Powdered willow bark for your headache?!

On a daily basis I am amazed by the number of students who have seemingly no idea what to take for their pain or fever. The same issue has been noticed by our colleagues at the local Emergency Department, who are somewhat frustrated with having to deal with people who haven’t yet tried a simple painkiller for their sore throat, headache, or sprained ankle.

So I thought it might be useful to write a short blog about painkillers (or analgesia, to use the technical term!), for future reference next time you have a pain somewhere, or a raised temperature.

Salicin, from powdered willow bark, is a method of pain control dating back to Hippocrates in the 4th century BC. Over the centuries it was modified, and since 1897 we have known it as aspirin.

Paracetamol is much newer, coming from France originally, then modified in Germany in 1899, to a form very similar to the one still manufactured in huge quantities today.

Indomethacin was the first Non Steroidal Anti Inflammatory Drug (NSAID) in the 1960s. The commonest NSAID we recommend is ibuprofen.

Opioids have been around since as early as 3400BC and have caused problems alongside bringing benefits, ever since! Methadone came along in the 1930s.

There is a reason that these medications have been around for a long time, and that is because they work. I regularly encounter a strange reluctance to take anything at all, despite seeing patients with raging sore throats or disabling headaches because ‘it will mask the symptoms for you, doctor’, or it’s seen as a form of ‘personal failure’ to need a medicine.

I have to admit that I am baffled by both approaches, as any significant clinical signs will not be ‘masked’ (other than fever, and we ask about history of fever, not just current fever), and how can it be a ‘failing’ to use the wonders of science to treat illness. We wouldn’t deny another pain relief, so why do we deny ourselves?

So please, if you are suffering with pain or fever, and are not allergic to these medications, try the following from the pharmacy or supermarket (no prescription required);

 Paracetamol;               1 gram (2 tablets) up to 4 times a day (adult dose)

 Ibuprofen;                    400-600mg 3 times a day with food (total 1800mg)

 Cocodamol;                 8/500 tablets, 2 to be taken 4 times a day (instead of paracetamol)

Paracetamol and ibuprofen are synergistic and therefore taking both will give you even greater benefit.

Read the packets for dosage and side effect information, and if unsure ask the pharmacist for advice.

 Don’t suffer, take something and take comfort in the fact that our ancestors were onto a good and painfree thing!