Tuesday, November 5, 2024

The Evolution of Pain Relief Medicines

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[This article was originally published in Care for Life] 

Since time immemorial, humans have sought soothing agents to ease pain – nature’s not-so-subtle way of telling us that we are doing something wrong or that we have injured ourselves. From regular experiences such as headaches, throbbing injuries and menstrual cramps, to physical trauma from extreme sports and the more controlled after-surgery pain. In all instances, one of the most important things is finding a way to relieve the pain. In the fourth iteration of this special series, Care for Life explores the history of popular pain relief medicines and how they developed.

Around the world at different points in time, peoples, cultures and entire races have had or tried various methods to alleviate pain. In the stone age, people used religious offerings and animal sacrifices, as well as noise-making instruments such as rattles and gongs to try to banish malevolent spirits under the belief that pain and diseases were punishments from the gods. Meanwhile, in some Native and South American cultures, pain pipes (placed against the ill person’s skin and sucked to extract the pain) and trepanation (where holes are cut into the head of the sufferer to get the pain out) respectively were the practiced forms of pain relief.

Back in Time

The current state of pain alleviation owes a lot to the past. For instance, the tradition from Ancient Egypt of placing electric eels on the wounds of patients is similar to transcutaneous electrical nerve stimulation (TENS), a modern-day lower back pain and arthritis relief technique. “We do it in a much more controlled fashion,” says Dr Carol Warfield, professor of anaesthesiology at Harvard Medical School in an interview with American Broadcasting Company (ABC) News.

The early Greeks also contributed to modern medicine. In the fifth century, on the recommendation of Hippocrates, a renowned physician and one of medical history’s most outstanding individuals, the ancient Greeks chewed willow leaves and the bark of the tree to reduce high fever, treat inflammation and ease pain – particularly during childbirth.

However, it was not until 1763 that British cleric Reverend Edward Stone discovered the medicinal properties of the plant – salicylic acid, which was used as an active ingredient much more controlled fashion,” and instrumental to the 1897 development of Aspirin by Felix Hoffman and Frederick Bayer of multinational chemical and pharmaceutical company, Bayer.

Global Pain

According to Marcia Meldrum, Co-Director of the John C. Liebeskind History of Pain Collection at the University of California, Los Angeles (UCLA) Biomedical Library, “The first new significant treatment for pain occurred in 1846 with the use of anaesthesia for surgery.” Dr Warfield notes that prior to Queen Victoria using chloroform as an anaesthetic for childbirth, some doctors and dentists used to hold children over a gas stove to breathe gas until they lost consciousness, while others choked their patients with carotid compression until they passed out.

During this time in other parts of the world, especially in Asia, morphine in opiates from opium poppy plants were already in use. While very effective as a pain suppressant, the side effects, which included total dependency on the drug, reached its highpoint in the 1830s and led to several attempts to create less addictive versions. The resultant products were codeine, primarily used in cough syrups and cocaine – which unfortunately had twice the addictive qualities of morphine.

Other results include one by Antikamnia Chemical Company called Antifebrin. Although the drug contained paracetamol, which is currently one of the most popular pain relievers, its side effect was cutting oxygen flow to the blood, and eventually death. The company was closed soon after, and by 1906, the US Federal Drug Administration passed the Pure Food and Drug Act which instituted that all medications must indicate and label their ingredients on the packaging.

Multiple Options

Since then, a lot has changed in terms of pain relief medications with various classes that cater to specific needs. For instance muscle relaxants, also called sedatives, are primary used in relaxing the central nervous system and relieving pain caused by tense muscles. According to the research institute New York University (NYU) Langone Medical Center, muscle relaxants can also be used to ease the pain in stroke patients and those who have undergone spinal surgery.

Others include anticonvulsants (to treat pain caused by a damaged peripheral or central nervous system), and Nonsteroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen and the most widely used drug in the world, aspirin, that treat and relieve pain, inflammation and fever.

With a wide range of pain medications available on the market, it is essential that sufferers have a reliable health provider that they can depend on to provide them with the right information. Tested and trusted by millions inside and outside Malaysia, KPJ Healthcare was the first in Malaysia to offer dedicated pain management services in 2008 and also has a specialised pain management centre. It is also one of the nation’s leading medical service providers, with the latest knowledge and equipment to ensure the delivery of quality healthcare.

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