To deal with inflammation and pain, more than 14 million patients turn to non-steroidal anti-inflammatory drugs (NSAIDs). While NSAIDs can provide acute pain relief and reduce swelling at the injury site, long-term use has been shown to cause serious health problems, leading to more than 100,000 hospitalizations and 16,500 deaths a year in the United States alone. What’s worse, the majority of patients taking NSAIDs are not aware of the side effects.
What are NSAIDs?
NSAIDs, or non-steroid anti-inflammatory drugs, are medications commonly used to treat headaches, arthritis, sports injuries, menstrual cramps, and allergies. They can also be used to inhibit the clotting of blood and prevent strokes and heart attacks in individuals at high risk. NSAIDs are products containing ibuprofen, naproxen, and ketoprofen (also known as Advil®, Motrin®, Aleve®, and Orudis®), aspirin (Bayer® and Excedrin®), common cold and flu medications (Advil Cold and Sinus®, Dimetapp Sinus®, Motrin IB Sinus® and Aleve Cold and Sinus®) and others. Newer NSAIDs include meloxicam (Mobic®) and COX-2 specific inhibitors, such as celecoxib (Celebrex®), valdecoxib (Bextra®) and rofecoxib (Vioxx®). Acetaminophen (Tylenol®) is not an NSAID.
Effects and Side Effects?
While NSAIDs reduce pain and swelling, they do not promote soft-tissue healing and may even inhibit bone healing or worsen degenerative joint changes. They can also cause problems—from mild stomach upset to stomach bleeding and ulcers. At the same time, NSAIDs prevent the body’s ability to stop bleeding. Problems can occur within one week of starting to take NSAIDs. Everyone who takes NSAIDs can be at some risk for developing a stomach problem, and about 80 percent of people who have a serious problem, such as significant gastrointestinal bleeding caused by NSAIDs, have no warning symptoms.
Several factors can increase the risk of developing serious side-effects from the use of NSAIDs:
Alternatives to NSAIDs
Many factors, including insufficient sleep, mental stressors, and too much or too little exercise, can increase inflammation. To reduce inflammation in your body and decrease your risk of chronic diseases, consider maintaining a healthy lifestyle, which includes proper nutrition. For managing acute pain, consider the following natural alternatives to NSAIDs.
Consider Chiropractic Care
Chiropractic care can replace NSAIDs as a means of relieving pain or reducing inflammation in many cases. Doctors of chiropractic are trained to relieve pain and improve joint function through natural therapies, such as chiropractic manipulation, trigger-point therapy, or some massage techniques. Talk to your doctor of chiropractic about other drug-free pain-relief options, such as applying heat or cold to the affected area. Your doctor of chiropractic can also help you plan an individualized exercise program and give you nutrition and supplement advice.
Choose a Healthy Diet
A typical American diet contains a 20:1 or 30:1 ratio of omega-6 and too few omega-3 fatty acids, while experts believe that, for optimum health, a 1:1 to 4:1 range is recommended. Reduce inflammatory components in your diet by increasing your intake of low-calorie, nutrientdense foods, such as lean meat, fish, skinless chicken, vegetables, fruit, and nuts.
Consumption of anti-inflammatory omega-3 fatty acids may also decrease chronic pain and inflammation and reduce the need for prescription NSAIDs. Omega-3 acids are contained in green leafy vegetables, flaxseed, flaxseed oil, canola oil, oily fish, seafood, seaweed, and fish oils.
Some supplements, such as a multivitamin, magnesium, fish oil, vitamin D, and probiotics, can also be beneficial. If you are taking Warfarin or other potent blood thinners, talk to your physician before introducing or increasing consumption of fish oils, as well as green tea, garlic, ginkgo biloba, or vitamin E.
Try Natural Anit-Inflammatory
For managing chronic pain, the following natural anti inflammatory products may also be helpful:
- Studies show that 2g of omega-3 fatty acids daily reduced joint pain and the need for
- NSAIDs in 59 percent of patients with neck and low-back pain.
- Boswellia affects several different enzyme systems and is very effective for arthritis and muscle pain.
- Turmeric may be protective against inflammation, Alzheimer’s, liver problems, and cancers.
- It’s a good idea to regularly include turmeric in the diet as curried spices. Taking a standardized curcumin extract, although beneficial, can be irritating to the stomach in large doses.
- Willow bark has also been shown to be effective in reducing pain and inflammation.
- Ginger, in addition to reducing inflammation, is good for those with poor circulation or nausea.
Talk to your healthcare provider before trying natural antiinflammatory products. As with any other healthcare intervention, herbs and other supplements should be selected individually, based on a patient’s history, assessment, and lab work.
Reducing the Risk
See your doctor immediately if you have:
- Stomach pain
- Dark black, tarry or bloody stools
- Vomiting of blood or materials that look like coffee grounds
To reduce your risk for developing a serious stomach problem:
- Talk to your doctor before taking any medication.
- Tell your doctor about all medications and vitamins and mineral or herbal supplements you are taking to avoid drug interactions or ingredient duplications.
- Be sure to tell your doctor if you experience any side effects from your medications.
- Talk with your doctor before taking any pain reliever for more than 10 days. Ask about alternative ways to reduce pain and inflammation.
- When taking a medication, follow the directions and be informed about its side effects.
- Never use prescription and over-thecounter pain relievers at the same time.
- Avoid or limit your use of alcohol when taking any pain medication.
Natalia Schetchikova, PHD, Writer
*This patient information page is a public service of the Journal of the American Chiropractic Association. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for a diagnosis by a specialist. For specific information concerning your health condition, consult your doctor of chiropractic. This page may be reproduced noncommercially by doctors of chiropractic and other healthcare professionals to educate patients. Any other reproduction is subject to ACA approval.