Non-steroidal anti-inflammatory drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs), alleviate pain by counteracting the cyclooxygenase (COX) enzyme. On its own COX enzyme synthesizes prostaglandins, creating inflammation. In whole the NSAIDs prevent the prostaglandins from ever being synthesized, reducing or eliminating the pain.

Some common examples of NSAIDs are: ibuprofen, aspirin and naproxen. The newer specific COX-inhibitors although probably sharing a similar mode of action are not classified together with the traditional NSAIDs.

In addition to medical drugs, many herbs have anti-inflammatory qualities, including hyssop, ginger, Turmeric, Arnica montana which contains helenalin, a sesquiterpene lactone, and willow bark, which contains salicylic acid, a substance related to the active ingredient in aspirin. Cannabichromene, one of the many cannabinoids present in the cannabis plant, has been shown to reduce inflammation.

On the other hand, there are analgesics which are commonly associated with anti-inflammatory drugs but which have no anti-inflammatory effects. An example is paracetamol, called acetaminophen in the U.S. and sold under the brand name of Tylenol. As opposed to NSAIDS, which reduce pain and inflammation by inhibiting COX enzymes, paracetamol has recently been shown to block the reuptake of endocannabinoids, which only reduces pain, likely explaining why it has minimal effect on inflammation.

Some are concerned about the long term usage of NSAIDs as they cause gastric erosions which can become stomach ulcers and in extreme cases can cause severe haemorrhage resulting in death. The risk of death as a result of use of NSAIDs is 1 in 10,000 for young adults aged 16-45[citation needed]. The risk increases tenfold for those over 75[citation needed]. Other dangers of NSAIDs are exacerbating asthma and causing kidney damage.