An analgesic is any medicine intended to kill pain. Over-the-counter analgesics (medicines bought without a prescription called NSAIDs ) include aspirin, acetaminophen, ibuprofen, naproxen sodium, and others.

Pain perception is hard-wired in our nervous system via neurotransmitters and other chemical messengers. Also, our immune system produces chemical messengers that can either transmit pain signals to the brain or cause inflammation. Our immune system plays a dual role in this scenario; it can be both helpful and destructive.

Body's Reaction to Pain

When it comes to relieving pain it is elevated levels of destructive inflammatory messengers that must be suppressed. The reason that they must be suppressed is that if they are not, they set up a chronic pain feedback loop with the brain. What this means is that an interaction between the brain and the immune system causes pain signals to remain permanently turned on-resulting in further chronic pain.

Some of the most recognizable substances that cause pain include:

• prostaglandins
• immunotransmitters (cytokines)
• peptides such as Substance P
• glutamate and nitric oxide

Since inflammation is at the heart of pain, the principal substances that produce inflammation include:

• histamine
• kinins
• leukotrienes
• complement glandins
• prostaglandins

Prostaglandins and leukotrienes are compounds that are produceed via the metabolism of fats in our diets. Both of these compounds are simplistically categorized as either "good" or "bad." The good prostaglandins and leukotrienes are beneficial and constructive to the body while the bad ones are very destructive, having roles in increasing cancer, heart disease and inflammation.

Pain Solutions

From a clinical perspective, the enzymes that are involved in the production of the destructive prostaglandins and leukotrienes, called cyclooxygenase-2 (COX-2) and lipoxygenase (LOX), are the target of both medical and nutritional intervention in order to suppress these inflammatory substances. The drugs that interrupt pain-such as acetominophen, NSAIDs and COX-2 inhibitors are focused on inhibiting the destructive, inflammatory prostaglandins.

Pain Relievers

NSAIDs

1. Aspirin and related drugs (salicylates)

Aspirin and it's derivatives contain salicylate, a chemical that is found in the bark of willow trees and in certain plants. The salicylates are a family of related drugs that reduce the effects of inflammation, a reaction of the body that causes pain, swelling, redness, and heat. The word salicylate refers to the active ingredient in the drugs. Aspirin (acetylsalicylic acid or ASA) is one of these drugs.

Small amounts of salicylate can relieve headaches, mild pain, fever, hangovers, and joint and muscle pain from too heavy exertion and also arthritis. 

Aspirin has blood-thinning properties. As a result, small amounts of aspirin taken on a daily basis can inhibit the re-occurence of a heart attack.Aspirin in small amounts is now recommended by cardioloists both to suppress at-risk persons for heart attack, and for those who have had a heart atack.

Larger amounts of Aspirin taken regularly over a period of time relieve some of the pain, heat, redness, and swelling associated with the inflammation of many forms of arthritis.

Many NSAIDs contain some form of salicylates and as a result are chemically related to aspirin; they have similar effects in the body.

Side Effects

Long Term 

(The following does not apply for the small amounts of aspirin taken daily by at-risk heart attack persons)

If aspirin is taken in normal daily doses over a long period of time (6 months or more), the following are the known possible complications that may occur:

• kidney damage
• liver damage
• hypertension
• gastrointestinal damage
• asthmatic attacks
• ringing in the ears

Brand Names of Common Salicylates NSAIDs

Acuprin 81 Amigesic Anacin Caplets Anacin Maximum Strength Anacin Tablets Anaflex 750 Arthritis Pain Ascriptin Arthritis Pain Formula Arthritis Strength Bufferin Arthropan Aspergum Aspirin Regimen Bayer Adult Low Dose Aspirin Regimen Bayer Regular Strength Caplets Aspir-Low Aspirtab Aspirtab-Max Backache Caplets Bayer Children's Aspirin Bayer Select Maximum Strength Backache Pain Relief Formula Bufferin Caplets Bufferin Tablets Buffex Buffinol Buffinol Extra Cama Arthritis Pain Reliever CMT Cope Disalcid Doan's Regular Strength Tablets Easprin Ecotrin Caplets Ecotrin Tablets Empirin

Extended-release Bayer 8-Hour Extra Strength Bayer Arthritis Pain Formula Caplets Extra Strength Bayer Aspirin Caplets Extra Strength Bayer Aspirin Tablets Extra Strength Bayer Plus Caplets Gensan Genuine Bayer Aspirin Caplets Genuine Bayer Aspirin Tablets Halfprin Healthprin Adult Low Strength Healthprin Full Strength Healthprin Half-Dose Magan Magnaprin Marthritic Maximum Strength Arthritis Foundation Safety Coated Aspirin Maximum Strength Ascriptin Maximum Strength Doan's Analgesic Caplets Mobidin Mono-Gesic Norwich Aspirin P-A-C Revised Formula Regular Strength Ascriptin Salflex Salsitab Sloprin St. Joseph Adult Chewable Aspirin Tricosal Trilisate ZORprin

2. Acetaminophens

Acetaminophen is an analgesic without anti-inflammatory effects. It does not have peripheral antiinflammatory effects or blood-thinning properties. It does not relieve the redness, stiffness, or swelling caused by rheumatoid arthritis. However, it may relieve the pain caused by mild forms of arthritis.

Acetaminophen is considered a drug of choice in patients who are aspirin intolerant, have ulcers, or difficulty in blood clotting. It  is generally very well tolerated.

Overuse: The recommended maximum dose of Acetaminophen  is 4gm/day in adults or 2.6gm/day in children under 12 years of age. Too much acetaminophen can damage the liver.

Acetaminophen and alcohol: Combining acetaminophen and alcohol can result in quick and severe liver damage, so alcohol should be avoided while taking acetaminophen.

Brand Names of Common Acetaminophen NSAIDs

Aceta Elixir Aceta Tablets Acetaminophen Uniserts Actamin Actamin Extra Actamin Super Aminofen Aminofen Max Apacet Capsules Apacet Elixir Apacet Extra Strength Caplets Apacet Extra Strength Tablets Apacet, Infants' Apacet Regular Strength Tablets Aspirin Free Anacin Maximum Strength Caplets Aspirin Free Anacin Maximum Strength Gel Caplets Aspirin Free Anacin Maximum Strength Tablets Aspirin-Free Excedrin Caplets Banesin Bayer Select Maximum Strength Headache Pain Relief Formula Dapa Dapa X-S Datril Extra-Strength Feverall, Children's Feverall, Infants' Feverall Junior Strength Feverall Sprinkle Caps, Children's Feverall Sprinkle Caps Junior Strength Genapap Children's Elixir Genapap Children's Tablets Genapap Extra Strength Caplets Genapap Extra Strength Tablets Genapap, Infants' Genapap Regular Strength Tablets Genebs Extra Strength Caplets Genebs Regular Strength Tablets Genebs X-Tra Liquiprin Children's Elixir Liquiprin Infants' Drops Neopap

Oraphen-PD Panadol, Children's Panadol, Infants' Panadol Junior Strength Caplets Panadol Maximum Strength Caplets Panadol Maximum Strength Tablets Phenaphen Caplets Redutemp Snaplets-FR St. Joseph Aspirin-Free Fever Reducer for Children Suppap-120 Suppap-325 Suppap-650 Tapanol Extra Strength Caplets Tapanol Extra Strength Tablets Tempra Tempra D.S Tempra, Infants' Tempra Syrup Tylenol Arthritis Extended Relief Tylenol Children's Chewable Tablets Tylenol Children's Elixir Tylenol Children's Suspension Liquid Tylenol Extra-Strength Adult Liquid Pain Reliever Tylenol Extra Strength Caplets Tylenol Extra Strength Gelcaps Tylenol Extra Strength Tablets Tylenol Infants' Drops Tylenol Infants' Suspension Drops Tylenol Junior Strength Caplets Tylenol Junior Strength Chewable Tablets Tylenol Regular Strength Caplets Tylenol Regular Strength Tablets Valorin Valorin Extra

3. Ibuprophen
This compound was introduced in 1974 and is often used where pain relief is needed without a large anti-inflammatory effect.

Ibuprofen is not as effective as aspirin in its anti-inflammatory effect and can cause gastrointestinal irritation. Lower doses can control pain but higher doses are needed to treat inflammation.

Side Effects: 

Minor side effects

• stomach upset
• diarrhea
• dizziness
• drowsiness
• gas or heartburn
• headaches.

Serious Side Effects

• kidney toxicity
• jaundice
• nausea
• dizziness
• rash
• gastric ulcers, especially with smokers

Brand Names of Common Ibuproophen NSAIDs
Actron Advil Advil Caplets Advil, Children's Aleve Anaprox Anaprox DS Ansaid < Bayer Select Ibuprofen Pain Relief Formula Caplets Cataflam Clinoril Cotylbutazone Cramp End Daypro Dolgesic Dolobid EC-Naprosyn Excedrin IB Excedrin IB Caplets Feldene Genpril Genpril Caplets Haltran Ibifon 600 Caplets Ibren Ibu Ibu-200 Ibu-4 Ibu-6 Ibu-8 Ibuprin Ibuprohm Ibuprohm Caplets Ibu-Tab Indocin	Indocin SR Lodine Lodine XL Meclomen Medipren Medipren Caplets Midol IB Mobic Motrin Motrin Chewables Motrin, Children's Motrin, Children's Oral Drops Motrin-IB Motrin-IB Caplets Motrin, Junior Strength Caplets Nalfon Nalfon 200 Naprelan Naprosyn Nuprin Nuprin Caplets Orudis Orudis KT Oruvail Pamprin-IB Ponstel Q-Profen Relafen Rufen Tolectin 200 Tolectin 600 Tolectin DS Trendar Voltaren

4. Naproxen
Pain relievers with Naproxen have both fever-reducing and pain-relieving properties.

Naproxen is used to treat the usual inflammatory and pain-related conditions:

• rheumatoid arthritis (rheumatism)
• osteoarthritis,
• juvenile (childhood-onset) arthritis
• pain associated with:
  • menses
  • premenstrual discomfort
  • surgery
  • childbirth.

Side Effects:

Minor Side Effects

• gas or heartburn
• nausea headache
• drowsiness
• ringing in the ears
• susceptibility to sunburn easier

Serious Side Effects

• vomiting
• diarrhea
• constipation
• gastric ulcers
• dizziness/vertigo

Brand Names of Common Naproxene NSAIDs

Aleve Anaprox Napro NaApo- Naproxyn Arthrosin Arthroxen Napralen Napron X Naprosyn Naxen Novo-Naprox Sodium Novo-Naprox Nu-Naprox Nycopren Rhodiaprox Synflex Timpron

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