Tylenol, advil and aspirin are all over-the-counter painkillers, but work in different ways in your body. Make sure you know the differences so that you take the right one for your specific problem.
Aspirin can halt two processes in the body: inflammation and blood clotting. As an anti-inflammatory it’s good for muscle sprains or other minor injuries and will reduce swelling, redness and pain. As a blood thinner, it is particularly good for pressure headaches, and can prevent heart attack in those who are at risk when they take it daily at a low dose.
The downside is that aspirin irritates the stomach lining, and can cause stomach pain and, in some cases, ulcers.
Advil (ibuprofen) seems to be more effective for sore muscles and arthritis. Ibuprofen tamps down prostaglandins, which are involved in many body functions, not just inflammation. One of these is the contraction or relaxation of smooth muscles (the ones found in the organs and intestines). This may be why it is effective in relieving menstrual pain.
Like aspirin, ibuprofen irritates the lining of the stomach and intestines. Athletes tend to take ibuprofen more regularly, so need to be more cautious. One study showed that taking this drug in combination with regular endurance training, such as distance running, can lead to intestinal damage. Another study showed that athletes who take aspirin or ibuprofen before exercising can be at risk for kidney failure. This is because aspirin and ibuprofen reduce blood flow to the kidneys, as does intense exercise, and these are often combined with another stressor for the kidneys—dehydration.
Tylenol (the brand name for the drug acetaminophen or paracetamol) is a painkiller, but targets the brain more than the body. This means that while it won’t have a huge effect on inflammation, it will raise your pain tolerance, by limiting how much your brain listens to pain and making pain more tolerable. Research shows that acetaminophen targets the cannabinoid receptors in the brain—the ones activated by marijuana. This may explain one route by which acetaminophen is able to lower the perceived intensity of pain.
Acetaminophen is much gentler on the stomach than any of the other painkillers, making it especially useful for those with stomach ulcers. However, it can lead to liver damage when taken in very high doses. Because it is included in many other medicines, it’s easier to overdose on acetaminophen than on other painkillers.
Painkillers should be used in the short term and at moderate doses. Long term use is linked to health problems. Chronic pain indicates there is an underlying issue that needs to be addressed rather than quieted with drugs.
Take aspirin for:
- muscle sprains
- minor injuries
- pressure headaches
- heart attack prevention (for those at risk)
Take ibuprofen (Advil) for:
- sore muscles
- menstrual pain
Take acetaminophen/paracetamol (Tylenol) for:
- making pain more tolerable
- Pain if you have stomach ulcers
Studies referred to in this article:
“COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: Cloning, structure, and expression.” Published in Proceedings of the National Academy of Sciences of the USA.
“TRPA1 mediates spinal antinociception induced by acetaminophen and the cannabinoid Δ9-tetrahydrocannabiorcol.” Published in Nature Communications.
“The analgesic activity of paracetamol is prevented by the blockade of cannabinoid CB1 receptors.” Published in European Journal of Pharmacology.
“Aggravation of Exercise-Induced Intestinal Injury by Ibuprofen in Athletes.” Published in Medicine Science in Sports Exercise.
“Anti-inflamatory Drugs, Kidney Function, and Exercise.” Published in Sports Science Exchange.
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