A human body is one of the most intricate designs on earth. The innumerable nerves, the super complicated brain, hundreds of muscles and so many other 'masterpieces' form a highly abstruse structure, the human body. Over time, we (read scientists/doctors) have dug deep and gained quite a lot of knowledge on the structure, but still many questions remain unanswered. With the advancements in science, people have got cure for hitherto fatal and life threatening diseases. History is abound with instances of epidemics where people were Quarantined (Read about 'Quarantine' history here) to control/limit the disease.
Today, we have a plethora of hospitals and emergency care units for our convenience. Surgical procedures for complex things along with small and innocuous looking tablets, bring one safely out of the danger zone. The compounds that go into making tablet/capsule/solution help fight microbes and restore the body to normalcy.
There is one tablet that is used across the world by people of all ages. The Analgesic or the 'Pain killer' is one of the most sought after tablets used to relieve pain of all kinds; headache, leg ache, knee ache, etc. But how does the tablet know where exactly is the person hurt and where to attack? Read on…
There is one tablet that is used across the world by people of all ages. The Analgesic or the 'Pain killer' is one of the most sought after tablets used to relieve pain of all kinds; headache, leg ache, knee ache, etc. But how does the tablet know where exactly is the person hurt and where to attack? Read on…
How does a painkiller know where you're feeling pain ?
My dad being a doctor, we have always had a stock of medicines at home. Pills for nausea, stomach ache, ulcer, digestion, and the generic painkiller safely rest in the white transparent box inside the cupboard. We are so familiar with majority of those medicines that we can tell the pill's name, purpose and dosage from the color/packaging of the medicine; in use since time unknown, these are quite like permanent roommates in the small plastic medicine box.
You have head ache, grab that white pill. Leg Ache, find that white pill. Hands are paining. Here comes the white pill. But how does the white pill (or for that matter any pain killer) know where I am hurt? An intriguing question indeed. Well, the answer is much more fascinating.
Before shedding light on the answer, let us understand how the pain is generated in the first place.
On an event of injury or hard labour, a group of chemicals called 'Prostaglandins' (or COX enzyme) are uncovered activating the 'Nociceptor neurons' and changing their shape thereby creating pores. This modification results in flowing of positive particles (Calcium and Sodium) into these neurons, which creates a potential difference between the neighboring cell membranes. Thus, signals (i.e. charge) start towards the brain with the damage information. Worse is the injury, more is the electric potential developed and higher is the pain signal sent to the brain.
On an event of injury or hard labour, a group of chemicals called 'Prostaglandins' (or COX enzyme) are uncovered activating the 'Nociceptor neurons' and changing their shape thereby creating pores. This modification results in flowing of positive particles (Calcium and Sodium) into these neurons, which creates a potential difference between the neighboring cell membranes. Thus, signals (i.e. charge) start towards the brain with the damage information. Worse is the injury, more is the electric potential developed and higher is the pain signal sent to the brain.
How does a painkiller kills pain?
The painkillers (i.e. Analgesics) are categorized into two major groups: Opioids and Non-Opioids. While Opioids are generally used for moderate to acute pain, Non-Opioids are prescribed for normal pain (though a study found out that Non-Opioids do not perform any less than the Opioids, over long term). Let us understand how each of these curtail the pain.
1. Non-Opioids: These are of two types: NSAIDs and Paracetamol.
i. NSAIDs (Nonsteroidal anti-inflammatory drugs): These drugs stops the cells to let out Prostaglandins or COX enzymes and hence cut-off its detection by the nociceptors. These, literally, nip the pain in the bud, leaving nothing which can tell nociceptors of the pain and also to the brain. Aspirin, Ibuprofen are all members of this group.
ii. Paracetamol: Also known as Acetaminophen, it is one of the commonly available over-the-counter drug for pain and fever. You will be surprised that Paracetamol's mechanism of controlling pain is still not exactly known. These are believed to cut off/reduce the signal sent to the brain, but we don’t know exactly how. Since the signal is broken in between, brain doesn't receive anything and we don’t feel pain. Crocin, Calpol etc. fall in this category.
2. Opioids: Utilized mainly for severe pain, Opioids are of two types: Natural and Synthetic. These inhibit pain by acting in the brain and spinal cord region. They attach to the existing network of receptors in brain thereby blocking any signal and providing a soothing effect. Having said that, Opioids have various side-effects and should always be taken under physician's supervision.
In a nutshell, we can say that, Analgesics are differentiated based on the stage at which they inhibit the signals from reaching the brain. While NSAIDs attack the very place of origin of pain; Paracetamol cuts off the signal generated from the place of origin and Opioids work in the brain to block the incoming signal.
Strange but true; the pain is always there. These medicines just fool our brain into believing the contrary. Nice way to tell "ALL IZZ WELL" to the brain. 😊
Nerd Notes:
- Receptors are group of specialized cells that detect changes in the environment, which are called stimuli, and turn them into electrical impulses
- We are in general fooling our brain when we apply ice or rub the affected area. This new sensation (ice-cool etc.) overrides the pain sensation making us feel good
Keep reading and don't forget to smile 😃
-Prakhar
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