I was operated on on Thursday and they gave me painkillers afterwards, but they didn't work. I felt a little high, but it didn't diminish the pain.

The same in January, they gave me a morphine analogue and, whilst I felt completely out of it, it didn't eliminate the pain. The pain was less and I could move, but it still hurt like hell.

After the operation, I was given Novalgin (Metamizole or dipyrone, an ampyrone sulfonate analgesic (pain reliever)). As said, this didn't affect the pain. I ended up with Ibuprofen for the swelling and that was it.

So, how do pain relievers work, should they kill the pain or just make you not care that you are in pain?

In my experience it's a case of trying them all until something works, guess it comes down to individual chemistry. But frankly I'd see what Mr Wolf has to say lol.

There are several different classes of pain killers, for example Opiates (like morphine), NSAIDs (non-steroidal anti-inflammatory drugs, like ibuprofen and aspirin), and others like parectamol (this is not an exhaustive list).
Each class has a different mode of action, generally speeking a different molecular target in the body. Opiates for example bind to opiate receptors in the brain.

The good doctor can provide far more information obviously.

You can, over time, develop resistance/tolerance to certain pain killers so if you've been on morphine for a while its effectiveness can diminish meaning you need more to achieve the same effect which can end up being a problem as morphine can cause respiratory depression. That's incidentally what can kill heroin addicts (or I should actually say HeroinTM, IIRC it's a Bayer trade mark) - over time they need more and more to get their hit until they OD and they end up with respiratory failure.

Dammit typed a long reply on my iphone, went to check whatever novalgin was and page reloaded, losing my response.

Long and short, anti inflammatories reduce prostaglandin levels which reduces pain and inflammation, opiates act centrally in the brain, and neuropathics modulate pain nerve fibres. Opiates vary in efficacy and side effect profile, and there'a drug and individual variability. Example: codeine is weaker than tramadol but more likely to cause side effects (albeit mild), Tramadol is stronger, causes fewer side effects but those side effects tend to be more debilitating. In addition, I can give codeine to one patient who will then hallucinate on it, and i can give morphine to another patient who will experience no pain relief and no side effects.

In medicine, the aim is to get a pain down from 9/10 to 4/10, not to necessarily completely eliminate it. Just to get you to a stage where you can do your daily activities without being disabled too much.

Mmmmm Tramadol. I've been on them for a few days now, and need to speak to my doctor about some side effects, which I'm experiencing.

They don't seem to be doing much for the pain either...

That seems to have been my problem, they gave me a morphine analogue and it didn't do a damned thing to reduce the pain.

Codeine - worked well for a back probelm I was having (60mg) and as I had them a number of years the woozy 'high' effects didn't hang around - I suppose I got used to them?

Tramadol - feel stronger to me than codeine but then I did take 100mg. Had horrible withdrawal even after short term use though.

Dihydrocodeine - again, stronger than Codeine but make me quite drowsy at first. I personally find 30mg of this is equal to or stronger than 60mg Codeine.

I recently had Orchitis and it was one of the most painful experiences of my life. I was given morphine orally in hospital which was great and sent home with Dihydrocodeine which, whilst not as good, did do the trick.

Going to Central America soon and I assume that they will have some of the good stuff available over the counter. Any recommendation on what would good for recreational use? I was thinking valium

I'm not a Doctor, kinda goes without saying, I know, but don't we need to know what kind of pain you are suffering from before recommending a painkiller?

Haha, I don't have any pain, I just want to relax with something nice, hence the reacreational use.