How to pick the right type of OTC pain reliever

Does this scenario sound familiar? Your lower back is aching. So you swing by the drugstore to grab an over-the-counter (OTC) pain reliever. Half an hour later, you’re still in the aisle wondering which one is right. 

There are many types of OTC pain relievers. But some are better than others for treating specific types of pain. Here’s what you need to know.

These OTC medications come as tablets, caplets and powders. They’re swallowed with water. Examples include:

Acetaminophen works on the part of the brain that gets pain signals.¹ It’s best for treating mild to moderate pain and lowering fevers, says Laura Purdy, M.D. She’s a family medicine practitioner in Nashville, Tennessee. Use acetaminophen for headaches, and toothaches.

These pain relievers work by blocking prostaglandins. Those are natural chemicals in the body that cause pain and inflammation, says Dr. Purdy. There are 3 types:

• Aspirin (Bayer® and St. Joseph®): This NSAID is helpful for mild to moderate pain and for lowering a fever, says Dr. Purdy.
• Ibuprofen (Motrin® and Advil®): This NSAID helps lowers inflammation. It’s a good choice for easing arthritis and sore and pulled muscles, says Dr. Purdy. 
• Naproxen sodium (Aleve®): Naproxen is similar to ibuprofen. It may ease inflammatory pain from tendonitis, arthritis and notes Dr. Purdy. One dose lasts 12 hours, about 6 hours longer than ibuprofen.

Excedrin® (and its generic version) is a combination of acetaminophen, aspirin and caffeine. It helps lower inflammation and constricts blood vessels in the brain, says Dr. Purdy. Consider it for intense headaches and migraines. 

These come as creams, lotions, patches and sprays. They’re used for a range of conditions (and body parts). Some examples include:

• Lidocaine: This ingredient numbs the skin’s nerve cells and stops them from sending pain signals.² It works best on minor cuts, burns and insect bites, says Dr. Purdy. Find it in such topicals and pain relief patches.
• Aloe vera: This is a gel with anti-inflammatory properties that helps soothe skin irritations and sunburns, notes Dr. Purdy.

• Menthol: Menthol has a cooling effect on sore muscles, explains Dr. Purdy.
• Capsaicin: Is an active substance in chili peppers. “It works by stimulating nerve receptors in the skin, which helps distract the brain from the pain,” says Dr. Purdy.
• Magnesium sulfate: This mineral helps lower inflammation and treats muscle aches and strains, Dr. Purdy says. Add Epsom salt to water to soak sore muscles.

• Look for products with witch hazel and aloe or hydrocortisone and lidocaine (hemorrhoid ointments). They help ease the itch and pain of hemorrhoids.

• Look for products with miconazole. These could help with athlete’s foot, jock itch and yeast infections.

For heartburn or indigestion, there are 3 classes of medications that can help:

• Antacids: These medicines help counter stomach acid, says Dr. Purdy. Common ones include Tums®, Alka-Seltzer®, Pepto-Bismol®, Rolaids® and Mylanta®.
• Histamine-2 (H2) blockers: These medicines lower the amount of acid the stomach produces. They work for several hours. They include Pepcid® (famotidine), Tagamet® (cimetidine) and Axid® (nizatidine).
• Proton pump inhibitors (PPIs): Take PPIs such as Prilosec® (omeprazole), Prevacid® (lansoprazole) and Nexium® (esomeprazole) for frequent heartburn.³ These can only be taken for 14 days at a time, up to 3 times a year.³

For painful gas, products with simethicone (such as Gas-X®) ease pressure, discomfort and bloating. 

Heating pads help increase blood flow to painful muscles or abdominal cramps to soothe them, says Dr. Purdy. Ice packs work in the opposite way, by decreasing blood flow to the injured area. “They lower inflammation and can help relieve pain from sports injuries and arthritis,” Dr. Purdy says.

Certain supplements can help ease pain too, including:

• Omega-3 fatty acids: “These essential fatty acids work by lowering inflammation in the body,” Dr. Purdy says. So, they’re helpful for arthritis, she adds.
• Magnesium: This mineral “plays a role in muscle and nerve function,” says Dr. Purdy. It may help relax muscles and reduce inflammation, so it’s good for soothing cramps, she adds.

Use this list to help understand which OTC product may be right for whatever may be hurting.