Pain Killers – A double edged sword


Pain is one of the basic and most important symptom of disease. It accounts to close to 50 percent of all visits to the doctor. When a problem occurs in any part of our body (a bruise, broken bone, heart attack, etc) the body responds immediately at the site of injury by starting a process called ‘inflammation’, a medical term used to describe pain, swelling, redness and warmth.

Pain, the most troubling of the lot is thus treated by a group of medicines called Anti-Inflammatory Drugs that have properties to reduce the factors that cause pain at the local site of injury or a more potent Narcotic Analgesics, such as morphine, that work at the brain to reduce the perceived sensation of pain. The most commonly used medicines (eg Brufen, Diclofenac) are NSAIDS – Non Steroidal Anti-inflammatory drugs. These act by inhibiting the production of substances that cause pain and inflammation at the site of injury.

Problems with NSAIDs

Although very effective in reducing pain and easy to use, they most commonly cause problems when used for long time or when its use is not medically supervised. The most common problem is ulcers in the stomach that cause bleeding and acidity. A combination of smoking and NSAIDs are the foremost cause of gastric ulcers that lead to intestinal bleeding. People who are diabetics for a long time and in whom there is some underlying kidney damage, NSAID’s can cause worsening of kidney function and even acute renal failure. Finally, in people with weak hearts that have a low pumping action, NSAID’s can cause retention of fluid and heart failure.

Safer Alternatives

For most mild pain, Acetamenofen (Crocin, Dolo) is the first and safest choice. It is safe on the stomach and is devoid of side effects. It not only reduces fever, but at higher doses, it is a very effective pain killer. In Severe pain, a mild narcotic analgesic is preferred in addition to acetamenofen under the guidance of your doctor.

In Chronic Pain as well ?

People with artharits of the knees, etc use pain killers regularly. Even in this situation, a good dose of Acetamenofen is advisable and if required mild narcotic analgesics. Short term use of NSAIDS is usually safe under proper medical supervision

Pain is universal and a part of our lives. Over the counter Acetamenofen should be a part of every travellers medical kit. It is safe and effective.

Q&A:

1. Is it safe to use any of the newer pain killers ?

All NSAIDs, new and old work by the same action and hence, prone to the same side effects. They must be avoided or in special situations, used sparingly

2. What about Aspirin that I use for the heart disease ?

Thankfully, the only problem with aspirin is the tendency to cause ulcers. It does not cause problems with the kidney and heart. If you are intolerant to aspirin, it can be safely taken along with medicines to protect the stomach.

3. Is it safe to use NSAID’s with Anti Acidity medicines ?

No. Anti acidity medicines may help to minimize the damage to the stomach, and to a certain extent prevent stomach ulcers. They do not prevent the damage to kidneys and heart.

4. I was undergoing surgery and the doctor advised NSAID’s. Is it safe ?

Short term NSAID’s under medical supervision is safe and at times very essential to tackle pain. Short term use does not lead to any problems when used correctly.

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