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We all need some help with pain from time to time.
Many people find pain relief helps them deal with the pain and enables them to get on with things until they can reduce their dose.
Over the counter (OTC) pain relief can be bought at a pharmacy or shop without a prescription.
Most people have taken OTC pain relief tablets, but pain relief patches, pain relief gel, pain relief mousse, pain relief spray and pain relief cream are all options which can be bought over the counter.
Pain relief medication works in different ways to relieve pain. Understanding the cause of your pain will help you select the right pain relief for you.
Paracetamol has a mild anti-inflammatory effect and can help if your pain is from swelling and inflammation, such as from arthritis, back pain or an injury such as a muscle sprain.1
Paracetamol can also help reduce a fever and is often recommended for flu-like illnesses.
Paracetamol is most suitable for mild to moderate pain.2
Dose: Adults may take 1 – 2 500mg tablets every 4-6 hours, but no more than 8 500mg tablets within the space of 24 hours.3
Suitable for: Adults, children over 2 months and pregnant women may take paracetamol (always check the label).
Part of the group of non-steroidal anti-inflammatory drugs (NSAIDs), ibuprofen changes the way your body responds to swelling.
Ibuprofen is also effective at helping manage the symptoms of cold and flu, as well as period pain and headaches.
Dose: The usual dose recommended for adults is 1 – 2 200mg tablets 3 times a day – with 6 hours between doses.
For more severe pain, a doctor may recommend a higher dose of up to 600mg to be take 4 times per day.3
Ibuprofen also comes in a gel, a mousse and a spray – doses work differently so always check the label.
Suitable for: Adults and children over 3 months (who weigh at least 5kg). Pregnant women are advised not to take ibuprofen.
Part of the NSAID group, naproxen works by reducing inflammation-causing hormones in the body.5
Naproxen is similar to ibuprofen in that it’s effective at reducing inflammation-based pain such as arthritis, gout, back pain, sprains and to help bring down swelling after surgery.6
You don’t have to take as many doses of naproxen as you would ibuprofen as each dose lasts longer in the body. For this reason, naproxen is best for chronic pain where you need to stay topped up.
Naproxen is also commonly used for period pain – it’s important to note naproxen is only usually given over the counter for period pain.
Dose: The dosage for period pain (the only approved OTC use of naproxen) is 500mg at first, then 250mg every 6 - 8 hours as required.7
Suitable for: Women and girls over 15 can buy naproxen from a pharmacy for period pain. Adults and children can be prescribed naproxen for musculoskeletal issues.
Another drug in the NSAID family, aspirin is a pain killer which is also sometimes prescribed in low doses to prevent heart attacks and stroke for people who are at high risk.8
Aspirin can be bought over the counter in the form of tablets, suppositories and gel.
Dose: For pain relief, the usual dose of aspirin is 1 or 2 300mg tablets, taken every 4 to 6 hours.10
Suitable for: Aspirin is suitable for adults over the age of 16. It’s not usually recommended for pregnant women except under special circumstances. Aspirin is not advised for children under the age of 16 for fever or pain, as there is a risk of Reye’s syndrome – a serious side effect.11
Co-codamol is a mix of two pain killers – codeine and paracetamol.
Codeine is an opiate. Opiates work by depressing the central nervous system and changing how the body responds to pain. Codeine on its own is strong and addictive – it can be dangerous if taken for a long period of time, which is why codeine is prescription-only and its use will be closely monitored by a doctor.
Co-codamol is much less strong than codeine on its own, but it’s stronger than ibuprofen, aspirin and paracetamol and shouldn’t be used for more than 3 days.
Co-codamol is the best pain relief for moderate to severe pain, including muscular pain, migraines and pain following surgery.
Dose: Adults can take 1 – 2 tablets containing 8mg codeine 500mg paracetamol to 4 times in 24 hours.12
Suitable for: Not usually recommended for pregnancy, co-codamol is suitable for adults over 16. In some cases, children aged over 12 can be prescribed co-codamol, but this should be guided by a doctor.13
The strongest painkiller for moderate to severe pain available over the counter in the UK is co-codamol.
There are 3 strengths of co-codamol – only the lower dose (which contains 8mg codeine) is available over the counter.14
Last updated: 29 April 2021
Joined Holland & Barrett: Apr 2019
Masters Degree in Toxicology and BSc Hons in Medical Biochemistry
Bhupesh started his career as a Clinical Toxicologist for Public Health England, advising healthcare professionals all around the country on how to manage clinical cases of adverse exposure to supplements, pharmaceuticals, cosmetics, industrial chemicals and agricultural products.
After 7 years in this role and a further year working as a drug safety officer in the pharmaceutical industry, Bhupesh joined Holland & Barrett as a Senior Regulatory Affairs Associate in 2019.