Pain from inflammation can and will likely affect all adults at some point in their lives. For some, the pain will become chronic conditions that interfere with a normal quality of life.
Along with non-pharmacologic modalities like ice packs, and elevation of the inflamed area, over-the-counter (OTC) and prescription anti-inflammatory medications are commonly used.
The most common anti-inflammatory medications are called NSAIDs:
Non-Steroidal Anti-inflammatory Drug
Based on consumer survey responses, more than 17 million Americans take NSAIDs on a daily basis, with more than 70 million prescriptions and more than 30 billion OTC NSAID tablets sold annually in the USA.
OTC NSAIDs include aspirin, ibuprofen, naproxen and prescription NSAIDs include celecoxib, diclofenac, etodolac and ketoprofen.
NSAIDs work by blocking enzymes called COX-1 & COX-2. These enzymes produce a group of compounds that our cells make called prostaglandins. Prostaglandins made by COX-1 enzymes activate your platelets (for blood clotting) and protect the lining of your stomach and intestines.
Prostaglandins made by COX-2 enzymes are made in response to injury or infection, regulating inflammation. Most NSAIDs work non-selectively on both enzymes.
This lack of selectivity becomes an issue because pain and inflammation relief from NSAIDs come from blocking COX-2, but unfortunately COX-1 is also blocked, causing unwanted adverse side effects.
Side effects and complications of NSAIDs can be serious and more pronounced in certain populations, like those with cardiovascular disease and the elderly.
Complications include: upper gastrointestinal bleeding and ulcers, heartburn, ringing in the ears, headaches, dizziness, liver and kidney problems, leg swelling, high blood pressure, heart attack, heart failure, stroke, and death.
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