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Arthritis

Pain is a problem that affects many. As one of the most common symptoms of most diseases, it afflicts us all at different times and with differing degrees of intensity.

As a result, a great deal of the history of medicine centres around the search for effective methods of pain relief – particularly joint pain. This is reported by a staggering 13 million people in the UK, according to a MORI poll conducted by the Arthritis Research Campaign.

A key cause of pain is inflammation, which is why the search for effective anti-inflammatory agents has been so intense. They go by the generic name of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs).

Aspirin (originally created by Bayer and derived from the plant meadowsweet) was the first commercially significant NSAID. In 1966 Stuart Adams, a scientist working for Boots the Chemist, developed ibuprofen. Ibuprofen is more powerful than aspirin and significantly less likely to cause stomach irritation.

It had been discovered in the ‘70s that aspirin and the other NSAIDs all work by inhibiting an enzyme in the body called cyclooxygenase (COX). COX facilitates the body’s ability to synthesise prostaglandins, hormone-like compounds that are involved in tissue damage, inflammation and pain.

To understand how the pain of arthritis is caused, how that pain can be stopped and how the underlying cause can be dealt with, you need to understand the following process. Don’t worry too much about the scientific terms, it’s only important that you follow the logic!

When tissue cells are damaged – for example by arthritis – not only is inflammation created, but an enzyme is released called PLA (phospholipase).

The PLA enzyme breaks down the outer membrane, not only of the damaged cell, but of neighbouring cells. These cell walls are made of fatty acids called phospholipids – which then break free.

The broken-down fatty acids are then processed by three further enzymes called COX 1, COX 2 and LIPOX 5. The end result of the process is the creation of another fatty acid called a prostaglandin.

In turn prostaglandins create pain – which is recognised by pain receptors and transmitted to the brain.

Prostaglandins also make the original inflammation worse which creates a vicious circle – because more PLA is created and therefore more cell membranes breakdown, and therefore more phospholipids are released and therefore more prostaglandin is produced, etc, etc.

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