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Personal Health


By Nancy Johnston Hall


What You Should Know About Over-the-Counter Pain Relievers

“Pain is inevitable. Suffering is optional.” M. Kathleen Casey, Canadian politician

We’re used to popping pills now and then to avoid the suffering that comes from pain. And thank heavens for the many over-the-counter (OTC) meds that offer inexpensive, non-addictive pain relief. Since these medications are so much a part of our lives and culture, however, it’s easy to forget that they are powerful drugs that come with significant risks and side effects.

The four most common over-the-counter pain relievers are:

•Ibuprofen (commonly sold as Advil, Motrin, or Midol)


•Naproxen (often sold as Aleve)

•Acetaminophen (Tylenol)

The first three (ibuprofen, aspirin, and naproxen) are non-steroidal anti-inflammatory drugs, a group of meds often referred to as NSAIDs, which fight pain by reducing swelling and inflammation. Acetaminophen is often helpful with pain but doesn’t address inflammation. So if you need relief from both pain and swelling, say from a sprain or swollen joints, an NSAID is a good choice. However, if you need relief from pain only—a headache or backache or aches and pains from the flu, for example, try Tylenol.

Over-the-counter pain relievers and alcohol aren’t a good mix.

Doctors advise those who drink alcoholic beverages more than occasionally to avoid ibuprofen due to increased risk of liver damage, ulcers, and bleeding and the potential for kidney damage. Combining acetaminophen with alcohol could also carry risks for your kidneys and liver. If you use ibuprofen or acetaminophen for long-term treatment, check with your doctor before you have a drink.

NSAIDs slow wound healing.

If you or a loved one has a chronic or non-healing wound caused by, for example, diabetes, poor circulation, trauma, vascular disease, or immobility (bed sores), you should know that NSAIDs inhibit wound healing. Even when used for short periods of time, these drugs have been shown to impair wound healing, according to the National Institutes of Health.

Pain relievers may lead to hearing loss.

Research suggests that frequent use of many over-the-counter pain relievers including ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) may lead to hearing loss. A Harvard study published in the American Journal of Epidemiology in 2016 showed that women who took the pain relievers at least twice a week were more likely to have hearing loss. More frequent use increased the risk. However, the overall increased risk was small. An earlier study of men and hearing loss showed similar findings, although aspirin was also found to contribute to loss. The Harvard researchers speculate that the pain relievers may be damaging cells of the inner ear’s hearing mechanism.

On the bright side: over-the-counter pain relievers face off with opioids

Many patients are first introduced to powerful opioid painkillers in an emergency room (ER). What if doctors provided nonaddictive over-the-counter meds instead? A new study (November 2017) published in the Journal of the American Medical Association tested that approach on patients with broken bones and sprains. They found that the pain relievers Tylenol and Motrin worked as well as opioids to reduce severe pain. The study could lead to changes in the common ER practice of using opioids for treating short-term, severe pain—changes that could help prevent new patients from becoming addicted.


Nancy Johnston Hall is a retired health writer with 40 years of experience. She has a master’s degree in medical journalism. Two years ago, Nancy and her husband became part-time residents of San Miguel.



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