1. Control of pain with medicines
Narcotic pain medications consist for the most part of opioids—drugs such as Percocet, Vicodin and Demerol. These drugs have an effect at the level of the brain, where they interfere with our brain pathways for perceiving pain. If you take them when there is no pain, they still affect your brain but cause a very different and unpleasant feeling (which, bizarrely, some people enjoy, leading to abuse of these medications). The problem with narcotics is that they alter your judgment, make you drowsy, make you incapable of operating machinery and cause nausea, vomiting and constipation.
-Non-aspirin anti-inflammatory drugs
Drugs such as Celebrex (and in past years Vioxx) work by blocking the chemicals that are released in the brain that lead to the perception of pain at the point of injury. The cox-2 chemicals that are released from the injured cells are blocked by these drugs, so the pain nerves never get the message that there has been injury.
– Aspirin-like medications
Medications such as aspirin, Motrin, ibuprofen, Naprosyn and combinations such as Advil or Excedrin all act by blocking another set of signals at the point of injury through which pain is transmitted. They also decrease swelling by blocking prostaglandins. Unfortunately, they cause stomach ulcers and bleeding in some patients.
This drug acts very much like aspirin but by blocking another pathway at the point of injury. It does not, however, have the effect of decreasing swelling; that is, it is not anti-inflammatory. It has the advantage that it does not cause bleeding in the stomach or development of ulcers.
– Local anesthesia
Lidocaine, Marcaine and Novocaine are drugs that numb the area of injury through yet another pathway. They have to be injected, so their use is limited to medical settings. They can give relief from 2-6 hours. My personal preference when I have pain? Take two Celebrex a day and two extra-strength Tylenol every six hours. It’s low-risk, great pain relief that allows me to continue working.