Pain medication

Living with arthritis pain, whether it’s new or something you’ve managed for a while, can be exhausting. You deserve support that works for you, and that includes understanding the different types of pain relief available. There’s no one-size-fits-all solution, but there are several options that can help ease your pain and improve your day-to-day life. 

There are many types of pain relief medicines, and your doctor or pharmacist can help you choose the right one for your needs and your body.

Paracetamol

Often the first step in pain relief. It helps by slowing down pain messages between your body and brain. It doesn’t reduce inflammation but can help reduce the feeling of pain.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

These reduce the chemicals in your body that cause pain and inflammation. You might know them by brand names like Voltaren (diclofenac) or Nurofen (ibuprofen). Some are stronger than others, and a special type called COX-2 inhibitors (like celecoxib) are gentler on the stomach.

Steroids

Steroids like prednisone (tablets) or corticosteroid injections are strong anti-inflammatories. They work well short-term, especially during a flare-up. But they aren’t a long-term solution, as they can have side effects and don’t prevent joint damage. If you have inflammatory arthritis, your doctor may talk to you about DMARDs (Disease-Modifying Anti-Rheumatic Drugs) instead.

Opiates

Medicines like codeine, tramadol, or morphine can help with short-term severe pain, such as after surgery. But they’re not usually recommended for arthritis or long-term use, as they don’t treat the cause and can lead to other problems.

Nerve pain medications

If your pain is caused by irritated nerves, your doctor may prescribe:

• Amitriptyline or nortriptyline – often used for nerve pain that keeps you up at night.
• Gabapentin, pregabalin, or carbamazepine – these change the way nerve messages are passed on, helping to calm the pain.

Topical medicines

For pain in just a few joints, creams and gels may help:

• Voltaren gel works like oral NSAIDs but is applied directly to the skin.
• Capsaicin cream (made from chilli peppers) reduces pain by overwhelming the nerves with a different signal. Some people love it, others find the burning too intense.

All medicines have a generic name (the actual drug) and a brand name (what the company calls it). For example:

• Paracetamol is the generic name.
• Pamol or Panadol are brand names.

The same goes for anti-inflammatories — diclofenac is the generic drug, and Voltaren is one of the brands.

Make sure you always know the generic name and dose of the medicines you're taking. This helps prevent accidentally doubling up when buying cold and flu products or taking multiple pain relief medications. Some over-the-counter meds may already contain paracetamol or NSAIDs - always check the label.

If you're unsure, ask your pharmacist. It's a good idea to stick with the same pharmacy so they can keep track of what you’re taking.

These are the anti-inflammatories currently funded by Pharmac in New Zealand:

• Diclofenac (e.g. Voltaren)
• Ibuprofen (e.g. Nurofen)
• Ketoprofen
• Naproxen (e.g. Naprogesic)
• Tenoxicam
• Mefenamic acid
• Celecoxib (a COX-2 inhibitor with fewer stomach side effects)

Not every medicine works for every person and that’s okay. Some may upset your puku (stomach), while others might work really well for you. If one doesn’t suit you, talk to your doctor or pharmacist about trying a different option.

• Don’t double up on paracetamol or NSAIDs
• Don’t take more than one NSAID at a time
• Don’t share medicines – what’s right for someone else might not be safe for you. Your age, ethnicity, other health issues, and even your kidney function all matter
• Don’t be afraid to ask questions. Your doctor or pharmacist is there to support you