Painkillers for foot conditions

Part 1

Painkillers for foot conditions are important. This article is intended for the lay reader. Firstly, you can save on time and money by avoiding an unnecessary appointment at the GP.  GPs will often provide ibuprofen as first line treatment. They will also ask you to buy your own as it does not need a prescription.

Sensible ‘self-treatment’ for painful foot conditions reduces GP’s workload. We can call this first aid.

Secondly. Most pain medications are inexpensive and available over the counter (OTC). I will provide some advice in this article to avoid paying higher prices. One should ideally not use NHS subsidy prescriptions to save the Nation’s health budgets.

Lastly. The discerning person can manage most things for a few days if certain guidelines are followed. I hope to offer you some tips in this two-part article for foot conditions. No one wants to experience pain.  Painkillers can help and do have a place. Nonetheless, bear in mind that not all conditions can be managed with painkillers. Medicines should be used responsibly to avoid some of their side effects.

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All the discussions in this article apply to adults over the age of 18. Seek professional guidance if you need to assist a minor as doses and some of the drugs discussed must be used with caution in under age groups. 

It is easy to become addicted to painkillers, perhaps no more so than codeine (an opioid). Ruth Santiago is a community outreach specialist with AddictionResource.net This article and has provided useful information about addiction resources in the UK. Addiction is not limited to painkillers, but sleeping and anxiety medications as well as alcohol. In the present time of crisis with Covid-19 and lockdown the use of alcohol has increased. Ruth informs me that this list was specifically created for UK residents and their families. Their resource site can be found at https://www.addictionresource.net/best-drug-rehab-centers/united-kingdom/

Reading score for this article = 57
(moderate complexity)

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Common Analgesics

Prevention of damage

 Using painkillers for some foot conditions may be helpful. Perhaps we should not call them ‘painkillers’ as they help manage pain but do not provide a cure. The condition you might be suffering from will have a cause and this must be removed in the first case. Pain causes anxiety, stress and can become chronic in time. In Part 2 I will discuss more about some of the types of pain seen in the foot.

Medicines or drugs that relieve or take away pain are called analgesics. Remember pain is there for a reason. The symptom of pain will stop more damage from occurring by forcing us to rest. We limp or remove the foot off the ground so as not to increase the injury. Not all pain is bad. It is the body’s way of slowing us down. We should also look at pain as a preservation mechanism.

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 Four common painkillers for foot conditions

paracetamol (500mg), aspirin (300mg), ibuprofen (200mg), codeine (8mg) 

Not all medicines work for ALL types of pain. Furthermore, not everyone can tolerate ALL medicines. This can render the painkilling medication of little value. The dose, given in milligrams, in brackets, provide a measure of weight or content of their active ingredients. This article will only provide the basic information about each drug. The interactions and complex chemistry are not intended for deeper discussion. Each given milligram (mg) value is typical all medicines. A ‘compound medicine’ is one with mixed ingredients. And so there are variations which when blended will alter with the combined weight of that medicine. 

Paracetamol is probably the best know analgesic. In the USA it is called Tylenol. The actual name is acetaminophen. The original discovery predates aspirin. By 1950 it was licensed in the USA for public use as a painkiller and in the UK in 1956. It has a mild effect on high temperatures. More detail can be found on Wikipedia but some of the details in this are necessary for lay understanding.

Aspirin is an older medication (1899) and also acts an anti-inflammatory as well as for pain relief. It will also bring down high temperatures (antipyretic). Ibuprofen is more modern and arrived in the UK in 1969 for the treatment of rheumatoid arthritis. Five years later is was designated as a non steroid anti-inflammatory drug or NSAID. An anti-inflammatory turns off some of the chemicals that create the acute inflammatory response. In removing some of the chemicals, or hormones, the NSAID also turns off chemicals that stimulate pain. This is why anti-inflammatories have analgesic properties. There are other NSAIDs now available over the counter (OTC) these include naprosyn and diclofenac and so the pharmacy is slowly opening up different possibilities for people. 

Codeine is older than aspirin. It was discovered as an alkaloid of opium in 1832. Other alkaloids include nicotine, quinine and strychnine. The word opium gives a clue as codeine is a derivative of morphine. You cannot actually buy pure codeine over the counter without a prescription. The reason I have included it here is that it is mixed (compounded) with either paracetamol and ibuprofen as a drug that you can buy. Please don’t ask for codeine 8mg over the counter. Prescription doses are usually 10mg, 15mg and 30mg.

Changes to medicines

In the UK codeine is now an issue that has parliamentary interest. Unfortunately the class of drugs called opioids, branded as codeine can become addictive. Modern society uses medication on an ever escalating basis and in some ways follows the patterns that we have seen with antibiotics. Overuse! Additionally one should be aware that overuse can reduce the value of analgesic effectiveness. This has been found with managing headaches. Headaches can worsen the more you use the drug.

Reducing the cost of medicines

There are medications that have branded names such as Nurofen and Panadol as 2 examples. These are proprietary names marketed for consumer sale and are listed on the packets sold under different names. The generic name, such as ibuprofen and paracetamol is the key ingredient and common to all these proprietary sales. Manufacturers have to make money for their investment. As time passes, a drug loses its patent. When this happens  other pharmaceutical manufacturers can use the same medicine and make it at a lower cost. You will see small packets of the medicines described for pence rather than pounds. Buy a proprietary named drug and you may pay more.

Look on the box at the ingredients and select one that is low cost and has the generic drug.

Mixed medications

To overcome the loss of income, companies are always looking for rebranding. They can do this in two ways. They can introduce the same drug in a different form. Liquid, capsule, dissolving tablet, capulet, gel or cream. A bit of fancy marketing, getting a dog involved, portrays the benefit of a drug in a gentle but suggestive way (TV advert). We might feel sorry for the dog, but also are made to believe  performance improves as a benefit of taking that preparation.

 

Consumers have to be aware that the market is fickle. Most pharmacies do not push drugs on you. They are also mindful of cost, but it is good to be aware of product placements in adverts. 

The other method of making a drug sound better is to add a mild chemical to rebrand it as ‘better’. Caffeine when added to paracetamol might give the suggestion it is EXTRA STRENGTH and therefore superior. At 65mg usually two tablets will give you 130mg of caffeine hit. Caffeine is a stimulant and can also increase your heart rate. In this Australian article (2010) the concerns have been published about the effect of additional ingredients with caffeine. You could drink a cup of 250 ml coffee and get the same effect!

Mixing paracetamol and ibuprofen is no longer the concern it once was. Both drugs work in different ways and do not seem to have problems being mixed. Such combinations will cost more and you need to decide if you want to buy and use the two separately. The general idea is to prevent the use of codeine being used.

Using codeine mixed with ibuprofen or paracetamol is available eg solpadeine. This proprietary drug has been around since the eighties. It is a useful drug and comes in different forms. 

Solpadeine (illustrated) is the brand name of a range of analgesic medication containing various amounts of paracetamol, ibuprofen, caffeine and codeine. In the United Kingdom there are four different medicines using the Solpadeine name, with no common active ingredient between them. The range includes:

• Solpadeine Headache, containing paracetamol with caffeine
• Solpadeine Plus, a compound analgesic containing paracetamol and codeine (co-codamol), with caffeine
• Solpadeine Max, a compound analgesic containing paracetamol and codeine (with a higher codeine content than Solpadeine Plus) and caffeine
• Solpadeine Migraine, a compound analgesic containing ibuprofen and codeine

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First line advice

Pharmacists are trained to provide a service to health care professionals and the public. They will always be happy to advise you about your medication need. It is common practise to be asked if you are taking other medication because some medicines interact.  Mixing drugs can produce an undesirable effects that can make people ill. Do not take paracetamol with a compound (mixed) drug that also contains paracetamol. An overdose is serious and can damage the liver permanently.

 

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What foot conditions can we use painkillers for?

Using painkillers for foot conditions has a list that is far from conclusive. Some of these conditions have been published as articles for Footlocker. In brackets I have hinted at the effect on each condition as anti-inflammatory or just analgesic alone.  These are only a guide.

• wounds (analgesic)
• blisters(analgesic)
• Sprains (anti-inflammatory)
• Joint pain (anti-inflammatory
• Heel pain (anti-inflammatory)
• Fasciitis(anti-inflammatory/analgesic)
• nerve pain(anti-inflammatory)
• infection ( i.e ingrown toe nail) (analgesic)
• tendon pain(anti-inflammatory)

You can find more on Foot Pain on my website for a FREE DOWNLOAD and download a copy of my simple guides on location (click). Location Guide Foot Pain 2019 & Your Rough Guide to pain (illustrated).

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There are broadly speaking two types of pain

Acute pain is immediate but can settle down quickly. Then there is chronic pain and in someways more difficult to manage. Both are clearly unpleasant. In Part 2 I will consider  Acute and Chronic Pain 

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Summary of points to remember when choosing pain medication

• Always read the packet and instructions first.
• Do not exceed the dose stated.
• Be aware of allergies and sensitivities.
• If known stomach or other problems seek medical advice before use.
• Don’t mix the medicines with others you take. Discuss with the pharmacist.
• Codeine products containing paracetamol should not be mixed with separate paracetamol.
• Take the most effective medicine early at the top dose recommended for acute pain
• Use pain medication together with the principles of RICE
• If pain is not managed (worsens) after 3 days seek professional help, or seek help if you feel unwell or have a high temperature.
• Gels and creams should not be used on open or infected wounds
• Be mindful of overuse and addiction

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Thanks for reading the first of my two-part article.
‘Painkillers for Foot Conditions’ by David R Tollafield

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Published by Busypencilcase Communications Est. 2015 for ConsultingFootPain