How Do NSAIDs Work To Reduce Pain?

Non-steroidal anti-inflammatory drugs (or ‘NSAIDs‘), are part of a drug class for inflammatory aches and pains. Millions of NSAIDs are taken every day in the United States alone. Because this type of medicine is readily available and typically administered over-the-counter, it’s often the go-to for pain management. 

Here’s how NSAIDs actually work for pain, and a few points to consider. 

How do NSAIDs work?

NSAIDs counteract inflammation. Symptoms of inflammation may include redness, swelling, heat, or pain. Understanding the inflammatory process clarifies how NSAIDs contribute to pain reduction.

What happens during inflammation?

Here are the 3 key players:

• COX-2. The body contains certain proteins called enzymes. Enzymes are known for causing reactions. The main enzyme involved in inflammation is called COX-2.
• Arachidonic acid. COX-2 interacts with a fatty acid known as arachidonic acid. Arachidonic acid is also found all over the body, particularly in certain organs and in the skeletal muscle. 
• Prostaglandins. COX-2 changes arachidonic acid into other molecules. One type of those molecules, called a prostaglandin, is involved in inflammation and sensation of pain. 

High level review: COX-2, an enzyme, eventually converts into a type of molecule called a prostaglandin that causes pain. 

Where does the NSAID come in?

Here’s where an NSAID intercepts the process of inflammation:

1. The NSAID enters the body
2. The NSAID binds to COX-2 
3. Because the NSAID is bound to COX-2, it’s unable to convert into arachidonic acid. 
4. Arachidonic acid is unable to convert to a prostaglandin
5. The perception of pain is decreased

How quickly do NSAIDs work?

• When taken orally: About 30 minutes
• When injected by a medical provider: A few minutes
• For chronic pain: Consult a medical provider. It may take a prescribed regimen for consistent relief 

How long can you take NSAIDs?

For most people, it’s safe to take NSAIDs for 7-10 days by following the directions on the medication label. With ongoing pain, consult a medical provider to determine which regimen and type of NSAID is safest and most effective for your condition.

Who should not take NSAIDs?

NSAIDs work well for inflammatory pain. For other types of pain, NSAIDs shouldn’t be taken unless directed by your provider. 

Never take an NSAID unless directed by your medical provider if you have the following conditions:

• Current pregnancy
• An allergy or hypersensitivity to NSAID medications
• Upcoming surgery
• Recent surgery
• Bleeding disorders
• Stomach pain
• Chest pain

The Bottom Line

NSAIDs work by stopping the chain reaction of inflammation. Knowing more about how NSAIDs work in the body may help you better understand your pain, and how to best manage it. 

If you would like more information or to schedule an appointment, contact us today.