Besides these two types of analgesics there are also other medications like aspirin and particular non-steroidal anti-inflammatory drugs (NSAIDS) that are commonly included and used as painkillers, but in fact they;re not. They provide some pain relieving effects but their primary purpose is elimination of inflammations, so including them to the class of analgesics is wrong.

Non-narcotics

Of all over-the-counter, non-narcotic painkillers the most popular is definitely acetaminophen. It is found in over 600 drugs, combined with other active elements for example in cold, flu or sinus infection medications. It is also available as a stand-alone drug. So when using it make sure you are not exceeding the dosage by combining it with drugs that contain acetaminophen, because an increased intake of this substance may damage your liver.

Narcotics

There are two main types of narcotic painkillers: opiates and opioids (substances derived from opiates). Opiates are the active chemicals that are contained in opium (the infamous liquid of white color that is extracted from the unripe seeds in poppies).

Opiates were previously widely used in medicine prior to the creation of effective opioids. But apart from analgesics effects the opiates provided, there were numerous side-effects that are very common for narcotics: delirium, hallucinations, loss of orientation, etc. This is why the use of painkillers in early days was quite limited and the effectiveness was traded for a certain price.

Opioids are considered any substance that affect the opioid receptors in the CNS (central nervous system) or gastointestinal tract. Opioids are usually divided into four main groups:

• Endogenous opioid peptides (substances produced within the human body such as endorphins, enkephalins, dynorphins)
• Opium alkaloids (thebaine, morphine, codeine)
• Partially-synthetic opioids (heroin, hydrocodone, hydromorphone, nicomorphine)
• Fully synthetic opioids (demerol, tramadol, methadone, propoxyphene, buprenorphine, butorphanol)

Opioids are applied as highly effective painkillers in cases of chronic or severe pain (for example, tramadol is known as the most effective medication is case of chronic pain). In contrast to opitates, opioids don’t have the negative narcotic side-effects and also don’t exhibit an upper limit in dosage. If increased gradually (especially in cases of chronic pain) the dosage of opioids used can be that high that it would be fatal for a person if taking any other medications with such concentration.

There are numerous discussions on the addictive nature of opioids, with many doctors claiming that they can form a habit over the long term. This is true, and as with any habit there may be withdrawal effects taking place in case the treatment is ceased immediately. However, when using opioids you have to weight all the pros and cons especially when you’re dealing with chronic pain, like in the case of arthritis. Is addiction such a high price for a relief when you’re constantly tortured by pain? It’s up to you to decide.

Chronic pain can be caused directly by an injury or disease, or it may be a side effect or complication following surgery, caused by drug interactions, etc. Always liking to produce lists, doctors have classified pain into the following categories:

Nociceptive where you feel a sensation in a specific location. This may be somatic and so felt in the joints, bones, muscles and ligaments, or visceral which is felt in the internal organs such as the heart, lungs, liver and kidneys. The latter can be more difficult to localize because the pain simply comes from inside the body.

Non-nociceptive may be neuropathic, i.e. pain generated by the nervous system and not tied to a specific location in the body. When the nervous system is damaged, the messages become more difficult to interpret and the brain is often confused by random effects. The result is unpredictable feelings of tingling, numbness, pins and needles and other unpleasant symptoms. Alternatively, there may be sympathetic pain where the skin and tissue around an injury become unusually sensitive and restrict movement.

No matter which variety of pain you may have, there are a range of analgesics or painkillers available to relieve any suffering. The less powerful drugs are the nonsteroidal anti-inflammatory drugs (NSAIDs) which reduce swelling and inflammation in the joints and elsewhere. The more powerful deal with moderate to severe pain with tramadol being the most commonly prescribed because it is less likely to cause dependence than the opiates. Tramadol works by changing the way in which the neurotransmitters carry messages in the nervous system. Because of this, it is equally effective no matter what the cause of the pain, i.e. localized or arising from the nervous system itself. The messages are not carried to the brain or not clearly interpreted as being pain messages. Thus, you can have a reasonably good quality of life even though the source of the pain remains active in your body.