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Over-the-counter medications: Where do I start?

Woman at pharmacyYou overdid it yesterday throwing the baseball around, and you wake up with searing shoulder pain. Or maybe your lower back pain has returned after sleeping wrong. You head to the grocery store looking for an over-the-counter (OTC) medication and are confronted with an array of options. What should you use? Here’s some common OTC pain medications that may be of use.

NSAIDS (non-steroidal anti-inflammatories)

There are numerous OTC NSAIDs available. Ibuprofen (Motrin, Advil) and naproxen (Aleve, Naprosyn) are readily available, and there’s no advantage to the name brand over generic. NSAIDs work by blocking chemicals that are involved in inflammation and pain. Ibuprofen tends to last around 4-6 hours, while naproxen lasts a bit longer, around 12 hours. If one NSAID doesn’t work well for you, it’s worth trying a different one. NSAIDs do thin your blood a bit, through the same mechanism that aspirin does. Patients on strong blood thinners, with kidney disease, or with a history of GI bleeds should avoid these. If you’re unsure if you can take them, be sure to ask your primary care provider!

Within the past two years, diclofenac gel (Voltaren gel) has become available over the counter. This is a topical NSAID, and only a small amount is absorbed into the system. This is a good option for some patients as well.

Acetaminophen (Tylenol)

Acetaminophen is an OTC pain medication that works very differently from NSAIDs. In fact, we don’t even know the exact mechanism of how it works! It doesn’t seem to affect inflammation directly, but rather affects pain perception. It’s also quite good at reducing fevers. Acetaminophen doesn’t affect bleeding, has no effect on kidneys, and is overall a very safe medication. The daily limit is 3000 mg per day. Patients with liver issues may need to avoid acetaminophen.

Topical medications

These include creams and patches. Think Aspercreme, Biofreeze, Icy Hot, among many others. Aspercreme’s active ingredient is very similar to aspirin. Biofreeze contains menthol, which induces a cooling sensation. Icy Hot contains menthol, but also camphor, which causes a warming sensation as well. There are also various formulations with lidocaine, a topical anesthetic with a numbing effect. An interesting medication in this class is capsaicin cream. Capsaicin is the substance in hot peppers which makes them spicy. Some patients may find the cream uncomfortable, but it works by essentially exhausting your small nerves in the region for a bit.

This is certainly not an all-encompassing list. And by all means, look at the active ingredient in the medication and comparison shop for generics. As long as the active ingredient is found in the same concentration, it should work just as well to help your pain. Hopefully this has been helpful for next time you find yourself walking through the Rx isle!

Mark Jordan, MD
About Dr. Mark Jordan

Dr. Mark Jordan provides orthopedic services at Door Orthopedic Center in Sturgeon Bay. The Door Orthopedic Center at Door County Medical Center is a state-of-the-art facility paired with a top-notch orthopedic team that can get you back to daily living and your favorite activities as soon as possible. To schedule an appointment at Door County Medical Center's Door Orthopedic Center, visit our Door Orthopedic Center page or call Door County Medical Center at 920-743-5566.

Published 9/23/2021 7:00:00 AM
Tags: Dr. Mark Jordan, health tips, medication, news

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