Finding the right over-the-counter medication for pain

I never know which type of over-the-counter pain medication to use for different types of pain, like headaches, sprained ankles or sore muscles.

- Erica Sweeney

Which works best for these unique situations?

When you have aches and pains, it can be challenging to decide which over-the-counter pain reliever is best for your affliction — Advil, Aleve, Panadol, Motrin?

The choice, experts say, comes down to just two classes of medication: acetaminophen and non-steroidal anti-inflammatory drugs (or NSAIDs).

Each addresses pain in its own way, said Dr. Mary Lynn McPherson, a professor at the University of Maryland School of Pharmacy. And not all types of pain respond equally well to both, she added.

Here is how to tell what types of pain these drugs are most effective at relieving and how to use them safely.

HOW THEY WORK

NSAIDs, which include ibuprofen (Advil, Motrin), naproxen (Aleve) and aspirin (Bayer), help relieve pain by rushing to sites of inflammation throughout the body, said Dr. Katherin Peperzak, medical director of the Center for Pain Relief at the University of Washington Medical Center.

They reduce or block two enzymes called COX-1 and COX-2. This action hinders the production of prostaglandins, chemicals that contribute to swelling, inflammation and pain, she said.

Acetaminophen (Panadol, Tylenol), on the other hand, is dispatched to receptors in the brain and the spinal cord, but what it does from there is more mysterious.

"We're not 100 per cent sure how the heck that bad boy works," Dr. McPherson said.