Pain Management

Pain Management

There is a wide selection of pain products available which can be used for acute (short-term) and chronic (long-term) treatment of painful conditions. These conditions include, but are not limited to:

  • Headache with or without tension
  • Low back pain
  • Muscle spasms
  • Inflammatory conditions
  • Sports injuries
  • Dental pain
  • Cancer pain
  • Post-operative pain

Learn here all about PAIN and speak to your healthcare provider about the range of pain medications which might be useful for you.

Back to top

What is pain?

Pain is described as an ‘unpleasant sensory and emotional experience’. In this way pain can be very complex!1a,b

Chronic pain (meaning long-lasting) is when pain persists longer than the normal time it takes to heal an injury.2a,3a

Back to top

The difference between acute and chronic pain:

Explaining chronic pain: In much the same way that a small flame from a match can cause a large forest fire, acute pain that is not properly treated can cause pain that persists long after the initial cause of pain.3b

Back to top

Types of chronic pain

Chronic pain affects almost 1 in every 5 patients, making it one of the most common conditions that any GP has to manage on a daily basis!4a

Chronic pain can actually be considered a disease in its own right!3c

“Pain is isolating, emotionally exhausting and adversely impacts on social relationships, daily functions, sleep and self-worth.”3e

Musculoskeletal pain (affecting the bones, muscles or joints) is the most common source of serious long-term pain and physical disability.4b

Chronic musculoskeletal pain is pain that has been present or persists for longer than 90 days and beyond an expected time frame for normal healing.4c,5a

Back to top

Pain pathways

Pain is divided into physiological pain (activation of pain receptors in the skin) which serves as a protective mechanism, for example, when you automatically pull your arm back from a burning pan; and clinical pain which is bodily and/or nerve injury and the associated inflammatory response (pain, swelling and inflammation).1e

Back to top

Managing pain

Poorly managed acute pain can result in the development of chronic pain,1l affecting the function of and wellbeing of the individual.2a

Back to top

 Did you know?

Psychological factors can influence the pain experience!1m

  • Anxiety and depression are associated with higher pain intensity.1m
  • Anxiety before surgery has been shown to contribute to increased postoperative pain!1m
Back to top


Medicines for the treatment of pain include paracetamol, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids and other therapies, such as muscle relaxants, steroids and antidepressants, all of which can play an important role in the management of pain.4d,e

Back to top

Treatment ladder: stepwise approach

A treatment ladder, based on how severe the pain is, will usually be utilised.1n The way it works is that treatment is gradually increased dependent on the specific pain experienced by the individual.4f

An example: A patient experiences persistent lower back (spinal) pain. What are his treatment options?

Your doctor or healthcare provider will advise you on which medicine to start with and then your options depending on how it works for you.

Back to top


Combining different medicines to treat pain is common as this means less amounts of each individual medicines is required with less potential side effects.1q

Back to top

Benefits of combinations:

When using opioids and NSAIDs, the combination of paracetamol with these agents is more effective than either agent alone, and it also reduces the dosage of the opioid, or NSAID, that is required to treat pain.4j

Back to top

Adjunctive (additional) medications

Generally, adjunctive medications (for example, muscle relaxants) are defined as medications that do not contain painkillers, but which play a role in the management of chronic pain, help reduce chronic musculoskeletal pain, and limit the need for painkillers.4m,n

Back to top

Suitability of use

Your pharmacist or doctor will help you choose the right medication for your needs. Be sure to highlight any medical conditions you might have so that any contraindications can be checked. People at risk of stomach ulcers (for example, age over 65 years or history of ulcer) or heart problems (risk factors include: high blood pressure, diabetes, high cholesterol) should be cautious taking NSAIDs and there are other combination medicines available in these and other cases.4o-q

Back to top

Effective management of pain:

Not only is the aim of adequate pain management to provide pain relief, it is also aimed at minimising the harmful effects caused by the bodies stress response, as well as preventing acute pain from becoming chronic.1r

Medical References

  1. South African Society of Anaesthesiologists (SASA). South African Acute Pain Guidelines; SSN-2220-1181.
  2. Practice Guidelines for Chronic Pain Management. An Updated Report by the American Society of Anesthesiologists (ASA) Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology 2010;112(4):1–24.
  3. Salduker S, et al. Practical approach to a patient with chronic pain of uncertain etiology in primary care. Journal of Pain Research 2019;12:2651–2662.
  4. Koch K. Chronic pain management options in general practice. South African Family Practice 2012;54:2:94-99.
  5. Raff M, et al. South African guideline for the use of chronic opioid therapy for chronic non-cancer pain. S Afr Med J 2014;104(1 Suppl 1):78-89.
  7. van Rensburg R, Reuter H. An overview of analgesics: NSAIDs, paracetamol, and topical analgesics Part 1, South African Family Practice 2019;61(sup1):S4-S10, DOI:10.1080/20786190.2019.1610228.
Mental Health
Infant Health

For more health information

Click on the body area you want to know more about. Select a related health topic from the menu

Select a body area


World Immunization Week

World Immunization week 24 - 30 April 2022



Warts and how to remove them


Minor Cuts and Scratches

How to treat cracked fingers and heels


Corns and Calluses

How to get rid of a corn / how to remove a corn / how to treat a corn



Will there be a flu season this year?

Content Disclaimer:
You understand and acknowledge that all users of the Dis-Chem website or app are responsible for their own medical care, treatment, and oversight. All of the content provided on the website, are for INFORMATIONAL PURPOSES ONLY and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. The content is not intended to establish a standard of care to be followed by a user of the website. You understand and acknowledge that you should always seek the advice of your physician or other qualified health provider with any questions or concerns you may have regarding your health. You also understand and acknowledge that you should never disregard or delay seeking medical advice relating to treatment or standard of care because of information contained in or transmitted through the website. Medical information changes constantly. Therefore the information on this website or on the linked websites should not be considered current, complete or exhaustive, nor should you rely on such information to recommend a course of treatment for you or any other individual. Reliance on any information provided on this website or any linked websites is solely at your own risk.
Back to top