When you have pain, there's nothing you want more than relief — right now. For many people, that means reaching for the bottle of pain relievers in the medicine cabinet.
Before treating pain yourself, however, you should understand where the pain is coming from. Some sources of pain are easier to decipher: You have a tension headache after a long day at your computer, or back pain after an afternoon of raking the yard or joint pain from arthritis. Other sources of pain are not as evident, especially when you're experiencing the pain for the first time (such as knee or hip pain when you are out for a walk) or when the pain lasts longer than usual (such as a stiff neck or lower back pain that doesn't subside).
In these cases, consult your health care professional to rule out or treat a possibly serious condition. For many types of acute pain, however, a number of self-care options can help. In addition to over-the-counter pain relievers, several simple lifestyle approaches can also be effective.
When you go to your local grocery store or box store, you'll always find a large selection of pain relievers. These medications — also called analgesics — help control pain by interfering with the way pain messages are developed, transmitted or interpreted.
Over-the-counter pain medications can be effective at relieving many types of mild to moderate pain. Some pain medications will also reduce the swelling and redness of inflammation.
Oral pain relievers. That bottle of pain-relieving pills in your medicine cabinet likely contains aspirin, ibuprofen (Advil, Motrin IB, others), or naproxen sodium (Aleve). These medications are most effective for mild to moderate pain that's accompanied by swelling and inflammation, such arthritis, sprains and strains.
However, these types of medications can have serious side effects, including nausea, stomach pain, or even stomach bleeding and ulcers. Large doses can also lead to kidney problems and high blood pressure. These risks are higher for older people, especially those over age 75.
Acetaminophen (Tylenol, others) is another commonly used pain reliever. It's frequently recommended for mild to moderate pain that isn't accompanied by inflammation — such as for headaches, menstrual cramps, and cold and flu aches. Acetaminophen can also help relieve the pain, although not the inflammation, associated with muscle aches and osteoarthritis.
When taken as recommended, acetaminophen has long been believed to have a low risk of side effects. Taking higher doses, however, brings an increased risk of liver or kidney damage. This risk is higher for individuals who have existing liver disease or long-term alcohol use. In fact, recent research suggests the recommended dose for long-term acetaminophen use should be lowered — from 4 to 2 grams a day — for individuals in these populations due to the risk of liver problems.
- Topical pain relievers. Topical analgesics are creams, gels, sprays and patches that are applied to the skin at the area where you feel pain — such as on painful joints or strained muscles. Topical pain relievers such as diclofenac (Voltaren, Solaraze) and salicylates (Bengay, Icy Hot, others) can help reduce mild to moderate pain without serious side effects — in part because they are applied locally instead of being circulated through the body. They are often recommended for older people who have a greater risk of side effects from oral pain relievers.
Sometimes relief can be a frozen bag of peas or a hot bath. This is because applying heat and cold can often help ease joint pain, back strains, neck pain and other types of pain.
Here's how these methods work:
- Cold can numb pain by causing blood vessels to constrict, which helps reduce swelling. That's why, when you experience an injury — whether it's a bee sting or a sprained ankle — icing is often a good first choice. You can use an ice pack or a bag of frozen vegetables, or you can submerge the affected area in a container of ice water.
- Heat, on the other hand, is a muscle relaxer. Heat helps loosen tense muscles, which contributes to pain relief. Heat also increases blood flow to an injury, which can help promote healing. Sources of heat can be a heating pad or a warm bath.
You may find that cold or heat provides more relief. Or you can alternate the two, ending with the cold treatment.
Unfortunately, simply applying heat or cold often doesn't completely resolve pain. It's more likely to lessen its severity and reduce inflammation. But in many cases, a heating pad or ice pack can be applied in addition to other pain treatments, such as analgesics, to increase the chances of relief.
An important part of treating pain is managing your overall health. Taking care of yourself — by getting regular exercise, eating a healthy diet, getting enough sleep, reducing stress and practicing relaxation — can help you take care of pain.
Other nonpharmaceutical pain-relieving practices that can be worked into your life include:
- Massage. Massage — the kneading, stroking and manipulation of your body's soft tissues — can help relieve muscle tension and stress. Research suggests that massage is most useful for relieving pain in the short term; only minimal research supports its long-term effects. One study found that acupressure — specialized massage that mimics acupuncture, but without the needles — might provide more relief than traditional massage.
- Transcutaneous electrical nerve stimulation (TENS). Resembling a portable MP3 player attached to wired electrodes, a TENS device helps relieve pain by delivering low-level, pulsed electrical currents that pass through the skin to the area of pain. These currents stimulate your peripheral nerves to induce pain relief. Research suggests that TENS works best for mild pain, but not all who use it benefit.
There are many other complementary and integrative approaches to pain management that you can work into your lifestyle. These include acupuncture, herbal treatments, meditation, music therapy, hypnosis and others. Explore what helps you feel better — and when you find something that works, stick with it.
You've tried pain relievers and massage. You've heated and iced. And yet your pain persists. Don't get discouraged. Instead, see your health care professional to discuss other options for pain relief.
You should also see your health care professional if:
- Your pain changes. For instance, the ache that started as a 4 on the pain scale is now an 8.
- You develop new symptoms. See your health care professional if you're experiencing tingling, numbness, burning or other new symptoms.
- You've exhausted your options. If you feel the need to take an over-the-counter medication for more than 10 days in a row, and other efforts — such as massage or using heating pads — aren't effective, then see your health care professional.
- You're frustrated or discouraged. Your health care professional should be able to recommend a plan using multiple approaches — including prescription medications, complementary methods and lifestyle changes — to improve your pain and your quality of life.
July 26, 2016
- Furlan A, et al. Massage for low-back pain. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001929.pub3/full. Accessed Feb. 10, 2016.
- Johnson M, et al. Transcutaneous electrical nerve stimulation for acute pain (Review). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006142.pub3/full/. Accessed Feb. 10, 2016.
- Millman M, et al. The healthy consumer. In: Mayo Clinic Guide to Self-Care. 6th ed. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2010.
- Bruce BK, et al, eds. In: Mayo Clinic Guide to Pain Relief. 2nd ed. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
- Low back pain fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm. Accessed Feb. 29, 2015.
- Garra G, et al. Heat or cold packs for neck and back strain: A randomized controlled trial of efficacy. Academy of Emerging Medicine. 2010;5:484.
- AskMayoExpert. Which is better for relieving tendinitis pain: Ice or heat? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Rosenquiest E, et al. Overview of the treatment of chronic pain. http://www.uptodate.com/home. Accessed Feb. 15, 2016.
- Schulenburg J. Considerations for complementary and alternative interventions for pain. AORN Journal. 2015;101:319.
- Derry S, et al. Topical NSAIDs for acute musculoskeletal pain in adults (Review). The Cochrane Library. 2015;6:1.
- Ickowicz E. Pharmacological management of persistent pain in older adults. Journal of the American Geriatrics Society. 2009;57:1331.
- Millman M, et al. Common problems. In: Mayo Clinic Guide to Self-Care. 6th ed. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2010.