Detailed, evidence-based help for common painful problems

OTC pain-killers in under 140 words or bust!

 •  • by Paul Ingraham
Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Impossible mission? I set out to summarize basic tips about over-the-counter pain medications as concisely as possible — a blurb I can re-use in many places on It has to be brief and readable and yet hit all the highlights that most people need to understand, most of the time. And of course it has to be safe and accurate advice, with a certain amount of legal paranoia. For instance, I’d like to be able to say that combining different types of OTC analgesics is quite safe, because I think it is, but I’m not absolutely sure and I would have to be. So it’s a very tricky paragraph to write. Here’s the result (so far, revised once after some reader suggestions):

Over-the-counter (OTC) pain medications are fairly safe and work in different ways, so do experiment cautiously. There are four kinds: acetaminophen/paracetamol (Tylenol, Panadol), plus three non-steroidal anti-inflammatories (NSAIDs): aspirin (Bayer, Bufferin), ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn). Don’t take any of them chronically — risks go up over time, and they can even backfire and cause pain (rebound headaches). So respect dosage limits, especially for acetaminophen, which hurts livers, and beware the hidden dosages in cold meds. NSAIDs are safer, but they irritate the gut, even taken with food, and especially with booze. Voltaren Gel & Friends, A Review and Guide is an ointment NSAID, and great for treating superficial pain with minimal dosing.

And I’d really like to include this, but I just can’t make it fit into 140 words!

Athletes, please don’t take “Vitamin I” to prevent soreness — it doesn’t work!

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