This article is in our series on Medications for Pain. What are your choices? How do various medications work? Pros and cons? Side effects?

NSAIDS are non-steroidal anti-inflammatory drugs. The 3 types of medication in this class are:

• Aspirin
• Non-selective cox inhibitors, e.g. Motrin (Ibuprophen). (The “cox” relates to an enzyme in our bodies involved in inflammation.)
• Selective cox-2 inhibitors, e.g. Celebrex

Effect of NSAIDS: NSAIDS block inflammation from occurring, and thus stop the pain that’s caused by inflammation.

Uses of NSAIDS: Because NSAIDS block inflammation, they’re helpful in disorders that have inflammation, such as arthritis and some types of back pain. They don’t help in pain disorders that don’t have inflammation, such as fibromyalgia.

Potential Side Effects:

• Bleeding
• Stomach upset
• Asthma (in 10% of people)
• Kidney problems
• Cox-2 medications increase clotting, which can cause heart attacks and stroke. This is why some of these medications have been taken off the market.
• Liver toxicity above recommended doses

While these medications can be helpful, don’t eat them like candy. They’re not benign! Many people don’t recognize this, as they’re sold over the counter, and so are assumed to be perfectly safe. Some stronger dosages have even been discontinued because of the risk of patients taking too much medication.

Interesting fact: In studies, there is no difference in effectiveness between 1 medication in a class and another. Therefore generic aspirin is just as good as Bayer.