Pain relief medicines for short term pain

Also called pain relievers or analgesics

Key points about pain relief medicines for short-term pain

Pain relief medicines for short-term pain are commonly used for injuries, infections or after surgery.
They’re usually only needed while the injury, infection or surgery is healing.
The choice of pain relief medicine can depend on many things, including the type, severity and cause of your pain, other medicines you take and any other health conditions you have.

Girl on crutches accompanied to medical centre by mother and brother

The content on this page covers medicines for short-term pain. For information about medicines for pain that continues for 3 months or longer, see pain relief medicines for chronic pain. Read more about the difference between acute pain and chronic pain.

What is short-term pain?

Short-term pain is also commonly called acute pain. Acute pain usually occurs because of surgery, injury or infection, such as a dental infection or bone fracture (break). It often comes on quickly, lasts for a short time and goes away as the underlying cause gets better. Pain relieving treatments usually only need to be given for a short time while the injury is healing.

Paracetamol and NSAIDs are commonly used.
Opioids are useful and usually only need to be given for a few days. The dose of opioid should be reduced as healing occurs.
Read more about acute pain.

Severity of the pain

Pain is usually grouped into mild pain, moderate pain or severe pain. The step-wise or ladder approach to managing pain is based on the severity of your pain. It's a 3-step approach.

Step 1: Mild-to-moderate pain – this type of pain is best treated with paracetamol, ibuprofen and other NSAIDs. Read more about paracetamol and NSAIDs.
Step 2: Moderate-to-severe pain – more intense pain is treated with mild opioid pain relievers such as codeine and tramadol. These may be used together with paracetamol or NSAIDs.
Step 3: Severe pain – severe pain is treated with strong opioids such as morphine and oxycodone. These may be used together with paracetamol or NSAIDs. Read more about opioids.

Image credit: The principles of managing acute pain in primary care(external link), BPAC

Paracetamol

Paracetamol is used to treat mild-to-moderate pain.

It acts mainly in your brain and has an effect on many different ways you feel pain.
If it's taken at the correct dose it's a safe and useful medicine, and can be effective for many different types of pain.
For most types of acute or short-term pain you only need to take paracetamol when you feel the pain.
It can be combined in the same tablet with caffeine or codeine for added benefit.
Paracetamol can be bought over-the-counter but paracetamol and codeine needs to be prescribed by a healthcare provider.
Read more about paracetamol and paracetamol and codeine.

Non-steroidal anti-inflammatories (also called NSAIDs)

NSAIDs are used to reduce mild-to-moderate pain and inflammation (swelling).

Some common ones are:
- Ibuprofen(external link) (Nurofen®, Advil®, Brufen®)
- Diclofenac(external link) (Voltaren®)
- Celecoxib(external link) (Celebrex®)
- Naproxen(external link) (Noflam®, Naprosyn®, Naprogesic®)
- Mefenamic acid (Ponstan®)
- Tenoxicam(external link) (Tilcotil®).
They work by blocking and reducing enzymes involved in making a hormone-like substance called prostaglandin that causes pain and swelling in your body.
NSAIDs can be used for short-term pain such as when you have an injury or a flare-up of symptoms (eg, a gout attack).
They're often used together with paracetamol to improve pain relief.
NSAIDs aren’t suitable if you’re pregnant or have asthma, heart, liver, kidney or stomach problems (because they may cause stomach bleeding). You may be prescribed another medicine while taking NSAIDs to protect your stomach, eg, omeprazole.
Before taking NSAIDs, check with your healthcare provider whether they're suitable for you.
NSAIDs are also available as gels or creams that can be bought over the counter for massaging into the painful area.
Some NSAIDs, eg, ibuprofen and Ponstan can be bought over the counter but stronger ones need to be prescribed by a healthcare provider.
Read more about NSAIDs and NSAID gels.

Opioids

Opioids can be used for moderate-to-severe short-term pain such as after an injury or surgery.

Some common ones are codeine, tramadol, morphine, oxycodone.
Codeine, dihydrocodeine and tramadol are weaker opioids for moderate pain, while morphine and oxycodone are used for more severe pain.
For some people they can cause unpleasant side effects, such as constipation, nausea (feeling sick), dizziness and sleepiness. You may be prescribed other medicines for nausea and constipation to help with these side effects.
Opioids reduce the pain but don’t take it away completely.
Only use opioids at the lowest dose that helps with your pain and for the shortest time possible.
If you think your pain is manageable, stop taking them. Ongoing use can lead to dependency and addiction.
Opioids need to be prescribed by a healthcare provider.

Steroids

Some steroids, eg, prednisone are used for pain relief by reducing swelling and inflammation when other pain relievers are not effective alone or are not suitable.

They may provide short-term pain relief, but don't improve joint function or stiffness.
They are most useful for treating flare-ups of pain, eg, with gout or asthma.
Steroids need to be prescribed by a healthcare provider.

Muscle Relaxants

Orphenadrine is also called Norflex®. It can provide pain relief for pain related to muscle spasms.
Hyoscine is also called Buscopan® or Gastrosoothe®. It can provide pain relief related to stomach muscle spasms.
These muscle relaxants shouldn’t be used on an ongoing basis due to their side effects.

Medical conditions

Some pain medicines can worsen some medical conditions and should be avoided. For example, NSAIDS can make stomach ulcers worse, so if you have a history of stomach ulcers, you should avoid them. NSAIDs must also be used with caution by older adults and people with heart disease, type 2 diabetes or kidney problems.

Medicines you are taking

Before taking medicine for pain relief, it’s important to ask if they might interact with medicines that you’re already taking for another condition, eg, codeine and gabapentin shouldn’t be taken together. If you’re unsure, check with your doctor or pharmacist.

Allergies

Some allergies may prevent you from taking certain types of pain relief medicines. For example, NSAIDs can cause allergic reactions in some people. Soon after taking the medicine, you may develop flushing, itchy rashes (hives), blocked and runny nose, and asthma (sometimes severe). If you have had hives (urticaria), nasal polyps or asthma, your risk of NSAID allergy is much higher than it is for people without these conditions.

All medicines have side effects and risks. Sometimes the risks may be small and the benefit to your health may outweigh the risks, while in other cases the risks may be a problem and other medicines may be safer. The best choice depends on your situation and the advice of your healthcare provider. Below is a list of the benefits and risks of different pain relief medicines.

Paracetamol

Benefits and risks
Benefits Paracetamol is a very effective pain reliever for many types of pain such as neck pain, back pain and headache. It avoids the stomach side effects that happen with some other pain relief medicines. It doesn't affect your kidneys. Risks The main risk of taking paracetamol is if you take too much. It can cause severe liver damage. Accidental overdose is also a risk because many other medicines, such as cold and flu medicines, have paracetamol in them. Make sure you check the label of any cold and flu medicines for ingredients or ask your pharmacist about this. Read more about paracetamol.

Benefits and risks

Benefits

Paracetamol is a very effective pain reliever for many types of pain such as neck pain, back pain and headache.
It avoids the stomach side effects that happen with some other pain relief medicines.
It doesn't affect your kidneys.

Risks

The main risk of taking paracetamol is if you take too much. It can cause severe liver damage.
Accidental overdose is also a risk because many other medicines, such as cold and flu medicines, have paracetamol in them. Make sure you check the label of any cold and flu medicines for ingredients or ask your pharmacist about this.
Read more about paracetamol.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Such as ibuprofen, diclofenac, naproxen and celecoxib.

Benefits and risks
Benefits NSAIDs are most effective if you have pain caused by inflammation. This includes arthritis (including gout), period pain and injuries such as sprains or strains. Some people find one type of NSAID better than another, so you may need to try different ones to find the one that works the best for you. Risks The main risks of taking NSAIDs are gastrointestinal problems such as indigestion and nausea (feeling sick). There's also a risk of developing a stomach ulcer. Most people can take NSAIDs and get good relief from their pain. Extra care is needed if you have high blood pressure, high cholesterol, you smoke or have cardiovascular disease (heart disease). NSAIDs can increase the chance of a heart attack or stroke. If you have diabetes, your kidneys don’t work very well or you have vomiting (being sick) or diarrhoea (runny poo), tell your healthcare provider before taking NSAIDs. The combination of one of these conditions and NSAIDs can damage your kidneys. If you’re on other medicines for your heart or blood pressure you need to take extra care with NSAIDs. Read more about the triple whammy(external link). These serious side effects can happen even in the first weeks of using an NSAID and the risk increases the longer you take it. The risk appears greater at higher doses, so use the lowest effective amount for the shortest possible time. Read more about NSAIDs.

Benefits and risks

Benefits

NSAIDs are most effective if you have pain caused by inflammation.
This includes arthritis (including gout), period pain and injuries such as sprains or strains.
Some people find one type of NSAID better than another, so you may need to try different ones to find the one that works the best for you.

Risks

The main risks of taking NSAIDs are gastrointestinal problems such as indigestion and nausea (feeling sick). There's also a risk of developing a stomach ulcer. Most people can take NSAIDs and get good relief from their pain.
Extra care is needed if you have high blood pressure, high cholesterol, you smoke or have cardiovascular disease (heart disease). NSAIDs can increase the chance of a heart attack or stroke.
If you have diabetes, your kidneys don’t work very well or you have vomiting (being sick) or diarrhoea (runny poo), tell your healthcare provider before taking NSAIDs. The combination of one of these conditions and NSAIDs can damage your kidneys.
If you’re on other medicines for your heart or blood pressure you need to take extra care with NSAIDs. Read more about the triple whammy(external link).
These serious side effects can happen even in the first weeks of using an NSAID and the risk increases the longer you take it. The risk appears greater at higher doses, so use the lowest effective amount for the shortest possible time.

Opioids

Such as morphine, codeine, tramadol and oxycodone.

Benefits and risks
Benefits Opioids are very effective for treating severe pain. The short-term use of opioids is effective for control of acute pain. They don't cause stomach ulcers or bleeding. Risks All opioids can have long-term addiction problems and over time your body may require increasing doses to get the same amount of relief from the pain. This puts you at increased risk of side effects. Side effects can affect your quality of life because opioids can cause drowsiness, nausea (feeling sick), vomiting (being sick), itching and constipation. Severe constipation can be very uncomfortable and distressing. Ask your healthcare provider to prescribe laxatives(external link) while you’re taking opioids. The long-term use of opioids must be carefully monitored by your doctor. Read more about opioids.

Benefits and risks

Benefits

Opioids are very effective for treating severe pain.
The short-term use of opioids is effective for control of acute pain.
They don't cause stomach ulcers or bleeding.

Risks

All opioids can have long-term addiction problems and over time your body may require increasing doses to get the same amount of relief from the pain. This puts you at increased risk of side effects.
Side effects can affect your quality of life because opioids can cause drowsiness, nausea (feeling sick), vomiting (being sick), itching and constipation.
Severe constipation can be very uncomfortable and distressing. Ask your healthcare provider to prescribe laxatives(external link) while you’re taking opioids.
The long-term use of opioids must be carefully monitored by your doctor.

Steroids

Such as prednisone tablets.

Benefits and risks
Benefits They're best used when inflammation is the main cause of pain. They are potent anti-inflammatories, but they don't have any other pain-relieving effect. Low doses of steroids may give relief from pain and stiffness for people with conditions such as rheumatoid arthritis. Short-term use of higher doses may help you with a severe flare-up of arthritis. Risks Side effects such as weight gain, thinning of your skin and easy bruising can happen with high doses and long-term use (for a few months to several years) of steroids. However, if they're used in small doses or for a short time these side effects are less likely.

Benefits and risks

Benefits

They're best used when inflammation is the main cause of pain. They are potent anti-inflammatories, but they don't have any other pain-relieving effect.
Low doses of steroids may give relief from pain and stiffness for people with conditions such as rheumatoid arthritis. Short-term use of higher doses may help you with a severe flare-up of arthritis.

Risks

Side effects such as weight gain, thinning of your skin and easy bruising can happen with high doses and long-term use (for a few months to several years) of steroids. However, if they're used in small doses or for a short time these side effects are less likely.

Opioid medicines overview
Pain relief medicines for chronic pain
Pain – general topics

The following links provide further information on short-term pain relief medicines. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.