The “Inside” Story

Pain and fever are the human body’s response when it repairs wounds and fights infections, yet excessive pain and high fevers need to be treated with medications. What are these medications, and how do they act?

Over the counter (OTC) medications like acetaminophen or ibuprofen are often the first line of defense for most of us when suffering from a headache or other pain, or a fever. Of course, over the course of the last four years many of us have also leaned into testing for COVID when we’ve been beset with unexplained pain and/or fever, because SARS-CoV-2 has not yet been vanquished.

So what causes pain and fever?

It’s complicated. Pain and fever are the body’s biochemical responses to assault — physical assault (e.g., a stubbed toe; a poorly considered exercise) will often cause pain at the site of the assault; and physiological assault (e.g., eating food that is too old) can cause pain and fever.

The complicated pathways to pain and fever have a few common biochemical components — specific enzymes and other proteins and lipids. These are primarily the cyclooxygenase enzymes COX-1 and COX-2, and proteins that are receptors for products resulting from the activity of these enzymes, and lipids that are substrates for these enzymes.