At first glance, visiting the pain-reliever section of your drugstore might just give you a headache -- if you don't already have one. You'll find the shelves crowded with scores of products to choose from.
Choosing the best one, however, may not be the most important thing to be concerned about. Rather, the dilemma is whether to take something for the pain or to see a doctor.
For mild aches and pains
Headache, muscle pain, joint pain, fever, non-streptococcal sore throat and menstrual cramps can be effectively treated with over-the-counter (OTC) pain relievers, according to the Philadelphia College of Pharmacy (PCP).
If the pain is severe or lasts for more than five days, see your health care provider, the PCP says. That advice also applies if the pain feels different than is typical, if it worsens, if the OTC drugs aren't working, or if you have other symptoms, like blurred vision or lightheadedness.
Most people, however, start with pain relievers in their medicine cabinet. According to the American Society of Health-System Pharmacists, about 2 percent of Americans take some kind of OTC pain reliever each day.
Down to the basics
Although pain relievers make all kinds of claims, are packaged differently and often include additional ingredients to treat other symptoms (such as upset stomach or a cold), just about all of them contain one of several chemicals: aspirin, acetaminophen or ibuprofen. All of these reduce fever, as well as pain. Aspirin and ibuprofen also reduce inflammation and are called nonsteroidal anti-inflammatory drugs (NSAIDs). Less expensive generic pain relievers contain the same chemicals as brand names and are just as effective.
So what should you take for different kinds of pain? It depends. "People perceive pain differently and have their own personal preferences," says Celeste M. Lindley, Pharm.D., associate professor at the University of North Carolina School of Pharmacy. "Unless there are medical reasons to avoid certain drugs, take what works best for you. You may find Excedrin, which has caffeine, works best for you for a headache, but that you prefer ibuprofen for everything else. And if you have other symptoms, products with other ingredients can help."
NSAIDs can cause gastrointestinal bleeding and stomach upset, but taking them with food can help relieve the upset. They should not be taken by people on blood thinners or with kidney disease, ulcers or bleeding disorders, or those who are allergic to aspirin, Dr. Lindley says. People with asthma should be cautious when taking aspirin or NSAIDs, because in some people, these medications may bring on an acute asthmatic attack, she says. Elderly adults should especially use caution when taking NSAIDs. Children should not take aspirin because of the risk for Reye's syndrome.
Long-term use of NSAIDS should be avoided unless you are being monitored by your health care provider.
Rarely, side effects causing liver damage have been recorded for taking acetaminophen according to directions, but overdose and long-term or excessive use can be extremely toxic to the liver, according to the U.S. Food and Drug Administration (FDA). Under no circumstances should you take more than the recommended dosage. Don't drink alcohol if you use acetaminophen; a recommended dose combined with drinking can damage the liver.
Any of these pain relievers may interact with prescription medicines and/or other OTC drugs. The FDA recommends reading the labels carefully to clearly understand the directions and any precautions. If you have questions, ask your pharmacist or health care provider.