Your guide to non-NSAID pain relief

Key takeaways

• If you can’t take nonsteroidal anti-inflammatory drugs (NSAIDs) due to kidney disease, liver disease, or allergies, several alternatives can help manage short-term pain.
• Over-the-counter options include acetaminophen (Tylenol) for pain and fever, plus topical treatments like capsaicin, arnica, and menthol creams for localized relief.
• For severe or long-term pain, a healthcare professional may prescribe corticosteroids like prednisone (Rayos) or, when other options haven’t worked, opioid medications for short-term use.

Overview

Not everyone can take NSAIDs, as they may interact with certain health conditions and lead to complications or side effects. For example, if you have kidney disease or liver disease, you will have a higher chance of side effects from NSAIDs. It is also possible to be allergic to several NSAIDs.

If this is the case, you may wish to explore other options for managing short-term pain, such as headaches or inflammation. If you need long-term pain management, it is important that you seek advice from a doctor.

While other medications are available to help relieve pain, natural substances can also soothe pain while helping to relieve inflammation.

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Over-the-counter (OTC) alternatives to NSAIDs

One of the benefits of NSAIDs is that they’re often available OTC, meaning they’re easy to buy yourself. If you’re looking for alternatives, there are many other OTC options to try.

Acetaminophen

Acetaminophen, the generic version of Tylenol, is a nonopioid pain-relieving medication that can help manage fever symptoms. It is available in several forms, such as oral tablets, liquid solutions, or capsules. Acetaminophen is one of the most commonly used OTC pain relievers that can help with mild to severe pain.

Taking acetaminophen instead of an NSAID can help reduce any heart-related risks you may have. However, as it contains no anti-inflammatory properties, acetaminophen can’t help reduce swelling, unlike common NSAIDs such as ibuprofen (Advil).

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Capsaicin topical creams

Capsaicin is a natural substance present in chili peppers, which gives them their spicy taste. It is a topical cream that can help reduce pain in specific areas, such as muscular pain. It works by stimulating your pain receptors and reducing pain sensitivity.

Many people find it useful for managing arthritis pain.

There are very few safety concerns linked to using capsaicin creams. However, it is common to experience temporary burning or discoloration wherever you apply the cream. This is why it is important to keep capsaicin creams away from your eyes, nose, mouth, and any broken skin.

Capsaicin topical creams are available OTC and by prescription.

Arnica topical creams

Arnica is a plant that belongs to the same family as marigolds and daisies. It has been used for centuries in traditional medicine to help relieve pain and manage inflammation.

While research is mixed, some studies suggest positive effects of arnica for reducing pain, particularly in people with arthritis.

Other types of pain that can respond well to creams containing arnica extracts include:

• low back pain
• postoperative pain
• other muscular pains, such as tendinitis

It’s important to note that Arnica products do not have standardized dosing, so concentrations can vary across manufacturers.

If you use arnica creams for a long time, you may be at risk of causing skin irritation and peeling. It is important to monitor the condition of your skin when you apply the cream.

Most natural Arnica creams are very low in dosage, so are typically safe for use. However, it is important to avoid using higher strength treatments like oral tablets or oil unless under a doctor’s supervision.

It’s also important to remember that Arnica products are homeopathic products, and there is limited evidence to support them as an effective treatment option.

The Food and Drug Administration (FDA) has not reviewed Arnica products for safety and effectiveness. These products are usually recommended based on people’s personal experiences with the products rather than the quality of the research behind them.

Menthol topical pain relief

Topical menthol treatments (like Biofreeze) are effective OTC creams and can help treat painful conditions like migraine and musculoskeletal pain. They work by creating a cooling sensation on the skin to distract you from the pain beneath.

These are typically only suitable for short-term relief, as the pain will reappear after the menthol wears off.

Menthol topical creams are typically very safe. However, in some rare cases, skin burns can occur from the use of these OTC creams. If you experience any sign of skin injury or blistering after applying a cream, seek medical help immediately.

Prescription NSAID alternatives

While many pain relief options are available OTC, doctors might also prescribe pain medications. These may include:

• Corticosteroids: If you take NSAIDs to manage pain due to inflammation, corticosteroids might be a good prescription alternative. They come in many forms, including creams and oral tablets, and are used to treat a variety of inflammatory conditions. One example is prednisone (Rayos).
• Opioid medications: For more severe pain, doctors might consider prescribing opioid medications. These are very strong pain medications that block your pain receptors. However, due to the potential for dependency, these are usually prescribed for short-term use after trying other options. Examples include codeine and oxycodone (Oxycontin).

How to know which one is right for you

When deciding which treatment is best suited to your needs, it’s important to consider the type of pain you are trying to manage.

For example, the above treatments may not be suitable for long-term and consistent pain. However, if the pain is mild or temporary, such as a headache or muscular injury, milder options may be able to help relieve symptoms.

Often, trial and error is the best way to find the most effective alternative pain relief for you. However, if you are trying to manage long-term or chronic pain, speak with a doctor about creating a treatment plan that works for you.

When to speak with a doctor

If you have previously managed pain with at-home treatments but notice a change, such as increasing pain intensity or that the treatment is no longer as effective, this may signal that you need to speak with a doctor.

For example, if your headaches become more frequent and intense, you may be experiencing migraine. Migraine has its own non-NSAID treatments that will help manage your symptoms more effectively than the above treatments.

If your pain is due to an underlying condition, it will likely be more helpful to treat that condition than to solely use pain medications. Doctors will be able to diagnose and treat underlying conditions.

Online care services, including Optum Perks Online Care, may make getting treatment easier. With these services, you can submit an online form answering a few questions about your symptoms, and a US-licensed healthcare professional will respond soon after to prescribe a treatment plan.

Summary

Nonsteroidal anti-inflammatory drugs (NSAIDs) can be effective pain-relieving medications. However, they are not the only option for managing short-term pain.

Several other options can help relieve symptoms, including:

• capsaicin topical creams
• acetaminophen
• Arnica topical creams
• menthol topical pain relief

However, if you experience chronic or severe pain, it is important to speak with a doctor. Together, you can create an effective treatment plan to manage your pain without NSAIDs.

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