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.

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. 

---

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