Analgesics and Anti-Inflammatory Medicines
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
Analgesics are medicines that ease pain. Anti-inflammatory medicines (NSAIDs), such as ibuprofen and diclofenac, also reduce swelling. They are used for sprains and strains, osteoarthritis, low back pain and pain after surgery. Gels and creams are usually tried first for a sore knee or soft-tissue injury. Most adults can use them, but not everyone, so check with your GP or pharmacist first. Expect partial relief, not a cure. The aim is the lowest dose for the shortest time.
What is it?
Analgesics are medicines that relieve pain. Anti-inflammatory medicines, called NSAIDs (non-steroidal anti-inflammatory drugs), also reduce inflammation (redness and swelling) and bring down a fever. Aspirin, ibuprofen and diclofenac are NSAIDs.
NSAIDs work by stopping injured cells from making prostaglandins. These are chemicals that cause swelling and pain. This eases your pain, but it doesn't cure the cause.
Paracetamol is often the first medicine from the pharmacy that people are advised to try for short-term pain. Opioids are a stronger group of prescription pain medicines. The right choice depends on the type of pain you have.
NSAIDs come as tablets, suppositories, and gels or creams that you rub on the skin. Which product suits you is a decision for your doctor or pharmacist.
What is it used for?
Sprains, strains and whiplash. For these injuries, a gel or cream is usually the first choice. It gives the best balance of benefit and harm. NSAID tablets or paracetamol are the alternatives. Opioids are not a first choice for most common injuries.
Knee osteoarthritis (wear and tear in the joint). Gels and creams are strongly recommended as a first step for the knee. For the hip, or when many joints are sore, NSAID tablets are more suitable. A gel is unlikely to reach a joint that deep. Exercise is also strongly recommended for osteoarthritis, alongside any medicine.
Pain after surgery. In adults, ibuprofen taken together with paracetamol gave the best relief of the single-dose options compared. Other NSAID tablets, such as diclofenac, also worked well.
Low back pain that has come on recently. Non-drug care comes first. This includes heat, massage, acupuncture or spinal manipulation. If you want a medicine, NSAIDs or muscle relaxants are the suggested options. Paracetamol did not shorten recovery from this kind of back pain.
Some long-term pain conditions. NSAIDs, and some prescription medicines for nerve-related pain, can bring small to moderate improvements in pain and daily function.
Is it right for me?
Most adults can take NSAIDs. Paracetamol and NSAIDs are the usual first options for mild to moderate short-term pain. For a sore knee or a soft-tissue injury, a gel or cream is the usual first choice. Gels and creams are also favoured for knee osteoarthritis if you are frail or have stomach or heart problems. Less of the medicine reaches the rest of your body.
You should not take NSAIDs if you:
- are allergic or hypersensitive to them
- are pregnant or planning a pregnancy
- have a kidney or liver condition
- have a stomach or gut ulcer, or bleeding in your gut
NSAIDs are not usually recommended while breastfeeding. If you have asthma, Crohn's disease, ulcerative colitis, heart problems or a bleeding disorder, avoid them or take particular care. If you have blood pressure that is hard to control, a high risk of heart disease or severe kidney disease, NSAIDs should be avoided whenever possible.
People over 65, people who are dehydrated, and people with high blood pressure, diabetes or reflux (GORD) are more likely to have side effects. Talk to your GP or pharmacist before you start an NSAID, especially if you take other medicines or blood thinners.
What happens?
The aim is the lowest dose that controls your pain, for the shortest time. Often that means taking it only when you need it, rather than every day. Follow the label and the advice of your doctor or pharmacist, as the right amount depends on you and the product.
For knee or soft-tissue pain, you will usually start with a gel or cream. Use the amount on the label. A tablet or suppository can take up to an hour to start working. A gel or cream can take up to 2 days to reach its full effect, so give it time.
Take NSAID tablets with food. This lowers the chance of an upset stomach.
If you want to use NSAIDs for a long-term condition, talk to your doctor or pharmacist first. They should check in with you regularly to make sure the medicine is still worth taking.
Medicines work best as one part of your care. Exercise is an important part for osteoarthritis. For low back pain, heat and other non-drug care come first.
How well does it work?
Benefit is usually modest. It depends on the medicine and the condition. Most of the figures below come from adults with knee or hip osteoarthritis, or adults recovering from surgery, and may not apply to other problems.
In knee osteoarthritis, gels and creams had a moderate effect on pain and on how well people could move. Some NSAID tablets gave clearly meaningful relief in knee and hip osteoarthritis. They lowered pain by about 14 mm and 16 mm on a 100 mm pain scale, compared with a dummy tablet. Paracetamol at high doses did much less, about 4 mm on the same scale. Opioids rarely gave relief worth the side effects.
After surgery, many people don't get good relief from a single dose. For many medicines, half or more of people did not get at least half of the maximum possible relief over four to six hours.
For long-term pain, most medicines help only about 1 in 4 or 5 people. On average they reduce pain by about 30 per cent. So relief is often partial, and the same medicine doesn't work equally for everyone.
Risks and side effects
NSAIDs can cause stomach ulcers or bleeding, kidney problems and allergic reactions. They are also linked to high blood pressure and heart disease. The chance of side effects goes up if you are over 65, are dehydrated, take more than the recommended amount, or use them for a long time. Using them only now and then, for a short time, at the lowest effective dose, lowers the risk. Gels and creams cause mostly minor skin reactions, and fewer stomach problems than tablets.
Opioids carry the clearest risks. They can cause dependence, and stopping suddenly can cause withdrawal. They can cause life-threatening breathing problems, even when taken exactly as prescribed. In osteoarthritis, they were up to 10 times more likely than a dummy tablet to cause side effects. Opioids may not be safe if you have obstructive sleep apnoea (breathing that stops and starts in sleep). Alcohol and other sedating medicines add to the risk of slowed breathing and drowsiness. Some nerve-pain medicines also cause drowsiness, which can raise your risk of falls.
Paracetamol is generally safe at usual doses. Regular large doses can seriously harm your liver. In older people, more than 3,000 mg a day has been linked to a higher risk of hospital stays for stomach bleeding.
Afterwards
If your pain improves, think about stopping the NSAID or lowering the dose. This cuts the chance of side effects. You can stop NSAIDs at any time, but if you have taken them for a long time, talk to a healthcare professional first.
If a medicine isn't helping, or the side effects are frequent or worrying, go back to your GP or pharmacist to review it. Keep up the other parts of your care, such as exercise.
Never share medicines or take someone else's.
When to see a podiatrist
Book an appointment if
Book an appointment with your GP or pharmacist if your medicine isn't helping, if you keep having side effects, if you want to take anti-inflammatory tablets for a long time, or before you start one if you are pregnant, breastfeeding, over 65, or have kidney, liver, heart, stomach ulcer, bleeding, blood pressure or asthma problems. Your podiatrist can also talk through your pain plan with you.
Seek prompt assessment if
Stop the anti-inflammatory medicine and call your local emergency number if your throat or tongue swells, or you have trouble breathing (a raised itchy rash along with these signs can be part of a serious allergic reaction). Do the same if you have chest pain, shortness of breath, or sudden weakness or difficulty speaking. Call your local emergency number too if someone who has taken an opioid isn't breathing or can't be woken: stay with them and be ready to give CPR. If you are vomiting blood or material that looks like coffee grounds, have black or bloody poo, or have severe stomach pain while taking an anti-inflammatory medicine, stop it. This needs urgent medical assessment: see your GP today, or go to an urgent care clinic or the nearest emergency department. If you think you or a child may have taken too much paracetamol, get help right away, because it can damage the liver. Call a poisons information line if there is one where you live, or go to an emergency department.
Frequently asked questions
Can I stop these medicines whenever I like?
You can stop NSAIDs at any time. If you have taken them for a long time, talk to a healthcare professional first. Opioids are different. Don't stop them suddenly or cut the dose quickly, because this can cause withdrawal, worse pain and serious distress. Any reduction should be slow and supervised by a healthcare professional.
Will these medicines help nerve pain?
Not usually. Paracetamol and anti-inflammatories work best for pain caused by inflammation, such as an injury or arthritis. Pain from sensitive or damaged nerves, such as shingles or sciatica, is typically treated with different prescription medicines. Ask your doctor which approach suits you.
Can I take more than one anti-inflammatory at a time?
No. Taking two medicines that both contain an NSAID raises your chance of side effects. Many cold and flu products and pain tablets contain one. Check the label or ask your pharmacist before you add another product.
Can children take these medicines?
Ask a doctor or pharmacist before giving any of these medicines to a child. The right product and amount depend on your child. Giving too much paracetamol can damage the liver, so always follow the label and the advice you are given.