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How Do Painkillers Know Where The Pain Is?

How can an inanimate chemical be so damn smart?

Posted on September 30, 2015, at 5:53 p.m. ET

BuzzFeed Science answers your science questions! This time we tackle this awesome question:

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We talked to pain expert Ted Price, Ph.D., a professor in behavioral and brain sciences at the University of Texas at Dallas and an expert in the neurology of pain, to get to the bottom of this question.

Advil (aka ibuprofen) is part of a group of painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs).


NSAIDs are the most common painkillers worldwide and include other drugs like aspirin and naproxen (Aleve). There are, of course, other types of pain meds out there. Tylenol (acetaminophen in the U.S., paracetamol in other parts of the world) is also an over-the-counter painkiller.

Another group of meds are the narcotic painkillers (oxycontin, etc.) that work in an entirely different way and carry more risk of addiction and overdose. For the purpose of this post, though, we will be focusing on NSAIDs, which all work in the same general way.

NSAIDs don’t actually "know" where the pain is, but they only work on areas associated with inflammation — aka where pain usually is.

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Price said that the painkiller distributes itself evenly throughout your body through your bloodstream without any specific target in mind. The key is that the medicine only reacts with chemicals in your body associated with inflammation.

Normally, when you injure yourself, enzymes jump into action and produce a group of chemicals called prostaglandins that cause inflammation, Price said.

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Inflammation is a protective response that your body uses to push out whatever may have caused the harm and to begin the healing response.

NSAIDs like Advil work by making it harder for your body to make the enzymes that help produce those prostaglandins. That helps with the pain, too.

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The drugs slow down or block the production of enzymes in your body that help create those prostaglandins, said Price. This has a pain-relieving effect, too. Because inflammation causes your pain-sensing neurons to become hyperactive, reduced inflammation can lead to reduced perception of pain.

Fun fact: Acetaminophen/paracetamol is kind of similar, but science doesn’t really have a clue about how it works.

Tylenol / Alex Kasprak / BuzzFeed / Via

Tylenol is another super common non-narcotic painkiller and fever reducer. “Tylenol is wild,” said Price. “Tylenol's been around forever, and still we don't know how it works exactly.” It doesn’t have very strong anti-inflammatory properties, and though some scientists have tied it to a similar enzyme blocking mechanism, other mechanisms have also been proposed with little scientific consensus. Still, Price said, it does “a really nice job” with many types of pain.

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Got an awesome or embarrassing question to ask BuzzFeed Science? Let us know in the comments or submit it anonymously here.

A BuzzFeed News investigation, in partnership with the International Consortium of Investigative Journalists, based on thousands of documents the government didn't want you to see.