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STORY AT-A-GLANCE
- Non-steroidal anti-inflammatory drugs or NSAIDs are among the most widely used pain killers in the world. In the United States, more than 70 million prescriptions for NSAIDs are written each year
- Each year, an estimated 107,000 patients are hospitalized for NSAID-related gastrointestinal complications. At least 16,500 NSAID-related deaths occur each year among arthritis patients alone
- All NSAIDs, including over-the-counter aspirin and ibuprofen, are associated with potentially serious side effects such as cardiovascular problems, GI bleeding, kidney problems, and hypertension
- Most recently, a Dutch study found that use of NSAIDs may increase your risk for atrial fibrillation, a heart condition characterized by a rapid and irregular heartbeat, which increases your risk for heart failure and stroke
- 15 drug-free alternatives are reviewed, including K-Laser therapy
By Dr. Mercola
Non-steroidal anti-inflammatory drugs or NSAIDs are among the most widely used pain killers in the world. In the United States, more than 70 million prescriptions for NSAIDs are written each year.
If you include over-the-counter (OTC) NSAIDs such as ibuprofen and aspirin, more than 30 billiondoses of NSAIDs are used annually1 to relieve pain associated with everything from backaches and headaches to menstrual and rheumatoid arthritis pain.
NSAIDs work primarily by inhibiting your body's ability to synthesize prostaglandins, which are hormone-like chemicals made in response to cell injury. Unfortunately, many are completely unaware that these medications can actually cause very serious harm.
Stomach upset, nausea, and vomiting are among the most common side effects, but numerous studies have linked NSAIDs to far more adverse effects, including death.2 According to a 1998 study published in the American Journal of Medicine:3
"Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures of all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated."
NSAIDs Carry Potentially Serious Health Risks
The poster child of deadly NSAIDs is Vioxx, which was released in 2000. A year before Vioxx was approved, I warned my readers about the cardiovascular risks associated with the drug. It took four years and 60,000 deaths (due to heart-related side effects) before warnings were heeded and Vioxx was removed from the market.
In 2004, the US Food and Drug Administration (FDA) also cautioned that NSAIDs, including COX-2 inhibitors like Bextra (which was removed from the market in 2005) and Celebrex, along with other over-the-counter varieties like Aleve, ibuprofen, and aspirin, are all associated with potentially serious side effects, including:
- Cardiovascular problems
- GI bleeding4
- Ulcers
- Kidney problems
- Increased blood pressure
In February this year, the FDA took another look at the heart risks associated with various NSAIDs. Some research had indicated that naproxen might be less risky than other NSAIDs, but the panel ultimately voted 16-9 against changing the warning label on naproxen to suggest it's safer for your heart other drugs in this class.5
Avoid NSAIDs During Pregnancy, and When You Have a Cold
Pregnant women were especially warned against using NSAIDs. One study reported that prescription and OTC non-aspirin NSAIDs, such as diclofenac (Voltaren), naproxen (Aleve), celecoxib (Celebrex), and ibuprofen (Advil), increased their risk of miscarriage.
As mentioned earlier, these drugs suppress the production of prostaglandins, which are needed for successful implantation of the embryo in the womb. Other pregnancy-related side effects linked to NSAIDs include heart problems in the offspring, low amniotic fluid, and prolonged labor.
If you're in the habit of taking aspirin or acetaminophen when you have a cold, beware that previous research has also found that these drugs suppress production of antibodies and increase cold symptoms, with a trend toward longer infectiousness.
In test-tube studies, therapeutic levels of aspirin were found to suppress the ability of human white blood cells to destroy bacteria. Another study found that a host of pain relievers, including aspirin and ibuprofen, inhibited white-cell production of antibodies by as much as 50 percent.
NSAIDs Again Linked to Increased Heart Risks
Most recently, a Dutch study published in BMJ Open6 found that use of NSAIDs may increase your risk for atrial fibrillation, a heart condition characterized by a rapid and irregular heartbeat. This condition in turn increases your risk of heart failure and stroke. As reported by Counsel & Heal:7
"[T]he researchers... analyzed a wide variety of NSAIDs, such as aspirin, ibuprofen, naproxen, Toradol, Aleve and Celebrex. The team studied 8,423 participants who had an average age of 68 at the beginning of the study and did not have atrial fibrillation. The participants were monitored over an average of 13 years...
The researchers found that participants who used NSAIDs were 1.8 times more likely to be diagnosed with atrial fibrillation in comparison to people who did not take the pain relievers. People who were chronic and current users had a 76 percent increased risk of atrial fibrillation."
Previous research has shown that rofecoxib (Vioxx) and lumiracoxib (Prexige) (both withdrawn from the market) were associated with twice the risk of heart attack, while ibuprofen was associated with more than three times the risk of stroke. Etoricoxib (Arcoxia) and diclofenac were associated with the highest risk of cardiovascular death.
Truth be told, it's very difficult to find a drug-based method of pain relief that is not saddled with severe side effects. (The FDA also recently limited the amount of acetaminophen allowed in prescription products and added a boxed warning due to liver toxicity concerns.)
As a general rule, I advise you to avoid ALL medications, including OTC drugs, to the greatest extent that you possibly can. It's important to realize that just because you don't need a prescription doesn't mean that a drug is harmless. This is particularly important to remember if you're using OTC drugs for your children. As senior author of the featured study, Dr. Bruno H. Stricker, told the New York Times:8 "I would really strongly advise that older people be very careful with using these drugs. They don't do anything except relieve pain. Pain is a nuisance, but dying is a nuisance, too."
There Are Many Ways to Address Pain Without Drugs
In related news, PreventDisease.com9 recently ran an article covering nine different pain killers alternatives to NSAIDs. Their list includes the following. For the rest, please see the original article:
•Boswellia: Also known as boswellin or "Indian frankincense," this herb contains specific active anti-inflammatory ingredients. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
•Curcumin: In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility. A past study also found that a turmeric extract composed of curcuminoids blocked inflammatory pathways, effectively preventing the overproduction of a protein that triggers swelling and pain.10
•Medical cannabis has a long history as a natural analgesic.11 At present, 20 US states have legalized cannabis for medical purposes. Its medicinal qualities are due to high amounts (about 10-20 percent) of cannabidiol (CBD), medicinal terpenes, and flavonoids. As discussed in thisprevious post, varieties of cannabis exist that are very low in tetrahydrocannabinol (THC)—the psychoactive component of marijuana that makes you feel "stoned"—and high in medicinal CBD. The Journal of Pain,12 a publication by the American Pain Society, has a long list of studies on the pain-relieving effects of cannabis.
•Capsaicin or cayenne cream. Capsaicin, the active ingredient in hot chili peppers, helps alleviate pain by depleting your body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.
•Devil's Claw. A South African herb found to be particularly effective against pain caused by inflammation, including arthritis and muscle pain. According to Prevent Disease:
"Some evidence suggests that devil's claw works about as well as pain relieving drugs for improving osteoarthritis pain in the hip and knee... This evidence comes from a study that used a specific powdered devil's claw root product (Harpadol, Arkopharma) containing 2% of the devil's claw ingredient harpagoside (9.5 mg/capsule) and 3% total iridoid glycosides (14.5 mg per capsule)."
K-Laser Class 4 Laser Therapy
If you suffer pain from an injury, arthritis, or other inflammation-based pain, I'd strongly encourage you to try out K-Laser therapy. It can be an excellent choice for many painful conditions, including acute injuries. By addressing the underlying cause of the pain, you will no longer need to rely on painkillers. K-Laser is a class 4 infrared laser therapy treatment that helps reduce pain, reduce inflammation, and enhance tissue healing—both in hard and soft tissues, including muscles, ligaments, or even bones. These benefits are the result of enhanced microcirculation, as the treatment stimulates red blood cell flow in the treatment area. Venous and lymphatic return is also enhanced, as is oxygenation of those tissues.
Even if you live the healthiest lifestyle possible it seems life invariably will throw us all curveballs where we get injured and have pain. That is why I obtained a K-Laser for my clinic and personal use and would really never want to be without one. The infrared wavelengths used in the K-Laser allow for targeting specific areas of your body, and can penetrate deeply into the body to reach areas such as your spine and hip. For more information about this groundbreaking technology and how it can help heal chronic pain, please listen to my previous interview with Dr. Harrington.
Other Drug-Free Solutions for Pain Relief
Given the risks associated with NSAIDs and other pain relieving drugs, such as narcotic painkillers(which now kill more people than murders and fatal car accidents in the US), I strongly recommend investigating safer options. And there are many. In addition to the alternatives already mentioned above, the following options can also provide pain relief.
- Eliminate or radically reduce processed foods, grains, and processed sugars from your diet. Avoiding grains and processed sugars will lower your insulin and leptin levels and decrease insulin and leptin resistance, which is one of the most important reasons why inflammatory prostaglandins are produced. That is why stopping sugar and sweets is so important to controlling your pain and other types of chronic illnesses.
- Start taking a high-quality, animal-based omega-3 fat. My personal favorite is krill oil. Omega-3fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work; they manipulate prostaglandins.)
- Optimize your production of vitamin D by getting regular, appropriate sun or safe tanning bed exposure, which will work through a variety of different mechanisms to reduce your pain.
- Emotional Freedom Technique (EFT) is a drug-free approach for pain management of all kinds. EFT borrows from the principles of acupuncture, in that it helps you balance out your subtle energy system. It helps resolve underlying, often subconscious, negative emotions that may be exacerbating your physical pain. By stimulating (tapping) well-established acupuncture points with your fingertips, you rebalance your energy system, which tends to dissipate pain.
- Chiropractic. Many studies have confirmed that chiropractic management is much safer and less expensive than allopathic medical treatments, especially when used for pain, such as low-back pain. Qualified chiropractic, osteopathic, and naturopathic physicians are reliable, as they have received extensive training in the management of musculoskeletal disorders during their course of graduate healthcare training, which lasts between four to six years. These health experts have comprehensive training in musculoskeletal management.
- Acupuncture can also effectively treat many kinds of pain. Research has discovered a "clear and robust" effect of acupuncture in the treatment of: back, neck, and shoulder pain, osteoarthritis, and headaches.
- Physical therapy has been shown to be as good as surgery for painful conditions such as torn cartilage and arthritis.
- Astaxanthin is one of the most effective fat-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than anti-inflammatory drugs. Higher doses are typically required and one may need 8 mg or more per day to achieve this benefit.
- Ginger: This herb has potent anti-inflammatory activity and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
- Bromelain: This enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form but eating fresh pineapple, including some of the bromelain-rich stem, may also be helpful.
- Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used this for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. I used a topical preparation for this.
- Evening primrose, black currant and borage oils: These contain the essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain.
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