An analgesic, or painkiller, is any member of the group of drugs used to achieve analgesia — relief from pain. The word analgesic derives from Greek ἀν-, “without”, and ἄλγος, “pain.
There are two main types of painkiller – opioids and non-steroid anti-inflammatory drugs (or NSAIDs). The type of medicines that you need to treat your pain depend on what type of pain you have.
Analgesic drugs act in various ways on the peripheral and central nervous systems. They are distinct from anesthetics, which reversibly eliminate sensation, and include paracetamol (known in the US as acetaminophen or simply APAP), the non-steroidal anti-inflammatory drugs (NSAIDs) such as the salicylates, and opioid drugs such as morphine and oxycodone.
The exact mechanism of action of paracetamol/acetaminophen is uncertain but appears to act centrally in the brain rather than peripherally in nerve endings. Aspirin and the other non-steroidal anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenases, leading to a decrease in prostaglandin production. In contrast to paracetamol and the opioids, this reduces not only pain but inflammation as well.
The graphic below from Compound Interest takes a look at a selection of common painkillers, their common brand names, and how they work.
For pain associated with inflammation, such as back pain or headaches, paracetamol and anti-inflammatory painkillers work best.
If the pain is caused by sensitive or damaged nerves, as is the case with shingles or sciatica, it is usually treated with tablets that are also used for epilepsy and depression. These tablets change the way the central nervous system works.
The aim of taking medication is to improve your quality of life. All painkillers have potential side effects, so you need to weigh up the advantages of taking them against the disadvantages
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