Pain Relief

Available treatment options

We have a wide array of treatments depending on the source of your discomfort. For musculoskeletal and inflammatory pain, non-steroidal anti-inflammatory drugs (NSAIDs) are a cornerstone. I frequently recommend Naproxen or Diclofenac for acute flare-ups.

For patients who need something more targeted for conditions like osteoarthritis, COX-2 inhibitors such as Etoricoxib (often known by the brand Arcoxia ) or Meloxicam can be highly effective while being somewhat gentler on the stomach.

For localized joint and muscle relief without systemic side effects, topical options like Arthrocann Gel are excellent additions to your toolkit.

Migraines require an entirely different approach. Over-the-counter painkillers rarely cut it. Instead, we use triptans, which constrict blood vessels in the brain. Sumatriptan is our standard first-line choice, but if patients find the side effects too heavy, I might switch them to Zolmitriptan (often prescribed as Zomig ), Rizatriptan ( Maxalt ), or Naratriptan ( Naramig ).

A crucial clinical pearl: many patients take their triptan during the visual aura phase of a migraine, but they actually work best when taken at the very onset of the headache phase.

For highly specific, localized pain, we use targeted topical anesthetics. Emla Cream and Xylocaine provide excellent numbing for superficial skin procedures or localized nerve irritation. For the severe, sharp pain associated with anal fissures or hemorrhoids, I rely on specialized treatments like Rectogesic ointment (which relaxes the sphincter muscle to promote healing) and Xyloproct , which combines an anesthetic with a mild steroid.

What to expect from treatment

It is important to set realistic expectations. An NSAID might reduce inflammation by 70%, but it rarely takes the pain down to an absolute zero immediately. With migraine treatments like triptans, you should expect relief within two hours, but you might experience what my patients call a "triptan hangover"—a feeling of heaviness or tingling in the chest and limbs.

This is a normal pharmacological effect, not a worsening of the migraine. A tip I always share: always take oral painkillers with a full glass of water and food; staying well-hydrated actually improves the efficacy of the medication by ensuring better absorption in the gut.

Self-care and prevention

Medication is only half the battle. For musculoskeletal pain, I always advise temperature therapy, but many get it wrong. Use ice for the first 48 hours of an acute injury to reduce swelling, but switch to heat for chronic muscle spasms to increase blood flow.

For migraine sufferers, keep a detailed diary, but don't just track what you ate—track your stress let-down. A phenomenon I frequently see is the "weekend migraine," which occurs not during high stress, but the moment your cortisol levels drop on a Saturday morning.

Maintaining a consistent sleep schedule, even on weekends, is one of the most powerful preventative tools you have.