Common painkillers for foot conditions

David Tollafield
Apr 25
6 min read

Selecting the right pain medicine (analgesic) can save time and money by avoiding an unnecessary appointment with the GP. Often, ibuprofen is considered first-line treatment, but is this the best? Help yourself, but be aware of concerns around pain medication.

Most pain medications are available over the counter (OTC), and non-branded ones are cheapest. Always look at the packet and compare the ingredients. If the cheaper medicine has the exact dosage in milligrams, then consider this. Some people prefer tablets, others dissolvable forms.

Most people can manage for a few days, but of course, if symptoms persist or do not improve, you should seek professional help.

addiction awareness — You won't become addicted to most simple pain medicines, but you may depend upon them, so their benefit decreases. However, it is easy to become addicted to painkillers that contain codeine (an opioid).

Addiction is not limited to painkillers but also sleeping and anxiety medications, and alcohol. A resource site for addiction can be found at https://www.addictionresource.net/best-drug-rehab-centers/united-kingdom/

Four Common Painkillers for Foot Conditions

Paracetamol (500mg),

Aspirin (300mg),

Ibuprofen (200mg),

Codeine (8mg)

Looking at basic information about each drug, the interactions and complex chemistry are not intended for deeper discussion. Each is given a milligram (mg) value as a dosage. A 'compound medicine' is one with mixed ingredients. And so there are variations that, when blended, will alter the combined weight of that medicine.

Using painkillers for some foot conditions may be helpful, but not for all. 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 and stress, and can become chronic over time.

Pain is an indicator of a problem.

Medicines or drugs that relieve or eliminate pain are called analgesics. Remember, pain is there for a reason. The symptoms 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.

Purchase medicine from recognisable outlets. — Primary pain management starts with over-the-counter medicines. Always seek advice from a qualified pharmacist. They are usually the ones hidden from sight.

Medicines don't work for all types of pain, and not everyone can tolerate all medicines, which can render painkilling medication of little value.

Paracetamol is probably the best-known analgesic. In the USA, it is called Tylenol, but its 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 details can be found on Wikipedia, but some of the details are necessary for lay understanding.

Aspirin is an older medication (1899) that also acts as an anti-inflammatory and pain relief medication. It can also bring down high temperatures (antipyretic). Ibuprofen arrived in the UK in 1969 to treat rheumatoid arthritis. Five years later, it was designated as a non-steroidal anti-inflammatory drug (NSAID).

An anti-inflammatory turns off some 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, so the pharmacy is slowly opening up different possibilities for people.

The one downside of anti-inflammatories is the risk to the stomach, especially for those with gastric problems. It is also advised to use these medicines with or after food.

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 that codeine is a derivative of morphine. You cannot buy codeine over the counter without a prescription. The reason I have included it here is that it is mixed (compounded) with either paracetamol or ibuprofen as a drug that you can buy. Prescription doses are usually 10mg, 15mg and 30mg.

The downside with codeine (apart from addiction) is the chance of constipation, which can provoke haemorrhoids and stomach pain. Over-the-counter doses are usually 8mg per tablet.

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 effectiveness of analgesics. This has been found in managing headaches. Headaches can worsen the more you use the drug.

Reducing the cost of medicines

Some medications have brand names, such as Nurofen and Panadol, as two examples. These are proprietary names marketed for consumer sale and are listed on the packets sold under different names. The key ingredients common in all these proprietary sales are generic names, such as ibuprofen and paracetamol. Manufacturers have to make money for their investments. As time passes, a drug loses its patent. Other pharmaceutical manufacturers can use the same medicine and make it cheaper when this happens.

Mixed or Compound Medications

Companies are always looking for rebranding to overcome the loss of income. They can do this in two ways. They can introduce the same drug in a different form—liquid, capsule, dissolving tablet, caplet, 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 we are also made to believe that performance improves as a result 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 knowing product placements in adverts is good.

The other method of making a drug sound better is to add a mild chemical to rebrand it as 'better'. When added to paracetamol, caffeine might suggest it is EXTRA STRENGTH and, therefore, superior. At 65mg, two tablets usually give you 130mg of caffeine. Caffeine is a stimulant and can also increase your heart rate. You could drink a cup of 250 ml of 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, but caution is always advised. Such combinations will cost more, and you must decide if you want to buy and use the two separately. The general idea is to prevent codeine from being used. Using codeine mixed with ibuprofen or paracetamol is available eg solpadeine. This proprietary drug has been around since the 1980s. It is useful and comes in different forms.

Solpadeine is the brand name of a range of analgesic medications containing various amounts of paracetamol, ibuprofen, caffeine, and codeine. Four medicines in the United Kingdom use the Solpadeine name, but they do not share any common active ingredient.

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

First line advice

Pharmacists are trained to serve healthcare professionals and the public. They will always be happy to advise you about your medication needs. It is common practice to ask if you are taking other medications because some medicines interact. Mixing drugs can produce undesirable effects that can make people ill. Do not take paracetamol with a compound (mixed) drug that also contains paracetamol. An overdose is severe and can damage the liver permanently.

What foot conditions can we use painkillers for?

The list of painkillers used for foot conditions is far from conclusive. Anti-inflammatory or just analgesic medications are indicated as 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., an ingrown toenail) (analgesic) + antiseptic is required.
tendon pain(anti-inflammatory)

N.B. Infections should be treated with first aid immediately on the foot and dressed. If signs and symptoms spread, seek professional help.

Summary of Points

Always read the packet and instructions first.
Do not exceed the dose stated.
Be aware of allergies and sensitivities, including stomach and bowel problems.
Caution is needed with liver and kidney disease.
Consult a pharmacist before mixing with prescribed medication or sleep medicines.
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 with the principles of RICE—rest, ice, compression and elevation.
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.
Children will require different doses and should be managed with professional advice.