Analgesic to reduce inflammation

Nonsteroidal Anti-Inflammatory Pain Medications (NSAIDs)

September 6, 2013 – 11:04


Nonsteroidal anti-inflammatory pain medications, commonly referred to as NSAIDs (pronounced en-sayds), are some of the most commonly prescribed medications, especially for patients with orthopedic problems such as arthritis, bursitis, and tendonitis. These medications are available over-the-counter (e.g. Ibuprofen, Motrin, Aleve) or as a prescription (e.g. Celebrex, DayPro, Relafen). NSAIDs are effective at pain relief (analgesia), and to reduce swelling (anti-inflammatory). How do NSAIDs work?
Medications that work to reduce inflammation come in two major categories:

  • Steroids (e.g. Cortisone)
  • Non-Steroidal Anti-Inflammatory Medications (NSAIDs)

NSAIDs work to block the effect of an enzyme called cyclooxygenase. This enzyme is critical in your body's production of prostaglandins. It is prostaglandins that cause swelling and pain in a condition such as arthritis or bursitis. Therefore by interfering with cyclooxygenase, you decrease the production of prostaglandins, and decrease pain and swelling associated with these conditions.

Simple, right?

Well, there's more to it. Prostaglandins also have other important functions in the body. One type of prostaglandin (there are many varieties) helps line the stomach with a protective fluid (called gastric mucosa). When the production of this protective fluid is diminished, some people are at risk for developing stomach ulcers.

What is different about the new NSAIDs?
In the past several years, some newer medications have come on the market; these are commonly referred to as COX-2 inhibitors. Remember, all NSAIDs work against cyclooxygenase (COX). Traditional NSAIDs (e.g. Ibuprofen, Motrin, Aleve) work against both COX-1 and COX-2. COX-1 and COX-2 are both types of cyclooxygenase enzymes that function in your body. The new medications (e.g. Celebrex) work primarily against COX-2, and allow COX-1 to function normally. Because COX-1 is more important in producing the protective lining in your gut (gastric mucosa), these newer NSAIDs are believed to have less of a risk of causing stomach ulcers.

That said, the newer NSAIDs have not been shown to work any better against the COX-2 enzyme. Therefore, the COX-2 inhibitors have the benefit of possibly having fewer side-effects, but not necessarily better relief from symptoms.


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