A recent report by the Health and Social Care Information Center (Reference 1) showed that – shockingly – nearly 50% of us are regularly taking prescription drugs. These could be for pain relief, cholesterol-lowering statins, or anti-depressants, and whilst I see plenty of people on the latter 2 (I see a number of people who are – often unknowingly – taking anti-depressants for physical issues, Amitriptyline, for example), on this blog I am going to focus on a few of the main pain relief medicines, and how they work. We are happily putting these drugs in us, but what do we know about how they work?
PARACETAMOL. Despite its widespread use for over 100 years, we still don’t fully understand how paracetamol works to relieve pain. Amazing! However, it is now thought that it works by reducing the production of prostaglandins in the brain and spinal cord. Prostaglandins are produced by the body in response to injury and some illness. One of their actions is to sensitise nerve endings, so that when the injury is stimulated it causes pain. As paracetamol reduces the production of these nerve sensitising prostaglandins it is thought it may increase our pain threshold, so we feel less pain. It also acts on the brains temperature control, lowering temperature when it is too high.
NSAIDs, or Non-Steroidal Anti-Inflammatory Drugs, are similar to paracetamol, but also work on a chemical level. They block the effects of special enzymes which play a key role in making the prostaglandins. This blocking means less swelling and less pain. Whether this blocking of the bodies inflammatory response is a positive thing is open to debate, and there is certainly plenty of evidence to suggest we should NOT interfere with this natural process, as seen here ;http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081099/ (“Inflammation is an intrinsically beneficial event that leads to removal of offending factors and restoration of tissue structure and physiological function”)
NSAIDs are the drug I come across most in clinic, with some people coming in and openly admitting to using them as part of their training, pre-match routine or even day to day living. This is something I strongly advise stopping, as evidence suggests that this can be extremely problematic long-term, particularly when combined with exercise (References 2,3,4). Examples of NSAIDS include Ibuprofen, Naproxen, Diclofenac
OPIOIDS act by attaching to opioid receptors, which are found in the brain, spinal cord, gastrointestinal tract, and other organs in the body. When these drugs attach to the receptors, they reduce the perception of pain, essentially stopping you from caring about your pain! According to Coastline Behavioral Health the abuse of opiates has grown at alarming rates over the past 20 years, and the problem continues to increase. Opiates originally derived from the opium poppy, and have been used for thousands of years for both recreational and medicinal purposes. The most active substance in opium is morphine – the most abused form of opiate is heroin. Examples of opioids include Codeine, Tramadol, Morphine. Drug and alcohol rehab near to Beach Side helps patients to effectively overcome their dependency.
CO-CODOMOL is a mix of codeine and paracetamol. It is available in differing strengths. The amount of paracetamol is always the same, but the amount of codeine can differ and this determines the ‘strength’ of the drug.
So if you are one of those people taking pain relief as a way of life, ask yourself if there is a better, healthier way to live pain free? And certainly next time your GP prescribes you pills, ask for the pros, cons and side effects of the drugs; read that boring looking leaflet that is tucked away inside the box; It’s your body after all!
Reference 1. http://www.hscic.gov.uk/catalogue/PUB16076
Reference 2. Aggravation of Exercise-Induced Intestinal Injury by Ibuprofen in Athletes http://journals.lww.com/acsm-msse/Fulltext/2012/12000/Aggravation_of_Exercise_Induced_Intestinal_Injury.1.aspx | “…the current study shows that in healthy endurance athletes, NSAID consumption can aggravate exercise-induced small intestinal injury and induces loss of gut barrier function”
Reference 3. http://well.blogs.nytimes.com/2012/12/05/for-athletes-risks-from-ibuprofen-use/?smid=tw-share&_r=0 | “…the ultramarathon racers who frequently used ibuprofen, an anti-inflammatory, wound up with higher overall levels of bodily inflammation”
Reference 4. http://www.ncbi.nlm.nih.gov/pubmed/21811592 | “Exercise-induced splanchnic hypoperfusion results in quantifiable small intestinal injury. Importantly, the extent of intestinal injury correlates with transiently increased small intestinal permeability”
N.B. There are no ‘one size fits all’ style quick fixes in most injury scenarios, so these article shouldn’t be seen as such. They are merely guides to a better understanding of how our bodies work.