Eight year old Lovie Taylor is dealing with a lot of pain. “Lovie is here today because she had surgery, very intense surgery. A lot of pain, we came into the emergency room, she was in an awful lot of pain,” says Rhonda, Lovie’s Grandma. Morphine is Lovie’s drug du jour. But for most kids who come to the E.R., or even are just treated at home, the pain can be managed with less intense medicine…
But which one is best? Tylenol? Ibuprofen? What about a narcotic like codeine? Dr. Ting An Lee, a pediatrician at Children’s Hospital at Montefiore, says, “You face a decision on which one do I choose. There haven’t been a lot of studies to necessarily compare, so this is the study is unique in that way.”
The research, in the latest issue of Pediatrics, compared acetaminophen, which is what tylenol is, ibuprofen, which is what motrin is, and codeine. The study looked at how well the medications worked for musculoskeletal injuries to the neck, back, arms or legs in kids who came to the emergency room.
The findings clearly show a pain relief advantage to ibuprofen, which acts both centrally in the brain pain centers and at the site of injury. We’re talking about one dose. After one hour, more patients got adequate pain relief than those taking tylenol or codeine. In fact, there’s no difference between tylenol and codeine in terms of pain relief.
“Tylenol acts more centrally and the ibuprofen also is acting centrally but also has peripheral effects. That is the major difference between the two. Often times we will use ibuprofen because of what I mentioned before the peripheral effects and helping to reduce the swelling and the inflammation that comes along with these muscular-skeletal injuries,” says Dr. Lee.
But what about using more than one together? “I would not recommended using acetaminophen and Ibuprofen together to treat muscular skeletal pain because there haven’t been studies to show that it has been helpful and if you can stick with one medication its always a safer way,”
Dr. Lee advises. We should make a strong point that if the child doesn’t get relief, certainly within 24 hours, or worsening symptoms, like more swelling or pain, you should bring your child to the doctor. Using ibuprofen repeatedly can cause side effects like stomach irritation and bleeding. Codeine, though, which is a narcotic, is associated with more side effects than ibuprofen, so it appears there’s little reason to use it.