How Pain Killers Work:

Understanding How Pain Killers Work

By Dr. Ben Kim
DrBenKim.com

An all-too-common mistake that I've encountered over the years is taking acetaminophen (Tylenol) to address muscular and ligamentous strains and sprains.

If you take an appropriate dose of acetaminophen to relieve pain associated with a soft tissue injury, you'll likely be fine as long as you prioritize resting your body and not aggravating the injured area.

If, however, you take acetaminophen as a temporary fix to allow you to continue to use the injured area, you stand a good chance of worsening your injury and even creating a chronically weak link in your body.

Acetaminophen primarily decreases registration of pain in your brain. It doesn't decrease inflammation outside of your central nervous system (brain and spinal cord).

So if you continue to burden injured tissues while taking acetaminophen to numb your senses, you will almost certainly prolong recovery time and possibly cause long term damage.

If complete rest is not possible and you absolutely must use an injured body part to some degree, the better choice is any over-the-counter pain medication that actually decreases inflammation throughout your body. Examples of pain killers that have system-wide anti-inflammatory properties are ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin (Bayer, Bufferin).

But even with intake of any of these anti-inflammatory drugs, it's best that you take the lowest possible dose and do all you can to rest until the injured area is fully healed.

Inflammation is a process that you want to proceed in full force after experiencing any soft tissue injury. Inflammation brings blood, nutrients, white blood cells, and several natural chemicals that work together to repair injured tissues one cell at a time.

If you deny injured tissues a full bout of inflammation, it's quite possible that the tissues won't return to full strength, especially if they've been injured before. Which is to say that by suppressing inflammation, you predispose an injured area to further injury.

When this principle is repeatedly ignored, the result is reduced strength and flexibility for the long term.

This is why I don't typically recommend using ice to decrease inflammation in most cases of acute muscular or ligamentous injury.

With severe or moderately severe injuries, after the first week or two of rest, it might be helpful to facilitate blood and lymphatic fluid flow through the injured area with contrast therapy, which you can learn about here:

How to Treat a Sprained Ankle

But generally, it is best to rely on rest and the process of inflammation to heal an injured area. Ice or any other type of cryotherapy will always impede the health-promoting effects of inflammation to some degree - not a conventional thought, I know, but this is what makes sense to me and I've repeatedly found this principle to hold true in managing acute soft tissue injuries.

Please note that inflammation that occurs as as result of a muscular or ligamentous injury is quite different in nature from chronic inflammation that is caused by dietary and environmental factors - more on this in a future post.


Summary of Common Over-The-Counter Pain Killers

  • Ibuprofen (Common Brands: Advil, Motrin)

    Ibuprofen decreases inflammation throughout your body by minimizing the production of prostaglandins.

  • Acetaminophen (Common Brand: Tylenol)

    Acetaminophen primarily decreases registration of pain in your brain. It doesn't work to decrease inflammation throughout your body, so it won't do anything for sprains, strains, or arthritis, though it may temporarily ease your discomfort.

  • Naproxen (Common Brand: Aleve)

    Naproxen works body-wide to decrease inflammation, and ounce for ounce, produces longer lasting effects than any other class of over-the-counter pain killers.

  • Aspirin (Common Brands: Bayer, Bufferin)
    Aspirin decreases pain, inflammation, and clot formation throughout your body. It's tougher on the esophagus and stomach than most other over-the-counter pain meds. Because of its effect on blood coagulation, it shouldn't be taken in conjunction with other drugs that affect bleeding time (without instruction from your physician).

    When used in children who are experiencing a viral infection, aspirin may precipitate Reye's Syndrome, a potentially fatal condition.

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