How does pain medicine know where to go?
“Daddy, how does the pain medicine know where to go?” is a question I was asked recently by my 12 year old daughter, Shelby. Hmmmm. Good question, Shelby! How does the pain medicine know where to go? How does it know where we are hurting? Does it affect our whole body like a blanket and the area of our pain just gets covered by it? Or do those tiny little pills have tiny little brains that investigate our bodies once inside?!?
Well, here’s the answer. Pain medicines don’t know where we are hurting. Earth-shattering news, right? They would be pretty complex little pills if they could! Actually, pain medicines work in a couple of different ways.
But first, let’s look at how pain develops. Shelby slides into home plate wearing shorts and no slider. Her leg is now beautifully decorated with abrasions. Once her tissues are damaged, they release a chemical called prostaglandin. Prostaglandin is then picked up by her nerve cells and taken to her brain. Her brain responds by sending out the message that her leg hurts, and thus, Shelby now has leg pain! On a side note, one thing that always amazes me is that we can have something as small as a tiny little splinter in the bottom of our foot, and although it may take up less than .01% of our total body surface area, our bodies are in tune enough to let us know exactly where it is!
Is pain really a good thing?
Pain, although painful (pun intended!), is actually a good thing. Imagine for a moment that we couldn’t sense pain. You place your hand on a hot stove, your brain doesn’t receive the message that your hand is burning to a crisp, and so, your brain doesn’t send the message for you to STOP TOUCHING THAT STOVE!!! Think about how much more damage you would have if you didn’t get that message! How long does it normally take for your brain to send the message for you to stop touching a hot stove? …it’s pretty immediate, right?
But some people really can’t feel pain. These people have a very rare condition called Congenital Insensitivity to Pain with Anhidrosis (CIPA). Although this may sound like something that would be nice to have, it is not. Most people with this disorder die before they reach the age of 3. And besides that, pain is actually a good part of an elaborate system that protects us from doing further harm to ourselves. Pain is a good thing!
So how do pain medicines work?
Different pain medicines work in different ways. Non-opioid drugs such as Acetaminophen (Tylenol), Aspirin, and Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen (Motrin, Advil) and Naproxen (Aleve) work by limiting the number of pain signals that reach the brain. They do this by blocking the enzymes that produce prostaglandin. The brain doesn’t receive the chemical, so the brain doesn’t send out the message that pain is present.
Opioid drugs (narcotics) such as Morphine, Codeine, Oxycodone (Percocet) and Hydrocodone (Vicodin, Lortab) work by dulling the sensation of pain. Unlike non-opioids that block the production of prostaglandin, opioids dissolve in the bloodstream, attach to the proteins that take the pain signals to the brain, and change how the brain interprets the signal. And they are addictive, so be careful if you are ever prescribed an opioid by a physician.
Why do some pain medicines work for some people, but not others?
Like fingerprints, no two people share the same chemical makeup. Since we don’t have the same chemical makeup, we all interact with pain medicines differently. This is why there are so many drug companies out there making so many different drugs. What pain medicine may work wonders for one person, may not do anything for another. Mom and I are a prime example. For Mom, Aleve is the crème de la crème of pain medicines, but for me, it doesn’t do anything. As close as we are genetically, we still have different chemical makeups.
Pain relief without pain relievers
Did you know our brains are powerful enough to block pain without medicine? Let’s say you arrive to a nice little getaway cabin up in the scenic mountains of Gatlinburg. It’s a beautiful sunny day. You get out of your car and accidentally slam your finger in the car door. Your finger is THROBBING!!! The pain is there and the pain is real. Then, out of nowhere, a black bear steps out of the woods. As it starts roaring and running towards you, guess what? Your finger doesn’t hurt anymore! Your brain has decided there are more important things to worry about! Fight or flight kicks in, adrenaline is released, and your finger gets put on the back burner!
So no, pain medicines don’t affect our entire body like a blanket, and no, they don’t have tiny little brains. Indeed, our bodies are amazingly complex – more so than most of us will ever realize. All I can say is praise to our Omnicient Creator! And oh yeah, Shelby was safe!
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