Severe pain Few studies have been done to determine the effectiveness of various
medications in severe pain after extensive trauma. However, the Cochrane Collaboration
has conducted a review of the most effective treatments for renal colic pain. This happens
when a kidney stone gets stuck in the ureter leading from the kidney to the bladder,
obstructing the flow of urine. Many consider renal colic to be one of the most severe pains
humans experience. The Cochrane Collaboration concluded that NSAIDs and opioids are
both effective. The review does mention that “(10 out of 13) studies reported lower pain
scores in patients receiving NSAIDs.” NSAIDs also had fewer side effects and required
fewer rescue medications, or additional pain medication. (Holdgate & Pollock, 2004)
In summary, regarding acute pain, it is frequently stated that NSAIDs and acetaminophen
should be used for mild to moderate pain, and opioids should be used for severe pain. There
is, however, no scientific evidence to support this recommendation. In fact, the evidence seems
to indicate that NSAIDs are more effective for severe pain. The combination of acetaminophen
and an NSAID may be the strongest option available for oral treatment of acute pain.