Combe Coastal Practice

The Medical Centre, St Brannocks Road, Ilfracombe EX34 8EG

Pain & Management

Ask your local community pharmacist for advice on treatments for pain

About Pain

Pain alerts us to disease or injury. The cause of pain can be obvious, for example, a broken arm, but sometimes it is not easy to find the cause. Experiencing pain is common and it can have a major impact on quality of life. It can result in days off work. No two people will experience pain in the same way so the pain is best described by the person who is experiencing it.

Different types of pain

  • Acute pain is short-term, lasting less than twelve weeks. It is described as intense, sharp, burning or shooting. An example of acute pain is a sprained ankle.
  • Chronic pain is long-term and lasts longer than 12 weeks. It is described as dull, constant or aching. Examples of chronic pain are back pain or arthritis.
  • Recurrent pain is a pain that comes and goes. Self-help tips and over-the-counter treatment could help you manage your condition, to minimise your pain and maximise your mobility.
  • Annually the NHS in England spends approximately £95.4 million on prescriptions for pain relief products that can be purchased over-the-counter at a pharmacy. If 20% of this prescribing was reduced the NHS could save £19 million, which could be invested in improving local healthcare services.

Pain self-help tips

Gentle exercise like walking, swimming, gardening and dancing can ease the pain by blocking signals to the brain. Exercise helps to stretch stiff, tense muscles; ligaments and joints; build up muscle strength and maintain joint movement. Lose weight if you are overweight it could help to manage your pain if you lost weight.
Hot and cold a hot water bottle or a bath can help muscular pains and period pains. A cold compress can help headaches or sprains. Massage can help to relieve muscular pains and massaging the temples can help to relieve headaches.
Deep breathing concentrating on breathing slowly and deeply when in pain can help you to feel more in control, keep you relaxed and prevent any muscle tension or anxiety from worsening your pain. Read books and leaflets for example, ‘The Pain Toolkit’ is a free booklet endorsed by the NHS. See the section on more information for details.
Counselling pain can make you tired, anxious, depressed and grumpy which in turn makes the pain worse! Pacing yourself, setting goals or talking to a counsellor could help you to deal with your emotions. Distraction think of something else so the pain isn’t the only thing on your mind. Involve yourself in an activity or hobby you find interesting and you enjoy.
Share your story it can help to talk to someone who understands how you are feeling. Try Pain Concern, Action on Pain, Arthritis Care, BackCare, health talk online and youth health talk.  See the section on more information for details. A good night’s sleep deprivation makes pain worse, but pain means many people struggle to sleep well. A good sleep routine helps. For tips on beating insomnia and getting a good night sleep see the section on more information for details.
Take a course self-management courses are available to help you develop new skills to manage your pain. See the section on more information for details. Keep in touch with friends and family don’t let pain isolate you from your friends and family, try short visits, invite people over or have a chat on the telephone.
Relaxation regularly practising relaxation techniques for example reading or meditation can help to reduce pain and stress. See the section on more information for details. Slowly does it gradually reintroduce daily activities you find difficult such as returning to work.

What treatments can I buy to help my pain?

Speak to a local pharmacist to get advice on the best treatment for you and always read the patient information leaflet that is included with the medicine.

Examples of products available to buy over the counter include:

Paracetamol
Paracetamol is excellent for everyday aches and pains. A safe dose for an adult is two tablets up to four times a day. Side effects are not usually common, but having too much paracetamol can have serious effects including damage to the liver, which can be permanent in overdose, so don’t take more than eight tablets in 24 hours. If your pain is severe go back and speak to the pharmacist. Also, care is needed as many cold and flu remedies contain paracetamol so do not take both at the same time.

Non-steroidal anti-inflammatory drugs (NSAIDs) including Aspirin
Ibuprofen and naproxen work well if your pain is due to inflammation, for example, arthritis, muscle pain or an injury. They should be used with caution in older people due to the risk of serious side-effects and fatalities. These drugs should always be taken with food. NSAIDS can trigger an asthma attack; this is an allergic reaction and can happen with the first few doses. They should not be used in high doses or for long periods of time as this increases the risk of side effects. Side effects can include upset stomachs, indigestion, bleeding from the gut, kidney problems, high blood pressure, fluid retention, affecting blood clotting and a slightly increased risk of heart attack and stroke. They should be used carefully especially if you have or had a stomach ulcer, asthma, heart, liver or kidney problems.

Aspirin is also a NSAID and will produce the same type of side effects mentioned above. It should NOT be given to children under 16 as it can cause a very rare illness called Reye’s syndrome, which can be fatal.

If you take any other medicines either from the doctor or medicines bought over-the-counter check with the pharmacist if NSAIDs can be taken at the same time. There are certain medications that should not be taken with NSAIDs for example, diuretics for your heart, some antidepressants, and warfarin. Also get advice from the pharmacist if you take any other medications that irritate the stomach such as aspirin 75mg or oral steroid tablets.

Codeine and Dihydrocodeine
Codeine and dihydrocodeine are found in some over-the-counter treatments that are available from a pharmacy. They are combined in low doses with either paracetamol or ibuprofen to provide relief for moderate pain, such as muscular and rheumatic pain, headache, migraine, backache, period pain and toothache that is not relieved by paracetamol, ibuprofen or aspirin alone. They can cause you to have constipation and prolonged use can lead to addiction. You should take them for no more than three days.

Other treatments
Depending on the type of pain you have, other treatments you could try include supports (for example elasticated tubular bandages, supportive footwear or a walking stick) or muscle rubs.

Soluble painkillers are high in salt and can contain up to 1g salt per tablet. This can raise your blood pressure and put you at increased risk of health problems such as heart disease and stroke.

Always read the instructions and information leaflet.

Do not take two products containing the same active ingredient.

When should I see a GP?

  • After 5 days if your pain is not getting any better (or is getting worse) despite using over-the-counter treatments in combination with self-help measures.
  • It is possible that your GP may refer you to a different healthcare professional for treatment, for example, a physiotherapist.

See ‘Living with Pain’ on the NHS Choices website, available at www.nhs.uk/Livewell/Pain/Pages/Painhome.aspx

See ‘Chronic Pain – A Self Help Guide’ on the Patient.co.uk website, available at www.patient.co.uk/health/chronic-pain-a-self-help-guide

The British Pain Society, available at www.britishpainsociety.org/index.htm

The pain toolkit is available from www.paintoolkit.org

For information on how to talk to others about your pain try:

Tips on beating insomnia and getting a good night sleep are available from www.nhs.uk/Livewell/insomnia/Pages/insomniatips.aspx

Information on self-management courses are available from http://selfmanagementuk.org/services/programmes

Information on relaxation tip available from www.nhs.uk/Conditions/stress-anxiety-depression/Pages/reduce-stress.aspx