ABSTRACT
The simple analgesics are easily chosen by the patient, if not the physician. They are inexpensive and easy to obtain. They include aspirin and acetaminophen. Aspirin appears to work by inhibiting the synthesis of prostaglandin by blocking the action of cyclooxygenase, an enzyme that enables the conversion of arachidonic acid to prostaglandin to occur. Prostaglandins are synthesized from cellular membrane phospholipids after activation or injury, and sensitize pain receptors. The import of the different chemical classes is simple: not every nonsteroidal anti-inflammatory medication (NSAID) will help every patient. If a patient does not receive relief from ibuprofen, the clinician should not try naproxen, which is in the same drug class, but another NSAID from another class should be utilized. Muscle relaxants are given for acute soft tissue spasm/pain by some clinicians. They are probably best utilized during the first one to three weeks post injury.
