Orthopedics & Sports Medicine

The Inside Scoop on NSAIDs

What are NSAIDs?

Non-steroidal anti-inflammatory drugs (or NSAIDs, for short) are the most commonly prescribed medications for treating joint pain. Popular over-the-counter NSAIDs include ibuprofen (Motrin, Advil) and naproxen (Aleve). These medications differ from acetaminophen (Tylenol) and other analgesics, or pain relievers, in that NSAIDs work on the painful joint itself by reducing the inflammation that causes pain. Pain relievers like Tylenol, on the other hand, work on the brain by inhibiting pain receptors. They have no effect on the joint itself.

How do NSAIDs Work?

All NSAIDs are created for the same purpose – to relieve pain by reducing inflammation. NSAIDs work by preventing an enzyme (a protein that causes chemical changes in the body) from doing its job. The enzyme itself is called cyclooxygenase, or COX, and it has two distinct types. COX-1 protects the stomach lining from acids and other substances that may cause an upset stomach. COX-2 is produced when joints are injured or inflamed. Traditional NSAIDs (like ibuprofen and naproxen) block the actions of both COX-1 and COX-2, which means they relieve pain and inflammation in the joint but can also cause nausea in some people as a side effect, especially when taken without food.

Special Types of NSAIDs

There are certain NSAIDs that are formulated to block only COX-2 enzymes, which means that they can relieve joint pain without the side effect of nausea. One example of this special class of NSAIDs is celecoxib, which is commonly sold under the brand name Celebrex. Other special NSAIDs can be formulated to be extended release, meaning they are formulated to slowly break down over time, releasing a slow and steady dose of medication into the bloodstream. Medications like these provide the advantage of lasting longer than normal NSAIDs, which allows them to be taken less frequently. If you’re currently being treated for an orthopedic ailment, consider asking your doctor which NSAID is the best fit for you.