How Prostaglandins Treat Inflammation and Pain

Pain Signal Influencers

Aspirin Tablets
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Prostaglandins are hormones that exert a lot of influence over key physiological processes in your body. They have both positive and negative effects on your health. In other words, prostaglandins facilitate homeostasis, but they also promote disease processes.


These short-lived substances are made from fatty acids, and they play a role in many basic functions. Some of these functions include, for example, vasodilation and vasoconstriction. Vasodilation and vasoconstriction are, respectively, the automatic process of blood vessel opening and closing. Others include bronchoconstriction, which is the constriction of air passageways, blood clotting, uterine contractions, fever, and maintenance of tissues such as your stomach lining.

Along with the items in the list above, prostaglandins influence pain levels and regulate inflammation, two body processes that affect nearly every person who deals with a neck or back problem.

According to a 2003 editorial in Nature Structural Biology, there are about 24 different types of prostaglandins.

Medications That Target Prostaglandins

Because prostaglandins play an important role in initiating and perpetuating inflammation, numerous drugs have been developed over the years to counter their action. These drugs are deemed effective as well as relatively inexpensive, and people around the world and down through the ages have regularly turned to them for relief. 

In ancient times, willow bark was used to relieve pain and reduce fever, and these days many a holistic herbalist recommends this plant to their feverish clients. In the 1820s, the active ingredient of willow bark was determined to be salicylic acid. But when patients experienced intense stomach problems, including diarrhea and vomiting, as a result of taking salicylic acid, acetylsalicylic acid began to be used in its place. 

In the 1890s, acetylsalicylic acid got its start in the market as aspirin by a company known then and now as Bayer.

COX Inhibitor Drugs

In the 1960s, a class of drugs called phenylolkanoic acids was found to reduce inflammation and pain. These acids do so by blocking the enzyme cyclooxygenase, or COX. (COX enzymes tend to act early on in the generation of prostaglandins.) The "Painkillers and prostaglandins" article says that three COX enzymes have been discovered: COX 1 which protects your GI tract, COX 2, which plays a role in inflammation, fever, and pain, and COX 3 which is found mainly in the brain. Well known COX inhibitors (that are currently on the market) for pain and inflammation—the type taken by people with neck or back pain—include aspirin and ibuprofen (Advil). Aspirin and Advil inhibit both COX 1 and COX 2 enzymes. Known side effects of these medications are ulcers and bleeding in the lining of the stomach.

Advil also comes with the risk for heart attack and stroke, unfortunately.

In fact, with the exception of aspirin, all non-steroidal anti-inflammatory drugs (NSAIDs) come with an FDA “black-box” warning that taking the medication raises the risk for cardiovascular disease.

You may remember Vioxx and Bextra, the once-promising pain relievers that were pulled from the market in 2004. The action of these drugs was to inhibit only the COX 2 enzyme; as such, they were also known as COX 2 inhibitors. Their benefit was that stomach-related side effects were gone; the problem was that at the same time these drugs were enjoying blockbuster status in the market, it was determined that COX-2 inhibitors increased the risk of serious and even fatal heart attacks and stroke.

In September of 2004, Merck voluntarily pulled Vioxx off the market. In April 2005, the FDA ordered drug maker Pfizer to pull Bextra off the market but allowed Celebrex (Celecoxib) to remain, where it does to this day.

A Word from Verywell

It is well known that inflammation is at the root of a number of modern-day diseases, including chronic pain. It's also well known that taking medication to address the ills associated with inflammation may come with side effects, some of which can be quite serious, indeed.

To that end, many health providers, patients, and natural medicine activists advocate or follow an anti-inflammatory diet An article published in Harvard Women's Health Watch reported that numerous studies have shown foods can have an anti-inflammatory effect.

Knowing which ones may help form the basis for a diet that can help fight the effects of inflammation.

Some people also take anti-inflammatory herbs or supplements, such as willow bark, which was discussed above.

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