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Painkillers - Friend or Foe?

Some 85% of people take painkillers at some point in their lives. It may be for a headache, back pain, arthritic pain or even period pain.

What are painkillers?

Painkillers (analgesics) are substances that give temporary relief from pain without causing a loss of consciousness. They do not address the cause of the problem, but mask the symptoms allowing you to continue your normal activities without feeling pain.

There are two major categories of painkillers: non-narcotic and narcotic.

The most commonly used non-narcotic painkillers are aspirin and non-steroidal anti-inflammatory drugs such as ibuprofen, which are available in both prescription and non-prescription forms.

Non-narcotic painkillers are by far the most commonly used of all medications. In addition to controlling pain, these analgesics also lower fever and counter inflammation.

Narcotic painkillers include opiates and opiods, which are natural or artificial forms of opium.

Codeine, pethedine and morphine are common examples. These drugs are usually on a short-term basis to control severe pain.

Many prescription analgesics contain a combination of narcotic and non-narcotic. These drugs are used as an alternative to prescriptions that contain only narcotic ingredients for painful conditions that are not totally relieved by non-narcotic agents.

How do painkillers work?

Opiates and opiods apparently work through specific receptors in the central nervous system. Aspirin and the other non-prescription drugs are thought to work by blocking the body's production of particular types of prostaglandins, hormone-like substances that are produced throughout the body.

Side effects

The most common side effect of aspirin and the stronger non-steroidal anti-inflammatory is stomach irritation and sometimes bleeding. This can be minimised by taking them with meals or milk. Doctors may not mention this to women who are trying to get pregnant, but their use of non-steroidal anti-inflammatory drugs, such as aspirin, can cause ovulation problems.

Specifically, the use of these medications can cause a failure of the follicles to burst and release eggs. Clearly they are not recommended during pregnancy or for breast-feeding mothers.

Caution is also advised for those people with liver or kidney abnormalities or with a history of hypersensitivity to other drugs. These drugs may impair blood clotting and are therefore not always suitable for people with bleeding disorders or who are taking drugs that reduce blood clotting.

Aspirin may have beneficial secondary effects, for example, low-dose aspirin may help prevent a heart attack or stroke by preventing clot formation, but by the same token, aspirin can cause stomach bleeding problems.

Opiates, such as codeine, often cause nausea, dizziness and constipation. A more serious problem, however, involves the tendency of codeine and other narcotic drugs to produce drowsiness. In addition, narcotic drugs should never be taken by anyone who must remain alert, for example, if you operate machinery or drive.

Narcotic drugs should also never be taken in conjunction with alcohol, antihistamines and other allergy or cold remedies, anti convulsants, tranquillisers or muscle relaxants. A combination of these drugs can result in a fatal overdose. The potentially addictive effect of opiates and other narcotic agents is another major drawback to their long term use.

What can be done to avoid the use of painkillers?

A person who suffers a chronic pain disorder, such as long term back pain or headaches learns by trail and error how best to manage the pain. If aerobic exercise is tolerated, secretions of endorphins, brain chemicals that are natural painkillers, are released. Pain is always a warning sign, try to seek the right help and get to the root of the problem instead of waging a war with drugs. It is important to remember that every drug has a side effect.

Recently a new generation of drugs has been developed to combat pain and inflammation. This drug does not have the traditional side effect of stomach irritation or bleeding, but as yet we don't know what its side effect will be with long term use.

If you have to take a painkiller make sure you follow all the instructions, and if the pain recurs or lasts over a longer period, seek treatment for the cause of the problem, masking the pain doesn't help.