Choosing pain medication is challenging considering the dizzying array options available.  How do you know which one choose?  That depends on what type of pain you're treating and your individual health profile.

Pain is a widely subjective.  Everyone feels it differently, based on the pain's source, how their nervous system interprets pain signals and their health history. What one person may feel as mild may be excruciating for someone else.  Additionally, one person may get excellent relief from mild pain relievers and another may require extra strength.  Some medications do a great job handling bone or joint pain while others are experts on headaches, surgical or nerve pain.

Pain medications break down into two categories:  those you can buy over-the-counter (OTC) and those your doctor can prescribe.

Over The Counter Pain Medications

There are two types of over-the-counter (OTC) pain medications:

1. Acetaminophen is the active ingredient in hundreds of OTC and prescription-strength medications including pain relievers, fever reducers, cough and cold medicines.

It's a great choice for most headaches, body aches, toothaches, minor injuries, mild arthritis, menstrual cramps and other occasional, routine pains.

It's generally well tolerated, has few side effects and as long as the daily cumulative dose doesn't exceed 4000 mgs (for healthy people) there's little risk for liver or kidney damage. 

It's not always effective for pain caused by swelling or inflammatory conditions.

2. Non-steroidal anti-inflammatory medications (NSAIDS - pronounced, "ensayds") are an active ingredient in many cold, flu, and sinus medications and work by inhibiting an enzyme that makes a specific chemical that causes pain.  They include ibuprofen, naproxen and aspirin. 

NSAIDS are great for menstrual cramps, headaches, body aches, and inflammatory processes including sprains, strains, injuries, joint pain, mild surgical pain and fibromyalgia.  

While they're well-tolerated by most people, NSAIDS aren't a great choice for people who experience gastric irritation, gastric bleeding, have liver or kidney disease, blood clotting disorders (or take blood thinners), asthma, certain cardiac conditions and those experiencing severe or chronic pain. 

Prescription Pain Medications

If OTC pain medications aren't enough, your doctor might choose either a non-opioid pain medication or an opioid pain medication

Non-Opioid Pain Medications

Prescription-strength NSAIDS like diclofenac, ketoprofin and high-dose ibuprofen act similarly to OTC NSAIDS, but are stronger and more effective for moderate to severe and chronic conditions.  They're often chosen for preventing pain and flare-ups from chronic or recurring conditions.  

Cox-2 inhibitors like Celebrex are effective for joint and bone pain like arthritis, but are associated with a small increased risk for cardiac complications.

Opiod Pain mMedications

These strong drugs attach to pain receptors in the brain, spinal cord and gastrointestinal tract and change the way a person experiences pain. 

They'll relieve the worst pain, but are risky for long-term use because they can lead to abuse.  These include:

  • Morphine often used for surgical or severe pain (like cancer).
  • Oxycodone for moderate to severe pain
  • Codeine for mild to moderate pain
  • Hydrocodone for moderate pain, recurring and chronic conditions like arthritis, migraines, fibromyalgia, neuralgia and injuries.

Use this rule of thumb when choosing pain medication: Select the lowest dose, lowest-risk medication to treat your individual pain.  If you need more than occasional, OTC help, talk to your doctor about what's causing your pain and the best plan of attack to eliminate it.


Food and Drug Administration

A Guide to Safe Use of Pain Medicine

Medline Plus

A service of the US National Library of Medicine, National Institutes of Health

Pain Relievers