Deciphering the many, varied names for pain relief

Let’s face it, many of the outdoor activities we call fun, like snowshoeing and snowboarding, can exercise our muscles such that we feel sore enough that it is bothersome. Shoveling snow or accidently falling down on a slippery walkway can create sore muscles. Even being cold can increase the pain felt in joints from those living with arthritis.

There are many pain relief options available. At the high end there are narcotics, which are also called opioid analgesics, which specifically block pain signals from reaching receptors in the brain. The word narcotic comes from the Greek word “narko” which literally means to make numb or be in a stupor.

The gold standard of opioids is morphine. Oxycodone is another one. When these drugs stimulate certain receptors in the brain, not only do they block pain, they also create a feeling of euphoria.

Opi-oids can be highly addictive as we begin to crave the sensation they create. That is why they are considered a controlled substance and highly regulated.

Tylenol, or acetaminophen, is readily available and is a very interesting and unique pain reliever as it is thought to raise the pain threshold that we feel. It is actually not clear how it does this though.

Some explanations of how acetaminophen works suggest that it blocks an enzyme that helps form signaling molecules associated with pain and inflammation. Other theories involve that it modifies aspects of neurotransmission in the brain and spinal cord. Scientists are still working all this out.

Another category of drugs is corticosteroids. These are not to be confused with anabolic steroids which have been used to build bigger muscles. Corticosteroids are designed to lower inflammation and reduce the activity of our immune system.

Steroids, such as prednisone and cortisone, work by reducing the production of chemicals that cause inflammation. These can be quite useful when an inflammation response threatens to damage some of our organs or tissue. They can also help for short term relief from rheumatoid arthritis.

My final category of pain relievers are non-steroidal anti-inflammatory drugs, or NSAIDs. This includes aspirin, naproxen, and ibuprofen. Each of these are readily available and fairly effective.

Non-steroidals, along with other pain relievers, have lots of side effects. This is a big problem. You could have liver and kidney problems, not to mention peptic ulcers, and increase the risk of bleeding, especially in your gut.

One natural remedy for every-day aches and pains comes from a spice called curcumin. This is extracted from the turmeric root commonly used in cooking Indian food. It looks like ginger root. Curcumin is what gives curry it’s unique yellow color.

Curcumin doesn’t have the downsides that the other prescriptive and over-the-counter medications have. While it works great to quell down soreness once you get enough into your body, it also has properties that lower inflammation both in the gut and in the brain. It appears to not reduce some aspects of inflammation that actually promote healing.

This is the opposite of other pain medications and anti-inflammatories that can cause problems both with our gut and brain. The sticking point with curcumin is absorption as it breaks down rather quickly in the liver and intestine. Adding pepper has been shown to increase absorption but this does not slow the breakdown.

Wrapping curcumin molecules with a fat, or phospholipid, does enhance bioavailability by bypassing quick metabolism in the liver. This can make it more successful at getting to the muscles and joints that are sore.

Come on down if you’d like to talk more.

Scott Porter, a functional medicine pharmacist, is the director of the Center for Functional Nutrition at Sandpoint Super Drug.