Most people think of them as innocent little pills. Headache, pop one; backache, take another; arthritis, take them all the time. But those innocent looking bottles of pain relief may carry some serious health risks. I'm referring to the NSAIDs (non-steroidal anti-inflammatory drugs) in just about everyone's medicine cabinet. You know them by the names ibuprofen, (Advil and Motrin) and naproxen (Aleve), aspirin and acetaminophen (Tylenol). NSAIDs are estimated to be responsible for up to 20 percent of hospital admissions for congestive heart failure (1).
According to the latest research from Copenhagen University, heart attack survivors taking ibuprofen-based NSAIDs were 45 percent more likely to suffer a second attack when taking NSAIDs, especially at prescription dosages (2). Studies showing a variety of toxic effects from NSAIDs have been around for years, yet these studies receive little attention. In 2007, a study showed that NSAIDs had been found to increase an existing risk of heart attack or stroke in people who suffer from arthritis (3).
Data analyzed on 114,460 women in the California Teachers Study showed "Ibuprofen use was associated with an increased risk of breast cancer, and long-term daily aspirin use was associated with an increased risk of ER/PR-negative breast cancer (4)." High blood pressure is also correlated to NSAID use (5).
Even though the FDA now requires a black box warning on some NSAIDs (the strongest warning possible on an over-the-counter product) the general public seems unaware of the very real dangers of taking NSAIDs long term and at high doses.
Beyond the risk factors, there are side effects of NSAIDs use you should be familiar with. Stomach upset or indigestion is the most common side-effect, including nausea, vomiting, heart-burn (otherwise known as GERD) , bleeding stomach ulcers and diarrhea, as well as other GI events (i.e. gastrointestinal bleeding) with ibuprofen based NSAIDs. Liver damage can also result from acetaminophen based pain killers. Hundreds of thousands of hospitalizations each year result from overuse of these drugs, many from unnecessary prescriptions (6). Other common adverse reactions to NSAIDs include higher than normal liver enzymes, constipation, headaches and possible allergies.
Over-the-counter (OTC) doesn't necessarily mean it's completely safe. Depending on your own use and dosage, side effects can be minimized and these products can be used safely. But you should be aware that relying on NSAIDs to manage severe to even moderate pain does carry risks.
Eastern medicine philosophies recognize pain as the body's early warning signal. It's the lights blinking at the train track telling you stop, look and listen to your body. It wants to tell you something is wrong. When you take NSAIDs, you mask these pain signals and possibly ignore your body's warning signs. Even though big box stores sell ibuprofen in bottles of 250 and 500 pills to a bottle, not all Americans seem to have bought into the idea that quick fix pill popping for pain is the only answer.
Other Alternatives
Acupuncture and Chinese herbs have served as natural pain relievers for centuries. Studies on the therapeutic effects and pain reduction of acupuncture are ample and pain management is one area acupuncture is widely accepted as being successful. Here's just one story from another Huffington Post blogger who helped to resolve years of pain with acupuncture treatments. This is just one of thousands of stories that play out each day in acupuncture offices across the country and around the world.
Acupuncture is not the only option. There are a wide variety of choices used for centuries in the East and around the world. Meditation, relaxation techniques, manual therapies such as massage, spinal manipulation, exercise forms such as yoga and Tai Chi all show promise for contributing to the management of pain, according to research presented at the Annual Scientific Meeting of the American Pain Society on May 19, 2011 (7).
Josephine Briggs, M.D., director of the National Center for Complementary and Alternative Medicine at the National Institutes of Health said in her keynote address at the American Pain Society Conference that these approaches are widely used by Americans as part of the management of painful conditions including headache, back or neck pain and arthritic or other musculoskeletal pain. There are numerous published studies on tai chi for fibromyalgia, meditation, yoga and acupuncture for low back pain and Briggs emphasized that symptom management is where NCCAMs research can have the greatest impact. The NCCAM is building a strong evidence base for these alternatives for pain management.
Chinese herbal alternatives offer additional remedies to OTC pain relievers and are just beginning to get the attention of Westerners. Throughout Asia, you can find an abundant variety of herbal pain patches, oils and creams for topical pain relief. Visit any Chinatown drug store and some of the same selection is available. Many are also available on the internet. These types of topical products are perfect for acute overuse injuries, which are often sports related.
Topical use is just the beginning of what Chinese herbal medicine offers. For chronic and acute pain relief there are standardized formulas for just about every imaginable pain: headaches, backaches, menstrual cramps, leg cramps, rib pain, arthritis pain, joint pain, etc. These herbal pain relievers are usually made from groups of herbs because Chinese herbal medicine almost always uses herbs in combinations or formulas rather than single herbs. But one single herb standout does come to mind and that is Boswellia Serrata, otherwise known as Frankincense or Indian Olibanum.
According to Traditional Chinese Medicine, boswellia can help to alleviate pain by invigorating the blood, relaxing the sinews and reducing swelling. In more Western medical terms, it is called an anti-inflammatory and used for arthritis support. Ancient cultures understood the very special healing properties of boswellia and, therefore, it has always been highly valued. The veterinary world has many products containing boswellia and, more often than not, it is used in combination with other herbs, some which may improve digestion and absorption.
Chinese herbs are most effective when recommended by your health practitioner for your particular symptoms. Most licensed Acupuncturists also study Chinese herbal medicine in the U.S. and many write custom formulas for their patients which can be filled by the growing number of herbal pharmacies from coast to coast. Herbal prescriptions come in the form of pills, powders, tinctures, pouches of herbal tea or raw herbs you cook for yourself at home.
Here on the West Coast, we have pharmacy chains such as Pharmaca and I know People's Pharmacy in Texas carries an excellent variety of Chinese herbal pain relief solutions and have licensed practitioners in the stores to help answer questions. Regardless of the modality you choose for pain relief, know the side-effects and be aware there are a variety of reliable choices without risks. The benefits will certainly be more lasting than a short acting pain pill.
1. http://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.110.004671v1
2. The Archives of Internal Medicine http://archinte.ama-assn.org/cgi/content/abstract/160/6/777
3. The Journal Annals of Rheumatic Diseases 2007 Jun;66(6):764-70. Epub 2007 Apr 5.
4. Journal of the National Cancer Institute. 2005;97:805-12. http://www.calteachersstudy.org/publications_05_05.html
5. Journal Hypertension November 2002 20(11):2301-2307)
All India Institute of Medical Sciences, New Delhi, India. http://www.ncbi.nlm.nih.gov/pubmed/20006955
6. Over the counter non-steroidal anti-inflammatory drugs and risk of gastrointestinal bleeding Authors: Blot W.1; Mclaughlin J.1 Source: Journal of Epidemiology and Biostatistics, Volume 5, Number 2, 1 February 2000, pp. 137-142(6)
7. www.ampainsoc.org.