Last week, when I stubbed my toe on our family room coffee table, a throbbing pain ensued. Over the next two to three days, as the bruise turned pink and then purple, the pain persisted.
During the same time, I had a case of the blues. I am overstressed at work with several staff on vacation, my college-age children had come home and then left to start their internships, and my father’s asthma was out of control.
When the toe pain became unbearable, I took a Tylenol or acetaminophen. Within hours, the pain subsided. But the funny thing was I also felt better overall, not just less physical pain.
So was this just in my mind — that taking away the noxious physical pain helped me deal with the emotional psychological pain, or was there more to it? In fact, research shows that the impact of acetaminophen may be much more than just reducing physical pain.
But first, some background on pain medications, which have been in the news. Pain medications include the common over-the-counter acetaminophen (Tylenol) and nonsteroidal anti-inflammatories like aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve), as well as prescription medicines like celecoxib (Celebrex) and the often-overused narcotics like oxycodone and morphine.
Acetaminophen is the safest and most often-used first-line treatment for common aches and pains. It blocks the production of an enzyme in the brain which leads to the production of the pain sensation. Acetaminophen has no anti-inflammatory effect, so it is not as useful as ibuprofen or aspirin for arthritis, and it can be harmful to the liver when taken in high doses.
While researchers do not completely understand the mechanism of acetaminophen’s action, it clearly reduces painful stimuli, and it can also muffle emotional response.
In an intriguing research study, volunteers were given two double strength Tylenols or a placebo (sugar pill) and then shown sad pictures of children weeping or starving and were asked to rate them. The Tylenol group rated the pictures 10 percent less sad than the group that did not take the Tylenol.
What does this mean? It seemed as if the acetaminophen was impacting emotional pain, by dampening the sadness.
However, there is a side effect of acetaminophen on our emotions. In the study, when volunteers from the two groups were shown happy pictures of children petting a kitten and asked to rate them, the Tylenol group was 20 percent less happy than the placebo group.
In effect, just as Tylenol numbs physical pain and sad emotional pain, it too was numbing emotional delight. So taking a Tylenol and going to your child’s or grandchildren’s graduation ceremony will likely lead to less happiness.
Researchers suspect that acetaminophen impacts the insula, the part of the brain which is involved with emotional processing. In effect, it muffles the response to both delightful and dreadful stimuli.
However, pain is highly subjective, and there is much more research to come. In my case, I wondered if my feeling better emotionally was due to relieving the noxious stimuli from the toe, the sheer placebo effect of knowing that the Tylenol may relieve both physical and emotional pain, or a significant emotional impact of the Tylenol itself.
In any case, the simple and safe pain medicine, acetaminophen, worked. It helped me get through the day with less pain, and maybe less sadness and happiness.
Manoj Jain is an infectious disease physician and contributor to the Washington Post and the Commercial Appeal. He can be reached at his self-titled site, Dr. Manoj Jain.
Image credit: Niloo / Shutterstock.com
