Ask a Pharmacist: Evaluating Different Types of Pain Relievers

If you’re experiencing pain, whether it’s a headache, achy muscle, or something more severe, you’re first instinct is most likely to reach for some form of pain reliever. There are several types of pain medications, each with its own uses and benefits. Some are best for fighting fever, while others are used to reduce inflammation or lower your risk of stroke.

Since pain relievers can be dangerous if taken in incorrect quantities or for the wrong reasons, we’ve broken down the different types of pain relievers to help you better understand the uses for each.

Narcotics vs. Non-Narcotics

Pain medications, called analgesics, fall into two basic categories: narcotics (also called opioids) and non-narcotics. Narcotic analgesics attach to nerve receptors in the brain that control the amount of pain you feel, thus reducing your perception of or sensitivity to the pain you’re experiencing. Non-narcotics work to reduce pain, fever, and inflammation by inhibiting the formation of pain-producing substances and chemicals. Non-narcotics do not bind to nerve receptors like opioids.

Types of Non-Narcotic Analgesics

When you’re in pain or have a fever, over-the-counter non-narcotics are usually your first go-to for relief.  The two main types of non-narcotic pain relievers that most people are familiar with are non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. Both are available over-the-counter, but NSAIDs are also available in prescription strength if your physician deems it necessary to prescribe them for your condition.

“Non-narcotic medications consist of NSAIDs such as ibuprofen and aspirin,” Paramount Rx CEO and in-house pharmacist Ken Hammond said. “Acetaminophen is also a widely used non-narcotic pain reliever with a different mechanism of action from the NSAIDs. It works best for headaches, mild pain, and fevers.”

NSAID Pain Medications

NSAIDs relieve pain by blocking the production of certain chemicals in the body that cause inflammation. When you’re injured or ill, your body produces two enzymes: Cox-1 and Cox-2. These enzymes produce a chemical called prostaglandin that promotes inflammation that your body needs in order to heal. Unfortunately, this inflammation most often results in pain or fever. 

The three main NSAIDs are ibuprofen, naproxen, and aspirin. “These drugs reduce inflammation and can help with a variety of pain conditions including joint or muscle pain,” Hammond said.

In addition to easing muscle and joint pain, NSAIDs can be used to reduce pain caused by swelling, stiffness, headaches, menstrual cramps, and muscle sprains, as well as help reduce fevers. Aspirin is different from other NSAIDs in that it has blood thinning properties. For this reason, your doctor may recommend an aspirin regimen to help prevent heart attack or stroke if you’re at risk for blood clots.

Common over-the-counter NSAIDs:

Common prescription NSAIDs:

Acetaminophen

Unlike NSAIDs, researchers aren’t exactly sure how acetaminophen works. They do know that it seems to work on the parts of the brain that receive pain messages as well as the section that controls body temperature. It most likely reduces the production of prostaglandins like NSAIDs but also relieves pain by elevating our pain threshold and tells our heat-regulating center to lower the body’s temperature when it is elevated.

Acetaminophen is used to reduce fever, headaches, and mild aches and pains. It does not reduce inflammation like NSAIDs but is less likely to cause an upset stomach or heart problems—two possible risks associated with NSAIDs. Acetaminophen is a commonly used ingredient in many cold and flu medications, such as DayQuil or Sudafed.

Acetaminophen in stronger forms can be prescribed by your physician but is usually combined with a narcotic ingredient in its prescription forms.

 Common over-the-counter medications containing acetaminophen: