Should I be taking painkillers?

Pain is such a difficult topic and in all of the people that I have asked, no-one is really able to give any clear answers. I have written some other blogs on pain itself. In this blog, I wanted to explore the topic of when to take painkillers. It is the question that I have asked every single medical practitioner that I have come into contact with and not really got any consistent or clear answer.

So here is my summary.

Pain as the protector

Pain is there for a reason – it is there to protect our tissues from damaging actions. So taking painkillers in order to be able to ‘push through’ and walk/sit/stand or even do more energetic actions is likely to be a bad thing. The physiotherapists generally seem to sign-up to the ‘listen to your body’ school of understanding the pain signal.

When we are trying to release the tension in over-active, tight muscles with stretches/releases, there are some tricks like using the contract/relax form of stretching that uses the inverse stretch reflex, or activating the antagonist muscle during the stretch to use reciprocal inhibition to enable the muscle to ‘turn-off’ and stretch.  But if the releases and exercises (to activate the under-active muscles) hurt such that you have trouble adhering to the physiotherapy regime, then the GPs seem often to recommend taking enough painkillers to get through these in order to support recovery.

Pain as the problem

When pain stops you sleeping and leaves you in a permanent state of stress (racing heart-rate, perspiring etc), then this is clearly a problem for your body as well as coping with life. For the body to have any chance of healing, it needs the parasympathetic nervous system activated (the one that goes with calm and balance), not the sympathetic nervous system (the fight-or-flight system). Therefore, if you are not sleeping or not reaching a state of calm, then it would seem necessary to take enough painkillers to manage this situation. Certainly the osteopaths and chiropractors seem to subscribe to this view of management – ideally without synthetic drugs, but definitely calming the system and getting it out of the hyper-vigilant or over-alert state that it can get into. Homeopaths will also suggest treatments that can help here.

Which is fuzzier – pain or painkillers?

A lot of painkillers seem to leave you feeling mentally very fuzzy and unable to focus and concentrate, but pain can also leave you feeling like the world is a long way away down a dark tunnel. So you need to find the type and dosage of painkillers (or none) that give you the best effect physically and mentally. Obviously, painkillers are more effective if you take them over a period, so taking them as the pain comes on, rather than when it is totally unmanageable will help – which I know is sometimes easier said than done.

Drugs are not the only solution

Research that shows that pain is worse when we are low and lonely, less active or less busy and feeling less good about ourselves. For some great explanation of the science behind pain check out these brilliant and simple explanations of understanding and managing pain at  https://www.retrainpain.org/

There are also all sorts of mental and physical techniques that you can try and see what works for you and your situation. There is no simple solution that works for everyone.

But what about the question of if/when to take painkillers?

You need to find what works for you. But I think that the principle of listening to and understanding your pain, and then recognising what you need to give your body in order to manage the pain and the recovery is really important. Painkillers may have to be a part of this, especially in the early stages, but the quicker you can get to other, more sustainable, solutions the better it is likely to be for your body.

I hope that you get out of pain soon. I know just how exhausting and enervating it is.

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