With the popularization of health knowledge and the development of the Internet, many people have a headache and fever like to buy their own painkillers, some patients have a good analgesic effect, and stop taking the drugs when the pain disappears. Some patients have good analgesic effect and stop taking the medication when the pain disappears, and then take the medication again after a few days, and so on repeatedly for 10 to 20 years. Finally, all the painkillers available in pharmacies are ineffective, so they have to go to the hospital to see a doctor. Of course, there are also some patients who buy their own painkillers that don’t work at all. There are also some patients who keep in mind the traditional idea that you can’t just take painkillers when you have pain, because taking painkillers will cover up the real condition, and these patients run to the hospital to see a doctor when they have pain. So how do painkillers actually work? Several pain patients seen in recent days are quite representative. A male patient, 39 years old, is a small boss in the building materials business. He started to have low back pain 4 years ago. The pain was heavier at night when he slept, and the low back was stiff in the morning when he woke up. The pain was reduced after activity. I thought it was due to strain caused by lumbar muscle strain, so I went to the street to buy some painkillers to eat, not to mention that it really worked. Recently, the back pain is getting heavier and heavier, taking painkillers is not working anymore, the patient thinks it is drug resistant, so he went to the hospital to see a doctor, and the first thing he said to me was: What painkillers can I take to stop the pain? I took a detailed medical history, gave the patient the necessary imaging tests, ran some blood tests, and told the patient: you have ankylosing spondylitis, which requires systemic treatment, which means that to cure the disease, simply taking painkillers is not an option. The patient was depressed for several days and finally accepted my advice. Example 2: A female patient, 40 years old, is the executive vice president of a technology-based company. Work was intense, and when the stock market crash happened some time ago, she said she could only sleep 2 hours a night because she had to study countermeasures with her boss. The company’s stock price fluctuated too much to calm down her fellow stockholders. She had intermittent headaches all year round and was said to have started taking painkiller tablets since she went to college. The patient told me that the MRI of head and cervical spine were done and it was fine. Recently, the painkiller side effects started to appear and the pain kept getting worse, so I had to see a doctor. According to the nature of the patient’s pain, the pattern of attacks, and the examination results, the diagnosis of occipital neuritis was made. After radiofrequency treatment, the pain disappeared and the painkillers were stopped completely. There are three categories of commonly used painkillers, the first category of anti-inflammatory painkillers, such as aspirin and ibuprofen. This class of drugs is mainly used for headache, muscle pain, joint pain, etc. The second category is the central class of painkillers, such as tramadol, morphine, dulcolax and so on. These drugs have strong analgesic effect and are mainly used for moderate to severe pain such as traumatic severe pain, visceral pain and cancer pain. The third type of painkillers is for special pain such as trigeminal neuralgia, post-herpetic neuralgia and other neuropathic pain. They must be taken under the guidance of a doctor. The painkillers that ordinary people can sell in pharmacies are the first type of painkillers. In principle, the painkillers you buy should not be taken for more than 5 days in general, and long-term use may produce “drug resistance”, and the pain relief effect will become worse and worse. In addition, improper use of such painkillers can cause peptic ulcers and bleeding, and also have adverse effects on people with high blood pressure and heart disease. Therefore, it is okay for patients to buy some painkillers on their own to take them temporarily to relieve pain symptoms, but if the pain relief effect is not good, or if the pain recurs, it should be taken under the guidance of a doctor, after all, the cause of pain is very complex, to cure the disease to truly eliminate pain.