Pain Relief

Strong Pain Relief

Use it if you need more powerful pain relief.

Paracetamol and ibuprofen are available without a prescription. They can be use for back pain, headaches, and muscle pain.

You can find a variety of pain relief at your local pharmacy. We can help you choose the right medicine.

Anti-inflammatory gels (e.g., Voltaren Emulgel): You can use this anti-inflammatory cream safely in conjunction with paracetamol.

Stronger anti-inflammatory drugs, e.g., diclofenac (Voltaren Rapid). Voltaren Rapid 25 may be available from your pharmacist if you need it. The strongest diclofenac can only be obtain by prescription. Voltaren Rapid 12.5mg tablets can bought from your local pharmacist.

Sale of codeine tablets Panadeine, Nurofen Plus, and Nurofen Plus are restrict. In the future, a doctor’s prescription will be require.

Combinations of Paracetamol and Ibuprofen Nuromol and Maxigesic): This combination is safe for pain relief in the short term when Ibuprofen or paracetamol are not enough.

Nuromol Tablets

Nuromol is a combination of ibuprofen and paracetamol. Nuromol is the only pain reliever tablet that has been clinically test and contains both This unique combination releases both, allowing for more effective pain relief.

Nuromol, a unique combination of pain relievers, provides stronger and more lasting pain relief than paracetamol or paracetamol with codeine.


Adults and children older than 12 years: 1 or 2 tablets every 6–8 hours (maximum 6 tablets in 24 hours).

Do not exceed the recommended dose.

You can take up to three consecutive days unless your physician advises you otherwise.

This medication should not administere to children under 12 years of age. Nurofen is available for children.


Use it only if your stomach does not have ulcers.

Some drugs have positive side effects, while others can have negative ones. Only use the medication according to the instructions. Always read the label. It is important to read the labels.

Primary care principles of acute pain management

The primary goal of acute pain management is to minimise side effects and maintain patients’ ability to function. A secondary goal is to prevent acute pain from becoming persistent. A multimodal analgesia plan is also recommen. Consideration is also give to other techniques or treatments that will help reduce


Acute Pain Management: Concepts

How a patient perceives and expresses pain can have a profound impact on their experience. Mental health, prior knowledge, and communication skills, as well as cultural or family background, are all factors that influence the patient’s experience.

Asking the patient these questions will help you determine their level of pain.

  • What is the pain intensity?
  • What are the location, frequency, and radiance of pain?
  • When did your pain begin?
  • What is the best way to relieve pain?
  • What causes pain to worsen, and why?

A verbal descriptor, e.g. A numerical scale, e.g. Use a numerical scale to show the progression of pain. The Faces Pain Scale may be more suitable for children, people with cognitive issues, and those who do not speak English.

Acute pain management aims to reduce the pain of patients with minimal side effects while maintaining their functionality.

Second, it is important to prevent chronic pain from developing as a result of acute pain.

Treat the pain’s underlying cause if possible.

Patients need to have realistic expectations about their pain management strategy. It is rare to find an analgesic regimen that can eliminate pain. Analgesics can reduce pain, even if finding the right dose takes some time. The pharmacological properties of painkillers, as well as the patient’s awareness and habit of taking them, are responsible for their effectiveness.

Reassure patients that they will need less medication as their pain will decrease over time. Explain that opioids should only be use for short-term relief of pain and create a plan to reduce the dosage and strength. This will prevent misuse and chronic pain.

Stress, insomnia, anxiety, and catastrophizing are all factors that increase the likelihood of acute pain becoming chronic, particularly after surgery. Patients with these symptoms will need to be reassure that their pain will eventually resolve. Psychosocial and occupational factors play a vital role in the treatment of patients suffering from acute back pain. The progression from acute to chronic back pain is link with dissatisfaction in the workplace. Early identification of factors is important for intervention.

Regular pain assessments can improve treatment outcomes.

Follow up regularly with patients who have prescribed analgesics for acute pain. It will help to ensure that the pain is go and the medication require by patients is decreasing. When pain persists or intensifies, you should consider the possibility of other causes, such as a surgical complication or infection.

Treatment with pharmaceuticals

You can use the WHO analgesic scale to create a pharmacological treatment regimen for acute pain.

If you are experiencing severe acute pain, begin by treating it with morphine. Then reduce the dose to codeine, and then continue with paracetamol until pain is minimal. Start with morphine at Step 3 for severe acute pain. As the pain decreases, switch to codeine at Step 2. Continue to use Paracetamol until the pain is minimal. (Figure 2). Adjuvant treatment, e.g., physiotherapy and non-analgesic medicines, is use as appropriate throughout the entire treatment.

There are many factors that can affect a patient’s reaction to an opioid standard dosage. This includes their level of pain, renal function, and any comorbidities. Genetics, co-prescribed medication, or comorbidities are other reasons. CYP2D6 polymorphisms (i.e., people with a slow or fast metabolism of CYP2D6) affect plasma concentrations of codeine, oxycodone, and tramadol (and, to a lesser extent, oxycodone). This can increase or decrease their effectiveness.

In order to achieve the best outcome for patients, opioid dosages must be individualise according to their clinical condition. Oral analgesics tend to be preferre in primary care. You can start with short-acting formulations and increase the dosage as your opioid requirements change.

Reduce the dosage in elderly or frail patients, but do not undertreat pain.

Multimodal pain management improves acute pain treatment.

Multimodal analgesia refers to the simultaneous use of multiple analgesics, such as paracetamol and NSAIDs. Both NSAIDs and paracetamol can be combine with opioids. Multimodal regimens provide better pain relief than monotherapy. It reduces the side effects and the need for opioids. Multimodal analgesia reduces the dose of opioids while providing pain relief for patients.

Additional medications may be require, such as laxatives, anti-nausea medications, and gastroprotective protection.

A laxative will almost always be prescribe if a patient is taking opioids for more than a few days.

It is not uncommon for opioids to cause nausea and vomiting. Consider adding anti-nausea medications such as prochlorperazine, cyclizine, or metoclopramide if the adverse effects are severe and pain relief is not improve by lowering the dosage or switching to another opioid.

Proton pump inhibitors may be need by patients who are prescribe an NSAID but are at risk of gastrointestinal complications.

Additional medicines may be need if the pain is neuropathic. Tricyclic antidepressants (including gabapentin) and pregabalin

See Managing Patients Suffering from Neuropathy for more information.

Patients should be give verbal and written instructions on analgesia.

Multiple medications are often prescribe at different doses or times. The plan must be understand by the patient and caregiver. They should also track their medication and know how much to take and when to stop.

A written analgesia schedule can help patients understand their medications and reduce errors. This can help optimise pain management through regular and adequate dosage.

Include the following in your treatment plan for analgesia:

  • It is important to know how often, at what dose, and for how long you should take each medication. You may also need extra doses if your pain persists.
  • How to deal with adverse reactions, e.g., reduce the dosage, take it with food, or consult a doctor
  • How to stop taking pain medication and reduce dosages as soon as the pain resolves.

Treatment options that are non-pharmacological, such as, e.g., elevation, and treatment goals such as, for example, walking to the mailbox at the end of the first week after surgery A plan for the patient could include going to the post office at the end of the first week following surgery.

Non-pharmacological Treatment

Physical interventions such as heat treatments, exercise, and physiotherapy may be recommend along with a pharmacological regimen, depending on the source of the pain.

Patients suffering from acute pain may benefit from non-pharmacological treatment options, depending on the cause.

  • A physical therapist can help maintain mobility, reduce muscle deconditioning, and prevent further injury.
  • Exercise, activity, and the application of heat can help with acute low back pain.
  • Yoga can reduce back pain and improve physical health. Patients with musculoskeletal issues can benefit from massages that improve their sleep.
  • Heat packs can provide relief to patients with renal colic by placing them on the lower abdomen, or lateral side.

Pain can be manage better by listening to music or using other distraction techniques.

It is important to consider the psychological side of pain management. Patients who have a positive attitude towards recovery and are proactive in achieving treatment goals can expect better outcomes. They will also be less likely to develop chronic pain.

The key to managing chronic pain is to not focus on it all the time. Distraction techniques include listening to music, reading, or practising mindfulness or meditation.