Pain Relief: How NSAIDs Work
NSAIDs are among the most common pain relievers in the world. And lately, they're among the most controversial. Find out what these anti-inflammatory pills actually do inside your body.
How Do NSAIDs Help Relieve Pain? continued...
Most NSAIDs block both Cox-1 and Cox-2 enzymes. They include the
- Aspirin (Bufferin, Bayer, and Excedrin)
- Ibuprofen (Advil, Motrin, Nuprin)
- Ketoprofen (Actron, Orudis)
- Naproxen (Aleve)
Other NSAIDs are available by prescription. They include:
Aspirin has some benefits that other NSAIDs do not. The biggest is that
aspirin works against the formation of blood clots. As a result, you are less
likely to form the clots that can cause heart attacks and strokes. Other
NSAIDs do not have this effect.
Cox-2 inhibitors are a newer form of prescription NSAID. As you might guess,
they only affect Cox-2 enzymes and not Cox-1. Two of them -- Bextra and Vioxx
-- are no longer sold because of concerns about their side effects. The third,
Celebrex, is still available.
What Are the Side Effects from Standard NSAIDs?
Most people who use NSAIDs don't have any serious problems with them. But in
some -- especially those who need pain relief regularly -- there can be a
When you swallow a pill, it affects your whole system, not just the part
that hurts. So while an NSAID may do a great job of easing your pain, it may
also be having other effects -- some of them unwanted -- in other parts of your
The most common risk of standard NSAIDs is that they can cause ulcers and
other problems in your esophagus, stomach, or small intestine.
Why? NSAIDs prevent the creation of prostaglandins, the hormone-like
chemicals that cause swelling and increase pain. But that's not all that
prostaglandins do. There are actually many different types of prostaglandins in
One type of prostaglandin helps protect the lining of the stomach and GI
tract. And the Cox-1 enzyme helps make this prostaglandin. Since regular NSAIDs
block Cox-1 enzymes, they slow down the manufacture of this prostaglandin. This
is why standard NSAIDs cause high rates of gastrointestinal problems. With its
defenses down, your GI tract becomes irritated and damaged by normal gastric
High Blood Pressure and Kidney Damage
How can NSAIDs affect your blood pressure? NSAIDs reduce the blood flow to
the kidneys, which makes them 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. It's that simple.
If you take NSAIDs in high doses, the reduced blood flow can permanently
damage your kidneys. It can eventually lead to kidney failure and require
NSAIDs can also cause extreme allergic reactions, especially in
people with asthma. Experts aren't sure why. Many specialists recommend that
people who have asthma stay away from any NSAID, especially if they have sinus
problems or nasal polyps.