OTC Painkillers - Use With Care

The two most commonly used over-the-counter pain relievers are acetaminophen (Paracetamol, Tylenol) and nonsteroidal anti-inflammatory drugs or NSAIDs (Aspirin, Ibuprofen, Aleve). There are many types of OTC painkillers marketed under different brand names with different prices, but there is no evidence that more expensive pills works better than cheaper ones.

Acetaminophen

Tylenol and Paracetamol belongs to the acetaminophen class. This type of drugs reduce pain and fever, but it does not have reduce inflammation and swelling. They are generally used to treat minor pain like tension headaches, influenza, and in chronic conditions where no inflammation is present.

Acetaminophen is metabolized in the liver and kidney. Therefore, people with liver and kidney condition or those who drinks alcohol should avoid taking it. Interaction with other medications like blood thinners and birth control pills also warrant precaution. Because acetaminophen is a common component in cough mixtures and in prescription medication, people often don't realize that they are taking products containing the same ingredient, resulting in overdose.

"People often don't realize that they are taking products containing the same ingredient."

Taking as little as 10-15 g of acetaminophen in 24 hours can cause life threatening liver damage which may not be apparent for 4-6 days. Symptoms of overdose includes nausea, vomiting, stomachache, kidney failure, and brain damage. Even though initial symptoms are not significant, patients should seek immediate medical attention.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs relieve pain and is especially useful in reducing inflammation. There are three types of NSAIDs available for purchase without prescription: aspirin (Anacin, Bufferin, Empirin), naproxen (Aleve), ibuprofen (Advil, Motrin, Excedrin). Naproxen is more long-acting than aspirin and ibuprofen.

The most concerning side effect of NSAIDs is stomach bleeding. Symptoms includes black tarry stools, abdominal pain, or vomiting blood. Long term use may also cause kidney problems, even more prevalent than that caused by acetaminophen. That's why acetaminophen is a safer choice for chronic usage.

Children under 18 years old should not take aspirin because of the risk of developing Reye Syndrome, a potentially fatal condition. Aspirin also increases the risk of bleeding in people undergoing surgery. So be sure to tell your dentist or doctor that you take aspirin before they perform any procedure.

Different Types of Headaches

The head is one of the most common location of pain in the body.

The head is one of the most common location of pain in the body. There are many causes of headache, making it difficult to classify. In 2007, the International headache Society made a new classification system for headache in hopes that this new system will make the diagnosis more specific and treatment more effective.


The three major categories of headache are primary headaches, secondary headaches, and cranial neuralgias, facial pain, along with other headaches.

Primary Headaches

In primary headaches, the pain is not a result of an injury or underlying structural problem. This is the most common type of headache. Examples of primary headaches are:

• Tension headache or chronic non-progressive headaches is the most common form of primary headaches. Up to 90% of adults will experience tension headache in some point of their life. The pain comes from muscle contraction that cause mild to moderate pain that comes and go.
• Migraine headache is the second most common form of primary headache. Up to 18% of women and 6% of men will experience tension headache in some point of their life. The exact cause of migraine is unknown. The pain is moderate to severe, with pounding or throbbing quality, and maybe accompanied by nausea or vomiting and sensitivity to bright light, noise, or smell. It occurs episodically and each attack can last from several hours to three days.
• Cluster headache is a rare form of primary headache that affects only 0.1% of the population with men in their late twenties more commonly affected. The pain is severe, with constant burning, piercing, or throbbing quality, usually occurring in one side of the head and most intense behind the eye. During a cluster period, which may last from two weeks to two months, headaches occur 1-3 times per day.

Secondary Headaches

An underlying disease or injury in the head or neck is the cause of secondary headache. Not all of these structural problems are harmful, but problems like meningitis, brain tumor, or bleeding must always be considered. Some of the worst headaches resulted from secondary causes, such as subarachnoid bleeding that causes 'thunderclap' headache.

Cranial Neuralgias, Facial Pain, and Other Headaches

Cranial neuralgias and facial pain occur because of the inflammation on the nerves in the head and neck region. Unspecified headaches or when there is not enough information to classify the headache into other categories falls into 'other headaches' waste basket classification.

Headache could be a sign of a serious life threatening condition. Seek immediate medical attention if you experience any of the following:

Seek medical attention if you feel the intensity of pain is unusual.

• A perceived sensation of the worst headache of your life 
• Fever or stiff neck
• Seizures
• Headache associated with recent trauma
• Persistent nausea and vomiting
• Weakness in any part of the body
• Changes in levels of consciousness, speech, or vision
• Headaches not responding to pain medication

Aching All Over? You May Suffer From Fibromyalgia

What is fibromyalgia?

Fibromyalgia is a syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. It affects around 12 million people in the United States, most commonly in women of 25-60 years old, and is the most common musculoskeletal condition after osteoarthritis.

Many people still thinks that the pain of fibromyalgia is not real pain and merely something that's 'going on in your head' only. The common misconception caused many cases of fibromyalgia go under-diagnosed and left untreated.

What are the symptoms of fibromyalgia?

The characteristics symptoms of fibromyalgia are widespread muscle and joint pain and fatigue that persist for at least three months. The pain may gets worse after physical activity, stress, or weather changes. Some areas called the 'tender points' may be especially painful when pressure is put on them. The back of the head, the shoulders, the nape, the elbows, and the knees are common tender points. Other symptoms may include increased sensitivity to pain, muscle stiffness and spasms, and numbness or tingling.

Back of the head, shoulders, and nape are common tender points 

The following conditions often accompanies fibromyalgia:

• anxiety and depression 
• chronic headaches or migraines 
• dryness in mouth, nose, and eyes 
• hypersensitivity to light, loud noises, cold and/or heat 
• incontinence 
• irritable bowel syndrome 
• memory and concentration problems (the so-called 'fibro fog') 
• menstrual problems 
• restless legs syndrome 
• sleep disturbances 

What is the treatment of fibromylagia?

Fibromyalgia is difficult to treat. A combination of physical exercise, behavioral techniques, pain medications, and anti-depressant may help relieve the symptoms of fibromyalgia. However, there is no single cure that will address all fibromyalgia related problems. The good news is, this condition is not life threatening and even though it can cause unbearable pain, there are no structural damage to your muscles.

Physiology and Psychology of Pain

Everyone experience pain at some point of their life. Pain is the most common reason for physician consultation in the United States.

What is pain?

From physiology point of view, it is defined as an unpleasant sensation often caused by intense or damaging stimuli. It's a sign that something wrong is happening in your body. In this sense, pain is actually a good thing as it warns us to take measure to prevent further damage.

In the simplest form, the pain circuit in our body starts whenever a painful stimulus came in contact with pain receptors. This stimulus is then transferred via specialized nerves to the spinal cord and from there to the brain. The pain stimulus is processed in the brain, which then sends an impulse down the spinal cord and through appropriate nerves which command the body to react, for instance by withdrawing the hand from a needle prick.

"Pain is the most common reason for physician consultation in the United States."

Our body is able to produce natural painkillers.

Modulation of pain

The psychology point of view argues that not everyone who think they are in pain actually have physical injury or disease. Psychological factors play a huge role in pain perception and pain is intimately tied to brain functions that regulate our behavior. A stoic individual may have a higher threshold for pain compared to other people. For this reason, reassurance and positive thinking may actually reduce the intensity of pain.

Our body is able to produce their own painkillers, sometimes known as natural opioids. When pain impulse reaches the brain, these opioids are released from their storage areas to block the transmission and perception of pain. There are many factors that influence the production of these natural opioids and psychological factors may be one of them.

It's all in your mind?

Logically speaking, if there's no visible or proven source of pain (such as trauma or diseases), then the source of that pain might be psychological. 'It's all in your mind' so to put it. But that doesn't mean that the person in pain doesn't need any help. Prolonged pain may lead to depression and reduce your sense of well-being. There are many ways to manage pain and not all of them are pharmacological. You can try relaxation or self hypnosis technique, for example. 

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Other articles about pain:

• The head is one of the most common location of pain in the body. There are many causes of headache, making it difficult to classify. Read more about different types of headaches 
• Fibromyalgia is a syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. Read more about fibromyalgia syndrome 
• Abdominal pain is one of the most common reasons for doctor visit with severity ranging from mild to life threatening. Everyone experiences abdominal pain from time to time. Read more about common causes of abdominal pain