March 08 2021 By Jeffrey Papo RPh
What is the best pain medication you can buy over the counter? Can you buy pain meds online? Find out all the answers in this article.
Narcotic Pain Meds - Opioid Painkillers
Narcotic (opioid) painkillers have analgesic effects by stimulating specific receptors responsible for pain perception by the nervous system.
The ancestor of the drugs in this group is morphine, which causes opioid addiction. That is why drugs that act like morphine are called narcotic (or opioid) analgesics.
When Are Opioid Pain Medications Used?
Narcotic pain meds are used for conditions accompanied by severe or very severe pain:
- multiple injuries;
- burns of a large area of the body;
- cancer in its final stages;
- pain after major surgery;
- myocardial infarction;
- kidney, liver, intestinal colic;
Besides, narcotic pain drugs are used before surgery, which allows to increase the effect of anesthetics and reduce their dose. [1]
Codeine, for example, is used to treat dry cough. [2]
Types Of Opioid Pain Medications
Narcotic pain relievers are classified according to their effect on specific types of opioid receptors as well as their origin:
- Full opioid receptor agonists stimulate all types of opioid receptors. This group includes natural narcotic analgesics (morphine, codeine, oxycodone) and synthetic (fentanyl, tramadol, trimeperidine).
- Partial opioid receptor agonists moderately stimulate all types of opioid receptors (buprenorphine, pentazocine).
- Opioid receptor agonists-antagonists stimulate one type of receptor while blocking another type (nalbuphine, butorphanol).
You need to have a prescription to buy narcotic pain meds online or in your nearby pharmacy.
Over The Counter Pain Meds (Non-Narcotic)
NSAIDs and acetaminophen are among the most widely used drugs worldwide. These drugs are prescribed on a long-term basis to treat chronic pain and inflammation related to musculoskeletal conditions.
You can buy such pain meds over-the-counter to treat different types of pain, fever, and constipation in low doses and on a short-term basis.
It is important to consider the mode of their action, the most appropriate dosage form, indications, contraindications, and other factors before buying OTC pain meds.
The most popular over the counter painkillers in the US are:
- Ibuprofen
- Aspirin
- Diclofenac
- Naproxen
- Paracetamol
The recommended doses for OTC pain meds are usually half of those prescribed to achieve an anti-inflammatory effect.
Paracetamol and Aspirin are more effective than placebo in treating different types of pain, fever, and constipation.
However, NSAIDs are more effective than paracetamol for the treatment of low back pain. [3]
Can You Buy Pain Medication Online?
You can buy pain meds online in the US only if you have a prescription from your doctor.
If you have severe pain and you need strong narcotic pain killers like Tramadol or Vicodin, the only way to buy them legally is to go to your doctor for a prescription.
With a prescription, you can order painkillers with overnight or next-day delivery.
Of course, you can try buying pain meds online without a prescription from offshore pharmacies. However, there is no guarantee you get the drugs of the desired quality. Plus, it is not legal.
If talking about painkillers for mild or moderate pain, you can buy some of these drugs over the counter.
Nerve Pain Medications
Neuropathic pain is extremely unpleasant. If it develops into a chronic stage, a person continually experiences the sensation of having boiling water spilled on him/herself.
What is the best medication for nerve pain? Non-opioid and opioid analgesics are the primary drugs used to treat pain. Antidepressants, anticonvulsants, and other centrally-acting medications are also used to treat chronic or neuropathic pain as first-line treatments for some conditions.
Intrathecal infusions, neurostimulation, injections, and peripheral nerve and root block may be used as additional pain management techniques.
Prescription Medications For Nerve Pain
Non-Opioid Drugs
Paracetamol and NSAIDs are often effective in controlling mild to moderate pain. Most common NSAIDs include:
- Ibuprofen
- Naproxen
- Diclofenac
- Celecoxib
- Mefenamic acid
- Indomethacin
- Voltaren
Most NSAIDs are available over the counter, but you need to have a prescription to buy Voltaren.
Non-opioid analgesics do not cause physical dependence or addiction.
Paracetamol is not anti-inflammatory and also does not irritate the gastric mucosa.
When using NSAIDs for a short time, the likelihood of developing adverse reactions is extremely low.
Use NSAIDs with caution if you suffer from renal insufficiency. [4]
Topical NSAIDs like Diclofenac, Voltaren, Lidocaine may be used directly on the affected area, for example, for osteoarthritis or mild sprains, bruises, and other lesions.
Antiderpessants and Anticonvulsants
Tricyclic antidepressants showed their effectiveness to treat neuropathic pain: Tricyclic antidepressants and SNRIs. [5]
Tricyclic antidepressants have been used for a long time to treat depression. It turned out that they can be beneficial for nerve pain relief. Keep in mind that these drugs can trigger side effects like blurred vision, dizziness, and stomach upset.
The most popular tricyclic antidepressants include:
- amitriptyline
- clomipramine
- nortriptyline
- imipramine
- doxepin
SNRIs (serotonin and norepinephrine reuptake inhibitors) are the next-generation antidepressants, which are also effecitve in relieving neuropathic pain.
Their advantage is that they do not have so many side effects as tricyclic antidepressants. Even older people can take these drugs for pain relief. However, the disadvantage is that they are not so efficient as tricyclic antidepressants.
Opioid Drugs
Opioid analgesics may provide some relief, but they are generally less effective for acute nerve pain. [6] The most commonly used drugs from this category are:
- Codeine
- Fentanyl
- Hydrocodone
- Vicodin
- Hydromorphone
- Tramadol
However, using opioids medications is connected with numerous possible side effects. That is why doctors prescribe them only if non-opioid meds have failed to provide pain relief.
Over The Counter Nerve Pain Medications
If you are not suffering from unbearable nerve pain, you can try OTC medications for pain relief first. You can try them alone, with prescription medications, or with nonprescription practices like acupuncture, massage, biofeedback, or hypnosis.
Dietary Supplements
Your nerve pain can be a result of vitamin B12 deficiency in your body. In this case, B12 supplements or injections may help to relieve your pain. [7]
Other supplements used for nerve pain include:
Consult with your doctor before using any medications or over-the-counter supplements.
Oral Painkillers
If your pain is relatively mild, you can try over-the-counter painkillers like Aspirin or Ibuprofen. However, these OTC meds can help you if your pain is not severe enough.
Take the pills strictly according to the label. Avoid taking drugs for more than 10 days. If you are still experiencing pain after this time, talk to your doctor.
Topical Painkillers
There are a lot of topical gels and creams available over the counter for pain relief. They are not strong like prescription medications, but their advantage is they are applied directly in the place where you experience pain.
Topical gels vary by their main ingredient: NSAIDs, chili pepper [10], other natural or synthetic components.
Arthritis Pain Medications
Arthritis pain medications might not eliminate your pain completely, but they could often help you live normal lives.
There are various kinds of medications to pick from, but just like all drugs, each has its advantages and disadvantages. Talk to your physician about them to choose what’s right for you.
Analgesics are often split into opioids (usually known as narcotics) and non-opioids (NSAIDs and Acetaminophen).
Over the Counter Arthritis Pain Medications
Topical Medications
Before you trying oral pills, doctors usually recommend you try topical nonsteroidal anti-inflammatory medications (NSAIDs). For example, Voltaren gel is currently available over-the-counter with no prescription. Studies reveal such gels can alleviate knee pain equally as the pill, causing fewer side effects. [11]
People with OA (osteoarthritis) can utilize topical medications for as long as needed.
Researchers have not yet verified that topical remedies can help in the case of hip osteoarthritis.
Acetaminophen
Acetaminophen can facilitate moderate and mild arthritis pain. [12] However, you need to take it with caution. Several different drugs contain acetaminophen. Therefore it’s easy to take a lot of without notice. The maximum daily dosage of acetaminophen is 3000 mg.
Acetaminophen can damage your liver, therefore avoid taking high dosages of the drug.
NSAIDs
Drugs like Ibuprofen, Naproxen, Aspirin, and Nabumetone belong to this nonsteroidal anti-inflammatory drug group (NSAIDs). [13] Diclofenac gel (Voltaren) is an NSAID, available OTC, that could be used topically on the skin to alleviate pain.
Please talk with your physician or pharmacist before starting any over-the-counter topical or oral NSAIDs.
Prescription Arthritis Pain Medications
Prescrpiption NSAIDs
It is possible to ask your physician for prescription NSAIDs to take care of arthritis pain and swelling. They are more potent than those you can get over the counter.
NSAIDs block enzymes that cause swelling and pain and would be the best oral medication for arthritis.
The issue is that a few of those enzymes also help blood vessels and protect the lining of the gut. Without them, it is possible to bruise easily, create ulcers, and even bleed on your intestines.
NSAIDs also raise your odds of heart attack, stroke, and cardiovascular failure.
Celecoxib (Celebrex) is an NSAID that is not as likely to cause gastrointestinal distress, but it might result in heart issues.
Your physician should consider the advantages and risks of NSAIDs.
Opioids For Arthritis
This type of drug provides rapid and efficient pain relief and is typically reserved for acute pain treatment. [14]
Opioids are powerful pain relievers ranging from relatively mild, such as codeine, to potent, such as morphine.
Examples of weak opioids are codeine and tramadol (Ultram). Potent opioids are oxycodone (Percocet), morphine, and fentanyl.
These drugs can be taken in pills, injected, or placed on the skin as a patch.
Your health care provider will determine if you will need these medications to take care of your pain. Remember, they can cause some severe adverse reactions when you take them for a long time.
The most common side effects of opioids are nausea, constipation, and drowsiness.
Back Pain Medications
Back pain is such a common problem that approximately one-third of all people between the ages of 18 and 70 experience it. According to the World Health Organization, about 80% of people in all countries experience back pain at least once in their lifetime.
Chronic and acute back pain is usually treated with the following types of medications:
- NSAIDs
- Opioids
- Antidepressants
- Topical medications
- Muscle relaxers
As with any chronic pain syndrome, providers should discuss the costs and benefits of long-term use of acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) with chronic back pain patients.
Patients on long-term nonsteroidal anti-inflammatory drugs will benefit from concurrent use of a PPI to minimize gastric ulcers’ risk.
Opioids and muscle relaxants have significant risks of addiction when used to treat chronic pain.
NSAIDs Back Pain
NonsteroidalNonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, Diclofenac, Dexketoprofen, Naproxen, and Aceclofenac are usually required to treat low back pain. [15]
Side effects from taking these medications for long periods can include gastrointestinal damage (such as gastric and small bowel ulcers), kidney damage, a complication of cardiovascular disease (from high blood pressure to heart attack). If you have any of the above conditions, your doctor will need to assess whether this type of drug is right for you.
Opioids For Back Pain
Sometimes your doctor will need to combine medications for pain relief: add paracetamol or use opioids:
- Tramadol
- Codeine
- Oxycodone
- Morphine
- Vicodin.
These medications can cause side effects such as nausea, vomiting, constipation, and drowsiness. Therefore, using opioids can affect your ability to do activities that require concentration, such as driving.
Opioids are often taken for a short time while the pain is still severe, and NSAIDs have no effect or are contraindicated.
Opioid drugs may be necessary for very severe back pain. [16] In this case, there is no need to worry about becoming addicted to them in the short term.
Antidepressants
Your doctor may add other medications acting on the nervous system to relieve your back pain. Antidepressants are also used to treat low back pain, especially in cases of chronic pain. [17]
There are many similarities between chronic pain and the mechanism of mood or stress regulation in the human brain. Therefore, antidepressants can be part of a chronic pain treatment regimen not because you are depressed or severely stressed but because antidepressants relieve pain through other mechanisms.
Muscle Relaxers
Muscle relaxants should not be considered as first-line therapy for lower back pain. However, in individual patients, their prescription may be a rational alternative to NSAIDs. [18]
In other cases, muscle relaxers may be prescribed after ineffective NSAID therapy or in combination with NSAIDs.
Myorelaxants should be used only for acute back pain, for a maximum of 2 weeks.
Most common prescription musle relaxers are:
- Soma (Carisoprodol)
- Baclofen
- Tizanidine (Zanaflex)
Over The Counter Back Pain Medications
OTC back pain meds can bring you relief if your pain is not severe. You can buy the following pain medications without a prescription online or in your local pharmacy:
- Topical creams and gels. Most studies showed that using topical agents for back pain was not very useful.
- Ibuprofen (Morin or Advil) and Acetaminophen (Tylenol). These drugs are relatively effective in getting rid of mild back pain. Use these meds according to the instruction as there is a risk of ulcers.
Joint Pain Medications
Joint pain is a common disorder. The pain may be greater or lesser in intensity, or it may be prolonged or short-lived. But regardless of the pain’s nature, it creates discomfort and affects the quality of life.
Medical treatment options for joint pain include:
- NSAIDs
- Topical agents
- Injections
NSAIDs
NonsteroidalNonsteroidal anti-inflammatory drugs (NSAIDs) suppress inflammation, reduce pain and swelling. [19] Medicines in this group are generally well-tolerated, but not recommended in cases of hypersensitivity to NSAIDs (including bronchial asthma), erosive lesions of the gastrointestinal tract.
Pregnant and breastfeeding women should avoid using these drugs as some NSAIDs can penetrate the placental barrier.
Most popular NSAIDs include:
- Aspirin
- Ibuprofen
- Naproxen
- Celebrex
Topical Creams And Gels
A fundamentally different group of drugs from the nonsteroidal ones are analgesics with local irritant effects, often used for joint pain. The following medicines are widely used based on chili pepper, which contains capsaicin.
This alkaloid irritates and warms up the skin and increases local blood flow in the area of application. In addition, it acts on pain receptors, which leads to a local analgesic effect.
Dimethyl Sulfoxide
Dimethyl Sulfoxide is an essential component of many topical agents used for joint pain. It improves the penetration of drug substances into tissues and has its local anti-inflammatory and analgesic effect. [20]
Other Topical Agents
Metal compounds can also be used in the treatment of joint pain. For example, there are medications based on titanium compounds. These gels and creams have anti-inflammatory, antimicrobial, and local analgesic effects.
Another option is the local use of anesthetics, such as novocaine, in combination with menthol, which causes both an analgesic effect and a cooling sensation in the affected joint.
Many of the above drugs are included in various combined remedies and enhance the effect of each other.
Toothache Painkillers
Modern pharmacology offers a wide range of effective drugs to relieve toothache.
They can be divided into three groups:
NSAIDs (non-steroidal anti-inflammatory drugs). As a rule, the source of dental pain is an inflammatory process. NSAIDs don’t just relieve pain - they reduce inflammation, thereby reducing pain. [21]
Analgesics do not affect the course of the inflammatory process. They eliminate the focus of pain by acting on nerve endings and pain centers in the brain area.
Local analgesics - drugs like lidocaine and novocaine. As a rule, these meds are available as injections, but you can also find small aerosol cans with lidocaine - one press, and the pain goes away for 30-40 minutes. The main disadvantage of local anesthetics is a substantial effect on the surrounding tissues, which can cause temporary loss of skin sensitivity in the area of exposure and lack of taste sensation.
When deciding to take a particular drug for pain relief, read the instructions and strictly adhere to the prescribed dosages.
After tooth extraction, dentists do not recommend taking Aspirin as an anesthetic - this drug has a blood-thinning effect, which can provoke heavy bleeding.
Other Over The Counter Medications For Toothache
In addition to tablets and capsules, you can you other OTC medication options to help you with dental pain:
Gels. They are most often used in children during the teething process. At the same time, similar remedies also affect adults’ wisdom teeth pain. Among the most popular gels are Orajel, liquid Tylenol, and Ibuprofen.
Tooth drops. These are safe, natural medications made of natural components, extracts, and essential oils. They have a local anti-inflammatory, soothing, analgesic effect.
Injections. Ketorol and Diclofenac for intramuscular injection are the most commonly used drugs. Professionals most often use injections for intense pain relief before tooth extraction or treatment.
Sprays. These drugs have a local anesthetic effect (simply put, they freeze the tooth). The most popular is the Lidocaine spray.