Part two of this Science Savvy pain series explains how common painkillers work, why many provide limited relief, and how pain is shaped by nerves, the spinal cord, the brain, and emotion!! (emotion?!?!)... we even talk about porn, sexual arousal, and its impact on pain... the ffff
The episode covers common drugs like ibuprofen, paracetamol, local anesthetics (at your dentist office) through to not-so-common drugs like opioids. We also talk about why expectations, social support, and non-drug approaches matter - a little bit of hope man, please.
As always, the full bibliography below:
1. None, M., None, A. A. & None, S. A. (2025). Pharmacological Agents Targeting Pain Pathways: A Systematic Review of Analgesic Efficacy and Physiological Correlates. Journal of Contemporary Clinical Practice, 11(9), 683-691.
2. Mallet C, Desmeules J, Pegahi R, Eschalier A. An Updated Review on the Metabolite (AM404)-Mediated Central Mechanism of Action of Paracetamol (Acetaminophen): Experimental Evidence and Potential Clinical Impact. J Pain Res. 2023;16:1081-1094
https://doi.org/10.2147/JPR.S393809
3. Moore RA, Derry S, Aldington D, Wiffen PJ. Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015 Sep 28;2015(9):CD008659. doi: 10.1002/14651858.CD008659.pub3. PMID: 26414123; PMCID: PMC6485441.
4. Mourkojannis, C., Wolf, MI., Wittkamp, C.A. et al. Pain modulation by self-generated expectations. Sci Rep 15, 31588 (2025). https://doi.org/10.1038/s41598-025-17276-8
5. Ghlichloo I, Gerriets V. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547742/
6. Lakhsassi L, Borg C, Martusewicz S, van der Ploeg K, de Jong PJ. Does heightened subjective sexual arousal lower pain in women? PLOS ONE. 2025;20(??):e0323095. doi:10.1371/journal.pone.0323095
7. Lakhsassi L, Borg C, Martusewicz S, van der Ploeg K, de Jong PJ. The influence of sexual arousal on subjective pain intensity during a cold pressor test in women. PLOS ONE. 2022;17(10):e0274331. doi:10.1371/journal.pone.0274331
8. Whipple B, Komisaruk BR. Elevation of pain threshold by vaginal stimulation in women. Pain. 1985;21(4):357–367.
9. Hambach A, Evers S, Summ O. The impact of sexual activity on idiopathic headaches: An observational study. Cephalalgia. 2013;33(6):384–389. doi:10.1177/0333102413476374
