Laser surgery

Alternative Names   — Surgery using a laser
Laser surgery is a medical procedure that uses laser light to remove diseased tissues or treat bleeding blood vessels. Laser surgery may also be used for cosmetic purposes, such as removing wrinkles, tattoos, or birthmarks.
A laser is a light beam that can be precisely focused. It is used to treat tissues by heating the targeted cells until they «burst.»
There are several types of lasers, including the carbon dioxide (CO2) laser, the YAG (yttrium aluminum garnet) laser, and the pulsed dye laser. Each laser has specific uses. The color of the light beam used is directly related to the type of surgery being performed and the color of the tissue being treated.
Why the Procedure is Performed    
Laser surgery can be used to:
Close small blood vessels to reduce blood loss
Close lymph vessels to reduce swelling and decrease the spread of tumor cells
Close nerve endings to reduce pain that occurs after surgery
Remove tumors (such as those in the brain or liver)
Remove warts, moles, and tattoos
Reduce the appearance of skin wrinkles, scars, and other skin blemishes
Remove hair
Possible risks of laser surgery include:
Incomplete treatment of the problem
Skin color changes
Some laser surgery is done when you under general anesthesia. Be sure to discuss the risks with your health care provider.
After the Procedure    
How well a patient does depends on the condition being treated. Always talk to your health care provider about your expected recovery before surgery.
The amount of time it takes to recover from surgery depends on the surgery and on the individual. Based on an evaluation of your health status prior to surgery, your health care provider can give you a good estimate of the recovery time.


Alternative Names — Phlebitis
Thrombophlebitis is swelling (inflammation) of a vein caused by a blood clot.
The following increase your chances for thrombophlebitis:
Being hospitalized for a major surgery or with a major illness
Disorders that make you more likely to develop blood clots
Sitting for a long period of time (such as on a long airplane trip)
There are two main types of thrombophlebitis:
Deep venous thrombosis (affects deeper, larger veins)
Superficial thrombophlebitis (affects veins near the skin surface)
The following symptoms are often associated with thrombophlebitis:
Inflammation (swelling) in the part of the body affected
Pain in the part of the body affected
Skin redness (not always present)
Warmth and tenderness over the vein
Exams and Tests    
The health care provider can usually diagnose the condition based on how the affected area looks. You may need to have your pulse, blood pressure, temperature, skin condition, and circulation frequently checked to make sure you don’t have complications.
If the cause cannot be easily identified, one or more of the following tests may be done:
Blood coagulation studies
Doppler ultrasound
In general, treatment may include support stockings and wraps to reduce discomfort as well as medications such as:
Analgesics (pain killers)
Antibiotics (if infection is present)
Anticoagulants (blood thinners) to prevent new clots from forming
Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen to reduce pain and inflammation
Thrombolytics to dissolve an existing clot
You may be told to do the following:
Apply moist heat to reduce inflammation and pain
Keep pressure off of the area to reduce pain and decrease the risk of further damage
Raise the affected area to reduce swelling
Surgical removal, stripping, or bypass of the vein is rarely needed but may be recommended in some situations.
For more specific recommendations, see the particular condition (superficial thrombophlebitis or deep venous thrombosis).
Thrombophlebitis and other forms of phlebitis usually respond to prompt medical treatment.
Possible Complications    
Superficial thrombophlebitis rarely causes complications.
Complications of deep vein thrombosis include blood clots in the lungs (pulmonary embolism) or chronic pain and swelling in the leg.
When to Contact a Medical Professional    
Call your health care provider if you have symptoms of thrombophlebitis.
Call your health care provider promptly if thrombophlebitis symptoms do not improve with treatment, if symptoms get worse, or if new symptoms occur (such as an entire limb becoming pale, cold, or swollen).

Prostate resection — minimally invasive

Alternative Names   
Laser prostatectomy; Transurethral needle ablation; TUNA; Transurethral incision; TUIP; Holmium laser enucleation of the prostate; HoLep; Interstitial laser coagulation; ILC; Photoselective vaporization of the prostate; PVP; Transurethral electrovaporization; TUVP; Transurethral microwave thermotherapy; TUMT
Minimally invasive prostate resection is surgery to remove part of the prostate gland, to treat an enlarged prostate. The surgery will improve the flow of urine through the urethra, the tube that carries urine from the bladder outside of your body. It can be done in several different ways. There is no incision (cut) in your skin.
These procedures are usually done in your doctor’s office or at an outpatient surgery clinic.
The surgery can be done in many different ways, depending on the size of your prostate and what caused it to grow. Your doctor will consider the size of your prostate, how healthy you are, and what type of surgery you may want.
All of these procedures are done by passing an instrument through the opening in your penis. You will be given general anesthesia (asleep and pain-free), spinal or epidural anesthesia (awake but pain-free), or local anesthesia and sedation. Choices are:
Laser prostatectomy: Laser prostatectomy takes about 1 hour. The laser destroys prostate tissue that blocks the opening of the urethra. You will probably go home the same day. You may need a Foley catheter placed in your bladder to help drain urine for a few days after surgery.
Transurethral needle ablation (TUNA): The surgeon passes needles into the prostate. High-frequency sound waves (ultrasound) heat the needles and prostate tissue. You may need a Foley catheter placed in your bladder to help drain urine after surgery for 3 to 5 days.
Transurethral microwave thermotherapy (TUMT): TUMT delivers heat using microwave pulses to destroy prostate tissue. Your doctor will insert the microwave antenna through your urethra.
Transurethral electrovaporization (TUVP): A tool or instrument delivers high-voltage electrical current to destroy prostate tissue. You will have a catheter place in your bladder. It may be removed within hours after the procedure.
Transurethral incision (TUIP): Your surgeon makes small incisions (cuts) where the prostate meets your bladder. As a result, the urethra becomes wider or more open. This procedure takes 20 to 30 minutes. Many men can go home the same day. Full recovery can take 2 to 3 weeks.
Why the Procedure is Performed    
An enlarged prostate can make it hard for you to urinate. You may also get urinary tract infections. Removing all, or part, of the prostate can gland can make these symptoms better. Before you have surgery, your doctor will suggest you change how you eat or drink. You may also try some medicines.
Your doctor may recommend prostate removal if you:
Cannot completely empty your bladder (urinary retention)
Have repeat urinary tract infections
Have bleeding from your prostate
Have bladder stones with your enlarged prostate
Urinate very slowly
Took medicines, and they did not help your symptoms
Risks for any surgery are:
Blood clots in the legs that may travel to the lungs
Breathing problems
Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
Blood loss
Heart attack or stroke during surgery
Reactions to medications
Additional risks for this surgery are:
Problems with urine control (incontinence)
Passing semen back into your bladder instead of out through the urethra (retrograde ejaculation)
Erection problems — impotence
Urethral stricture (tightening of the urinary outlet from scar tissue)
Before the Procedure    
You will have many visits with your doctor and tests before surgery:
Complete physical exam
Visits with your doctor to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems, are being treated well
If you are a smoker, you should stop several weeks before the surgery. Your doctor or nurse can help.
Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.
During the weeks before your surgery:
You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and other drugs like these.
Ask your doctor which drugs you should still take on the day of your surgery.
On the day of your surgery:
Do not eat or drink anything after midnight the night before your surgery.
Take the drugs your doctor told you to take with a small sip of water.
Your doctor or nurse will tell you when to arrive at the hospital.
After the Procedure    
You will probably go home the day you have surgery, or the day after. You may still have a catheter in your bladder when you leave the hospital.


Alternative Names -Plaque psoriasis
Psoriasis is a common skin condition that causes skin redness and irritation. Most persons with psoriasis have thick, red skin with flaky, silver-white patches called scales.
   Psoriasis is a very common condition. The disorder may affect people of any age, but it most commonly begins between ages 15 and 35. It can appear suddenly or slowly. In many cases, psoriasis goes away and then flares up again repeatedly over time. The condition is not contagious.
 Psoriasis seems to be an inherited disorder. That means it is passed down through families. Doctors think it probably occurs when the body’s immune system mistakes healthy cells for dangerous substances.
 Skin cells grow deep in the skin and normally rise to the surface about once a month. In persons with psoriasis, this process is too fast and dead skin cells build up on the skin’s surface.
Psoriasis may affect any or all parts of the skin. There are five main types of psoriasis.
Erythrodermic — The skin redness is very intense and covers a large area.
Guttate — Small, pink-red spots appear on the skin.
Inverse — Skin redness and irritation occurs in the armpits, groin, and in between overlapping skin.
Plaque — Thick, red patches of skin are covered by flaky, silver-white scales. This is the most common type of psoriasis.
Pustular — White blisters are surrounded by red, irritated skin.
In general, psoriasis may be severe in persons who have a weakened immune system. This may include persons who have:
Autoimmune disorders (such as rheumatoid arthritis)
Cancer chemotherapy
Up to 30% of people with psoriasis may also have arthritis, a condition known as psoriatic arthritis. Psoriasis may also affect the nails. About 10% of people with psoriasis have visible changes only in the nails.
Persons with psoriasis have irritated patches of skin. The redness is most often seen on the elbows, knees, and trunk, but can appear anywhere on the body. For example, there may be flaky patches on the scalp.
 Sunlight may help your symptoms go away. Be careful not to get sunburned. Some people may choose to have phototherapy. Phototherapy is a medical procedure in which your skin is carefully exposed to ultraviolet light. Phototherapy may be given alone or after you take a drug that makes the skin sensitive to light.
 Persons with very severe psoriasis may receive medicines to suppress the body’s immune response. These medicines include methotrexate or cyclosporine. (Persons who have psoriatic arthritis may also receive these drugs.)
    Psoriasis is a life-long condition that can be controlled with treatment. It may go away for a long time and then return. With appropriate treatment, it usually does not affect your general physical health.

Erection problems

Alternative Names    
Erectile dysfunction; Impotence; Sexual dysfunction — male
An erection problem is the inability to get or maintain an erection that is firm enough for a man to have intercourse. You may be unable to get an erection at all, or you may lose the erection during intercourse before you are ready. If the condition persists, the medical term is erectile dysfunction.
Erection problems are common in adult men. In fact, almost all men experience occasional difficulty getting or maintaining an erection. In many cases, it is a temporary condition that will go away with little or no treatment. In other cases, it can be an ongoing problem that can damage a man’s self esteem and harm his relationship with his partner, and thus requires treatment.
If you have difficulty having or keeping an erection more than 25% of the time, it is considered a problem.
In the past, erection problems were thought to be «all in the man’s mind.» Men often were given unhelpful advice such as «don’t worry» or «just relax and it will take care of itself.» Today, doctors believe that when the problem is not temporary or does not go away on its own, physical factors are often the cause.
One way to know if the cause is physical or psychologic is to determine if you are having nighttime erections. Normally, men have 3 to 5 erections per night, each lasting up to 30 minutes. Your doctor can explain a test to find out if you are having the normal number of nighttime erections.
In most men, erection difficulties do not affect their sex drive.
Premature ejaculation (when orgasm comes on too quickly) is not the same as impotence. Together with your partner, you should seek counseling for this problem, which is usually due to psychological factors.
Male infertility is also quite different from impotence. A man who is unable to maintain an erection may be very capable of producing sperm that could fertilize an egg. An infertile man is usually able to maintain an erection, but he may be unable to father a child due to problems with sperm count or other factors.
An erection requires the interaction of your brain, nerves, hormones, and blood vessels. Anything that interferes with the normal process can lead to a problem.
Common causes of erection problems include:
Diseases and conditions such as diabetes, high blood pressure, heart or thyroid conditions, poor blood flow, depression, or neurologic disorders (such as multiple sclerosis or Parkinson’s disease)
Medications such as blood pressure medications (especially beta-blockers), heart medications (such as digoxin), some peptic ulcer medications, sleeping pills, and antidepressants
Nerve damage from prostate surgery
Nicotine, alcohol, or cocaine use
Poor communication with your partner
Repeated feelings of doubt and failure or negative communication that reinforce the erection problems
Spinal cord injury
Stress, fear, anxiety, or anger
Unrealistic sexual expectations, which make sex a task rather than a pleasure
Erection problems tend to become more common as you age, but it can affect men at any age and at any time in their lives. Physical causes are more common in older men, while psychological causes are more common in younger men.
Low levels of testosterone rarely lead to erection problems, but may reduce a man’s sex drive.
Home Care    
For many men, lifestyle changes can help:
Cut down on smoking, alcohol, and illegal drugs.
Get plenty of rest and take time to relax.
Exercise and eat a healthy diet to maintain good circulation.
Use safe sex practices, which reduces fear of HIV and STDs.
Talk openly to your partner about sex and your relationship. If you are unable to do this, counseling can help.
Couples who cannot talk to each other are likely to have problems with sexual intimacy. Men who have trouble communicating their feelings may find it difficult to share with their partner any anxieties about their sexual performance. In these circumstances, counseling can be very helpful for both you and your partner.
When to Contact a Medical Professional    
Call your doctor if:
The problem does not go away with self-care measures — effective treatments are available
The problem begins after an injury or prostate surgery
You have other symptoms like low back pain, abdominal pain, or change in urination
If erection problems seem to be caused by a medication you are taking for an unrelated condition, consult your doctor. You may benefit from reducing the dose of the drug or changing to another drug that has the same result but not the same side effects. DO NOT change or stop taking any medications without first talking to your doctor.
Talk to your health care provider if your erection problems are related to fear of recurring heart problems. Sexual intercourse is usually safe in these circumstances.
Call your doctor immediately or go to an emergency room if medication for erection problems give you an unwanted erection that lasts more than 4 hours. Permanent impotence or other lasting damage to your penis may result from this condition.
What to Expect at Your Office Visit    
Your doctor will perform a physical examination, which will likely include:
Checking your blood flow (circulation)
Exam of your penis
Neurological exam
Rectal exam
To help diagnose the cause of the problem, your doctor will ask medical history questions such as:
Have you been able to achieve and maintain erections in the past?
Is the difficulty in achieving erections or maintaining the erection?
Do you have erections during sleep?
How long have you had difficulty with erections?
What medications are you taking (including prescription medications, over-the-counter medications, and recreational drugs)?
Do you smoke? How much each day?
Do you use alcohol? How much?
Have you recently had surgery?
Have you ever had vascular surgery or other treatments for your blood vessels?
Are you depressed?
Are you afraid or worried about something?
Are you experiencing a lot of stress?
Has your energy level decreased?
Are you sleeping well each night?
Are you afraid of sexual activity because of physical problems?
Have there been any recent changes in your life?
What other symptoms do you have?
Have you noticed changes in sensations in your penis?
Do you have any problems with urination?
Tests that may be done include:
Blood tests, including complete blood count, metabolic panel, hormone profile, and PSA
Neurological (nerve) testing
Nocturnal penile tumescence (NPT) to check for normal nighttime erections
Penile ultrasound to check for blood vessel or blood flow problems
Psychometric testing
Rigidity monitoring
Urine analysis
The treatment depends on the cause. For example, if the problem is caused by a hormonal imbalance, medication to treat the underlying endocrine disorder will be prescribed. Consult your health care provider for appropriate evaluation and management.
There are many treatment options today. These include medicines taken by mouth, injections into the penis, vacuum devices, and surgery. In order to treat erectile dysfunction effectively, you must be aware of and comfortable with the possible side effects and complications that may occur with each therapy.
Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are medicines prescribed for mild-to-moderate erection difficulties caused by either physical or psychological problems. The drugs work only when the man is sexually aroused. The effect is usually seen within 15 — 45 minutes.
These drugs are called phosphodiesterase-5 (PDE5) inhibitors.
Although these drugs have become extremely popular, they do not enhance erections if you are not impotent. And they DO have side effects, which can be as serious as a heart attack or as minor as muscle pain or facial flushing.
These drugs should not be used with certain other medications, including nitroglycerin. When taken with nitroglycerin, a man’s blood pressure can become dangerously low. Some men have died after taking these drugs and nitroglycerin.
PDE5 inhibitors should be used with caution if you have any of the following conditions:
Recent stroke
Severe heart disease, such as unstable angina, a recent heart attack, or arrhythmia
Severe heart failure
Uncontrolled hypertension (high blood pressure)
Uncontrolled diabetes
Very low blood pressure (hypotension)
If pills do not work, other options are available. Testosterone skin patches or injectionjs may be prescribed, especially if the problem is related to age. A medicine called alprostadil, injected at the penis or inserted as pellets, improves blood flow to the penis. This usually works better than medications taken by mouth.
For some patients, a vacuum pump or penile implant (prosthesis) may also be recommended or needed.
Consult your health care provider to see if one of these treatments is right for you

Radical prostatectomy

Alternative Names   
Prostatectomy — radical; Radical retropubic prostatectomy; Radical perineal prostatectomy; Laparoscopic radical prostatectomy; LRP; Robotic-assisted laparoscopic prostatectomy; RALP; Pelvic lymphadenectomy
Radical prostatectomy is surgery to remove all of the prostate gland and some of the tissue around it, to treat prostate cancer.
The surgeon removes the prostate gland from the surrounding tissue. The seminal vesicles, two small fluid filled sacs next to your prostate, are also removed.
The surgeon tries carefully not to damage nerves and blood vessels.
The surgeon reattaches the urethra to a part of the bladder called the bladder neck. The urethra is the tube that carries urine from the bladder out through the penis.
Many surgeons will also remove lymph nodes in the pelvis to check for cancer.
The surgeon may leave a drain, called a Jackson-Pratt drain, in your belly to drain extra fluids after surgery.
A tube or urinary catheter is left in your bladder to drain urine.
Why the Procedure is Performed    
Radical prostatectomy is most often done when the cancer has not spread beyond the prostate gland. Healthy men who will probably live 10 or more years often have this procedure.
Other treatment options for prostate cancer are:
External beam radiation therapy
Implant radiation therapy (brachytherapy)
Hormone therapy (androgen deprivation therapy)
Cryotherapy of the prostate
Visits with your doctor and tests to check for changes in your prostate cancer (called active surveillance)
Sometimes, your doctor may recommend one treatment for you because of what is known about your type of cancer and your risk factors. Other times, your doctor will talk with you about two or more treatments that could be good for your cancer.
Risks of this procedure are:
Difficulty controlling urine (urinary incontinence)
Erection problems -impotence
Injury to the rectum
Difficulty controlling bowel movements (bowel incontinence)
Urethral stricture (tightening of the urinary outlet from scar tissue)
Before the Procedure    
You will have many visits with your doctor and tests before your surgery:
Complete physical exam
Visits with your doctor to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems, are being treated well
If you smoke, you should stop several weeks before the surgery. Your doctor or nurse can help.
Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.


Alternative Names 

Cancer chemotherapy; Cancer drug therapy; Cytotoxic chemotherapy


Chemotherapy is the use of drugs to kill bacteria, viruses, fungi, and cancer cells. Most commonly, the term is used to refer to cancer-killing drugs. This article focuses on cancer chemotherapy.


Chemotherapy drugs can be given by mouth or injection. Because the medicines travel through the blood stream to the entire body, chemotherapy is considered a body-wide (systemic) treatment.

Chemotherapy may be used to:

  • Cure the cancer
  • Keep the cancer from spreading
  • Ease symptoms (when the cancer cannot be cured)

Chemotherapy medicines usually target cells that quickly divide. However, normal cells — including those found in the blood, hair, and the lining of the gastrointestinal tract — also divide very quickly. That means chemotherapy can also damage or kill these healthy cells. When this occurs, side effects such as nausea, anemia, and hair loss can occur. Some persons who receive chemotherapy also have fatigue, nerve pain, and infection.

Side effects of chemotherapy depend on many things, including the type of cancer and specific drugs being used. Newer chemotherapy drugs that better target cancer cells may cause fewer side effects.

Physical exam frequency

Alternative Names  

How often you need a physical exam; Health maintenance visit


All adults should visit their health care provider from time to time, even if they are healthy. The purpose of these visits is to:

  • Screen for diseases
  • Assess risk of future medical problems
  • Encourage a healthy lifestyle
  • Update vaccinations
  • Maintain a relationship with a doctor in case of an illness


Even if you feel fine, it is still important to see your health care provider regularly to check for potential problems. Most people who have high blood pressure don’t even know it. The only way to find out is to have your blood pressure checked regularly. Likewise, high blood sugar and high cholesterol levels often do not produce any symptoms until the disease becomes advanced.

Note: Patients with risk factors for colon cancer, including long-standing ulcerative colitis, personal or family history of colorectal cancer, or history of large colorectal adenomas may need a colonoscopy more often.

Pets and the immunocompromised person

Alternative Names 

AIDS patients and pets; Bone marrow transplant patients and pets; Chemotherapy patients and pets


Persons with weakened immune systems are often advised to give up their pets to avoid getting various diseases from the animals. Persons in this category include those who take high doses of steroids and others who have:

  • Alcoholism
  • Cancer
  • Cirrhosis
  • Diabetes
  • Had an organ transplant
  • Had their spleen removed
  • HIV
  • Kidney failure
  • Leukemia

However, many patients decide to keep their pets. Therefore, the patient and their family must be aware of the potential risk for diseases that can be passed from animals to humans.

Here are some guidelines:

  • Ask your veterinarian for information on infections that you might get from your pets.
  • Keep your pet clean and healthy. Make sure that all vaccinations are up-to-date. If you own a cat, have it tested for the feline leukemia and feline immunodeficiency viruses. Although these viruses do not spread to humans, they do affect the cat’s immune system, putting you and your cat at risk for other infections that may be spread to humans.
  • Have your veterinarian examine all your pets. If you are considering adopting one, you should get a pet that is more than 1 year old. Kittens and puppies are more likely to scratch and bite and are more likely to contract infections.
  • Keep your pets indoors. If they do go outside, keep them on a leash.
  • Have all pets surgically spayed or neutered. Neutered animals are less likely to roam and therefore less likely to contract diseases.
  • Bring your pet to a veterinarian if the animal has diarrhea, is coughing and sneezing, has decreased appetite, or has lost weight.
  • Feed your pet only commercially prepared food and treats. Animals can get sick from undercooked or raw meat or eggs. Cats can get infections such as toxoplasmosis by eating wild animals.
  • Do not let your pet drink from the toilet. Several infections can be spread this way.
  • Wash your hands after handling your pet or a litter box, especially before you eat, prepare food, or smoke.
  • Keep your cat’s litter box away from eating areas. Use disposable pan liners so that the entire pan can be cleaned with each litter change. If possible, have someone else change the litter pan. If you must change the litter, wear rubber gloves and a disposable face mask. The litter should be scooped daily to prevent the risk of toxoplasmosis infection. Similar precautions should be taken when cleaning a bird’s cage.
  • Keep your pet’s nails short or declaw the animal to reduce the risk of infection caused by animal scratches. Cats can spread B. henselae, the organism responsible for cat scratch disease.
  • Take measures to prevent flea or tick infestations, as several bacterial and viral infections are spread by fleas and ticks. Dogs and cats can use flea collars. Permethrin-treated bedding can decrease risk of flea and tick infestations.
  • Do not adopt wild or exotic animals. These animals are more likely to bite, and they often carry rare but serious diseases.
  • Dogs can spread «kennel cough» to persons with weakened immune systems. If possible, do not place your dog in a boarding kennel or other high risk environment.
  • Reptiles carry the bacteria salmonella. If you own a reptile, wear gloves when handling the animal or its feces because salmonella is easily passed from animal to human.
  • Wear rubber gloves when handling or cleaning fish tanks.

Pain medications

  Pain medicines are also called analgesics. Every type of pain medicine has benefits and risks. Specific types of pain may respond better to one kind of medication than to another kind. What takes away your pain might not work for someone else.


Over-the-counter (OTC) medications are good for many types of pain. OTC medicines include:

  • Acetaminophen (Tylenol)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

Acetaminophen is a non-aspirin pain reliever. It can be used to lower a fever and soothe headaches and other common aches and pains. However, acetaminophen does not reduce swelling (inflammation). This medicine is easier on the stomach than other pain medications, and it is safer for children. It can, however, be harmful to the liver if you take more than the recommended dose. See: Acetaminophen overdose

NSAIDs include aspirin, naproxen, ibuprofen, and several others that require a prescription. These medicines relieve pain, but they also reduce inflammation caused by injury, arthritis, or fever. NSAIDs work by reducing the production of hormone-like substances called prostaglandins, which cause pain.

DO NOT give aspirin to children. Reye syndrome is associated with the use of aspirin to treat children with viral infections, such as chicken pox or the flu.

If you have high blood pressure, kidney disease, or a history of gastrointestinal bleeding, you should talk to your health care provider before using any over-the-counter NSAID.


Prescription medications may be needed for other types of pain. COX-2 inhibitors are a type of prescription painkiller that block an inflammation-promoting substance called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach side effects. However, numerous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and benefits of the COX-2s. Patients should ask their doctor whether a COX-2 drug is appropriate and safe for them.

Narcotic painkillers are very strong, potentially habit-forming medicines used to treat severe pain. They include oxycodone, hydrocodone, morphine, and codeine.

Talk to your doctor if your pain lasts longer than a few days, if over-the-counter pain medications do not relieve your pain, or if other symptoms develop. A pain specialist may be needed to help manage long-term pain.