Anti-inflammatories are defined as a medication or drug used to reduce inflammation. Anti-inflammatories are used to ease joint pain, muscle and ligament pain, period pain, pain after operations, headache, migraine, and other types of pain. They work by blocking, or inhibiting, the effect of chemicals called cyclo-oxygenase, or COX, enzymes. COX enzymes help to make other chemicals called prostaglandins. Some prostaglandins are involved in the production of pain and inflammation at sites of injury or damage. A reduction in prostaglandin production reduces pain and inflammation. There are two types of COX enzymes - COX-1 and COX-2. It is the COX-2 enzyme that is mainly involved in making the prostaglandins that are involved with pain and inflammation. Anti-inflammatory painkillers are sometimes classified into two main groups: NSAIDs and coxibs. Most anti-inflammatory medications fall into the NSAID group, including diclofenac, ibuprofen, indometacin, and naproxen. These block both COX-1 and COX-2 enzymes. While others such as celecoxib and etoricoxib fall into the coxib group and block just the COX-2 enzyme. Anti-inflammatories do not alter the course of painful conditions such as arthritis. They just ease symptoms of pain and stiffness. However, this may provide further benefit because, if pain is eased, eventually a person may then be able to move around more easily or use a painful joint more easily. The inflammation and pain of various types of arthritis often come and go. During good spells, when symptoms are not too bad, a person may not need to take anti-inflammatories. Some people find that one preparation works better than another for them. If one preparation does not work very well at first, then a different one may work better. Anti-inflammatories can also help with back ache, inflammation and stiffness, and sprains. Like every medication anti-inflammation drugs are not without their side effects. Some of the most commonly reported side effects include stomach upset, diarrhea, and gas. Other side effects include ringing in the ears, blurry vision, rash, hives, and itching, fluid retention, blood in the urine or bloody stool, decreased appetite, drowsiness, liver failure, ulcers, kidney failure, vomiting or blood in the vomit, severe stomach pain, rapid heartbeat, chest pain, jaundice, sweating, hyperventilation, and muscle spasms. Anti-inflammatories are intended for short term or occasional use and the risk of side effects increase the long the drugs are taken. When taken with other drugs such as warfarin, lithium, cyclosporine, aspirin, diuretics, and SSRIs, anti-inflammatories may have a negative reaction which may have severe effects on a person’s health. Medications such as Motrin, Advil, Indocin, Celebrex, Cambia, Aleve, Anaprox, Naprelan, Naprosyn, Daypro, Clinoril, and Feldene are known to help with inflammation and pain associated with inflammation.