Aspirin, ibuprofen, acetaminophen? Common over the counter pain relievers.
But not all pain relievers work the same way and can have various effects on your body.
The two main categories of commonly used pain relievers (analgesics) are acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin (Bayer, Bufferin, Excedrin), ibuprofen (Advil, Motrin) and naproxen (Aleve). Most are available over the counter and some by prescription only.
Acetaminophen (brand name Tylenol) relieves mild-to-moderate pain and reduces fever but does not affect inflammation. It can be helpful for pain but won’t do much for sprains or inflammatory-related conditions (suffix ending -itis). Aspirin remained the premier over-the-counter painkiller until the development of acetaminophen in 1956 and ibuprofen in 1962. Aspirin (acetylsalicylic acid) is most often used to relieve minor pain, fever and inflammation but it can cause problems in the digestive tract (esophagus, stomach and small intestine) and is NOT recommended for certain patients because of its anticoagulant (blood “thinning” agent) or for children (linked to Reye’s syndrome). Acetaminophen is easier on the stomach than aspirin and other NSAIDs but has its own set of problems (reports of people developing liver problems after taking small to moderate amounts for long periods of time). Drinking alcohol while taking acetaminophen can also cause liver damage.
NSAIDs ease pain, lower fever and turn down inflammation. They can be very helpful for pain arising from inflammation-related conditions. NSAIDs reduce the level of prostaglandins your body makes by blocking certain enzymes. This hormone-like substance irritates your nerve endings and creates the feeling of pain. By blocking these enzymes, NSAIDs stop your body from making as many prostaglandins. This means less swelling and less pain. NSAIDs are effective in reducing pain and inflammation often associated with joint and muscle diseases and injuries.
Potential problems arise with unregulated reliance on OTC analgesics. The U.S. Food & Drug Administration advises that NSAIDs shouldn’t be taken for more than 10 days without seeing your doctor. Your doctor will need to see you periodically to monitor the medication. One of the problems with NSAIDs is that they reduce the blood flow to the kidneys which makes the kidneys work more slowly. When your kidneys are not working well, fluid builds up in your body. The more fluid in your bloodstream, the higher your blood pressure. If you take NSAIDs in high doses, the reduced blood flow can permanently damage your kidneys. Prolonged usage of unregulated and long term usage of NSAIDs can also have negative side effects on connective tissue and injury rates.
In planning your treatment, your doctor will take into account the effectiveness and the risks of drugs and work with you to develop an appropriate treatment program. Your doctor will consider your medical history, physical exam, X-rays, blood tests, and other medical conditions. It is important to meet with your healthcare provider regularly so he or she can watch for any harmful side effects and change your treatment, if necessary. Your doctor may order periodic blood tests or other tests (including a kidney function test) from time to time to determine how effective your treatment is and to look for any harmful side effects.