure as to how to cope with the pain, you should consult a doctor.