What are the Risks of Taking Painkillers?

Painkillers are medications that can reduce or ease pain. Some can help with swelling or inflammation. Different types of painkillers work in different ways. When painkillers are used correctly, they can improve the quality of life, especially for someone suffering from chronic pain. But they can have side effects and in rare cases lead to complications. In order to avoid harmful effects, it is important to make sure you use them properly. This is particularly true for people who have certain medical conditions or use painkillers regularly.

Types of painkillers

Painkillers can be grouped as:

  • Simple pain relief, such as paracetamol.
  • Non-steroidal anti-inflammatories (NSAIDs), such as ibuprofen, naproxen, aspirin.
  • Opioids, such as morphine, codeine.
  • Steroids, such as prednisone, dexamethasone.

Painkillers that simply relieve pain such as paracetamol and opioids, are called analgesics. Painkillers that act by reducing inflammation are called non-steroidal anti-inflammatories (NSAIDs). Steroids reduce swelling and inflammation.

The following is a list of commonly used painkillers and some of the risks associated with each of them:

Paracetamol

Relieves mild to moderate pain that is not directly caused by inflammation such as neck pain, back pain and headache. Often used for short-term pain. It has the advantage of avoiding any of the stomach related side effects associated with other medications, and also does not affect the kidneys.

Risks of paracetamol include:

  • Nausea
  • Rash
  • When taken in very high doses, it can cause severe liver damage. The risk increases in patients who regularly consume moderate to heavy amounts of alcohol.
  • People are most at risk of exceeding the recommended dose of paracetamol if they are taking several other medications, for example paracetamol is also found in cough and cold medicines and allergy tablets.

NSAIDs

Examples include ibuprofen, naproxen, aspirin. Most effective in people with inflammatory pain. This includes almost any form of arthritis, period pain and injuries such as sprains or strains. May be used for short or long term (chronic) pain.

Risks of NSAIDs include:

  • Gastrointestinal problems such as indigestion, heartburn, nausea, and diarrhea. Taking the medicine with food may help prevent some of these problems.
  • Gastrointestinal bleeding and stomach ulcers.
  • Fluid retention and sometimes kidney failure.
  • Increased risk of high blood pressure, heart attack or stroke.
  • These risks are greater if the medicine is taken at higher doses or for longer than recommended. Use the lowest effective amount for the shortest possible time.

Opioids

Examples include morphine, codeine, and hydrocodone. Very effective for the management of severe pain. They do not cause stomach ulcers or bleeding. Usually used for severe short-term pain (such as from injury or after surgery). Also used to treat cancer pain. Some opioids, like codeine, can cause drowsiness, so you should avoid them, if you need to drive or operate machinery.

Risks of opioids include:

  • Severe constipation
  • Nausea or vomiting
  • Itching
  • Dizziness, lightheadedness, or feeling faint
  • Drowsiness
  • Potential long-term addiction problems

Steroids

Examples include dexamethasone and prednisone. Effective only for people with significant inflammation as the cause of their pain, as steroids are very strong anti-inflammatories, but they do not have any other analgesic or pain-relieving effect. Side effects of steroids are often a cause of concern, but if used in small doses for the correct reason, side effects can be limited.

Risks of steroids include:

  • Nausea and vomiting
  • Swelling of hands and feet
  • Increased appetite and weight gain
  • Difficulty sleeping
  • Increased risk of infection
  • Thinning of the skin and easy bruising
  • Osteoporosis (with long-term use)
  • Cataracts (with long-term use)

Painkillers are not usually a long-term solution. If your pain persists, or if you have other health issues, such as high blood pressure or kidney problems, you should definitely inform your doctor.