Most of my patients come to see me for one problem - pain.
And it usually is a big problem...
...but it can also be something valuable.
We immediately pull our hand away when we touch something hot… so we don’t get badly burned. We jump when ants bite our toes… so our feet don’t balloon up, bitten by the whole swarm.
Pain tells us when our bodies are injured, so we can rest and recover, and that’s something good.
How do medicines stop pain?
How would you stop your finger being burned by a hot kettle? ....You would stop touching the kettle, of course.
In a way, that is how anti-inflammatory medicines work. When our knees are damaged by osteoarthritis, inflammatory chemicals are produced within the joint making it swell up and get painful.
By blocking these inflammatory chemicals, anti-inflammatory medicine reduce inflammation, and when the inflammation is gone, the knee stops sending signals to the brain – and we don’t feel pain in our knee anymore.
There’s also another way to stop pain - by blocking those signals our injured knee sends to our brain. We can either make our brain less sensitive to the signal, or we can stop the signal from travelling through our nerves on its way to our brain.
This may sound like science fiction, but it is what drugs like Opium and Morphine (and similar medicines called opioid analgesics (e.g. Tramadol) do.
When we think of analgesics (remember our previous promise not to call them painkillers), these (opioids) usually have a bad reputation. Drowsiness. Nausea. Medication dependency and addiction.
Even the Malay word for anti-pain medicines makes them sound a bit suspicious: ubat tahan sakit. It makes it sound as if the medicine is trying to cheat your body into not feeling pain, and trick you that you are feeling better.
The bad name is not completely untrue - many analgesics are only a temporary relief from pain. They do not cure. Simply taking pain blocking medicines and not exercising / doing physiotherapy may worsen the problem - because our joints continue to get damaged, we just don’t feel it.
But stopping pain can be useful, because many problems (arthritis is one of them) can be improved by exercising and strengthening the surrounding muscles. We can only exercise these muscles if pain doesn’t get in the way.
Strengthening our muscles stabilises our joints and helps us keep moving - which is the main motto of my orthopaedic practice.
Life is a complex thing. We care for our families, work, interact with others, fall in love.
Many of these things need us to be mobile - burping a baby, teaching our children to ride a bicycle, cooking and eating a meal. We need our joints for all of these things.
To live is to keep moving. Sometimes, analgesics help us do just that.
As always, remember to check with your friendly orthopaedic surgeon or doctor before taking any medicines.
Next in this series :
Paracetamol - the drug in your fridge.
Image redrawn by the author from Hanna-Barbera Productions' 'The Flinstones'
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