Friday, April 13, 2012

Killing pain

On Radio 4’s Inside Health this week Dr Andrew Moore from the Pain Research Unit at the Churchill Hospital in Oxford talked everyday pain relief.

He said that there is a hierarchy of effectiveness in simple over-the-counter remedies: aspirin works in about 35%-40% of cases, for paracetamol the figure rises to 45%, while ibuprofen provides relief for 55%.

I have heard or read these kinds of figures before, & it always irritates me that it is unclear whether the aspirin & paracetamol for example work on non-overlapping groups of patients (so that, between them, they may, if given to the right patients, ease the plight of up to 95%, or whether the conclusion is that you may just as well give everyone paracetamol because the 45% includes the 35%.

But the latest news is that a combination of pain killers is likely to be even more effective. So 1 paracetamol tablet plus 1 ibuprofen will banish 75% of pains. (It is important to stress that this is a half-and-half mix & match approach, not double-dosing with a normal two tablets of each of the two drugs). Again, it is not clear whether it is the combination which works the magic, or it simply that you increase the chance of getting the pain killer which works for you.

There is also good evidence that the addition of caffeine might increase the effectiveness in another 5% of cases, though how, exactly, is unclear. Caffeine may aid absorption or act on receptors in a way which is so complicated that nobody, including Dr Moore, understands them.

So there may be after all a good reason behind my idea that cola works where coffee does not.

In some people at least.