Can somebody explain to me in dummy terms how anti-inflammatory pills work?

  1. I have an extremely bad stress fracture in my tibia and have been taking 2 Ibuprofen (only once a day now), for the pain. It works great. I pretty much feel nothing when I walk unless my little 9 lb Chihuahua decides to step on it. Then I jump in the air and scream like somebody just whacked me in the leg with a steel pole.

    But my question is, how does it work? I didn't want to use it for a while because I felt like it was just masking the pain. I was very ignorant to it. But after my mom explained to me that it's easing my inflammation and THAT is what's causing me pain, I'm starting to think differently. So, is the main problem not necessarily my bone and really the muscles and tendons, etc. around it that are inflamed? I'm just really confused. The doctor said to call and schedule an MRI by the 10th if I'm still having pain, but I can't tell if I am or not because I've been taking the Ibuprofen. I know if I don't take it I'll most likely have pain but once I do, I'm pain free for up to two days.

    Can somebody explain to me what's going on inside my leg? Is there a doctor in the house? Hahaha!!
     
  2. Ibuprofen is an NSAID which is believed to work through inhibition of cyclooxygenase (COX), thus inhibiting prostaglandin synthesis. There are at least 2 variants of cyclooxygenase (COX-1 and COX-2). Ibuprofen inhibits both COX-1 and COX-2. It appears that its analgesic, antipyretic, and anti-inflammatory activity are achieved principally through COX-1 inhibition; whereas COX-2 inhibition is responsible for its unwanted effects on platelet aggregation and the GI mucosa.

    ^^ I found this online.

    Basically there are pain receptors in your brain and the ibuprofen blocks the pain from your brain so you don't feel it.
     
  3. Traci's right--basically your body can't make prostaglandins when you use NSAIDs. Prostaglandins are basically a family of molecules that are released in the setting of inflammation--some dilate and some constrict blood vessels, some make blood vessels more porous, some change how platelets work (clump), and some prostaglandins can make you more sensitive to pain, so therefore fewer prostaglandins=less pain.

    However, prostaglandins are a big family, so by blocking all prostaglandins in the body (like a pill or shot rather than a local injection would do), you can change things like blood flow to certain organs as well--it's kind of a "collateral damage" situation, because until recently, we didn't have drugs that could selectively block certain pathways of prostaglandin synthesis. This is why you have to be careful about taking NSAIDs for a long time--one of the big problems can be adverse effects on your kidney function.

    Hope that helps!
     
  4. If you're not having pain---that's a good thing. Don't worry about "masking" pain with painkillers in your situation. I think your doctor meant, come back for an MRI if you are having worsening pain or pain uncontrolled by pain meds. If your pain is well-controlled by 400 mg of ibuprofen once a day then you are in good shape.

    PS in case you were wondering NSAID stands for non-steroidal anti-inflammatory drug.