Updated: Oct 9, 2018
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed and over the counter sold drugs in the world. NSAIDs include drugs like ibuprofen, advil, celebrex, naproxen, aspirin, vioxx and more. NSAIDs are commonly used for both acute pain, chronic pain or inflammatory conditions, and many people pop an anti-inflammatory drug without hesitation. But caution should be heeded for these drugs which have a wide range of serious side effects many people are unaware of.
More than 70 million prescriptions for NSAIDs are written each year in the United States. With over-the-counter use included, more than 30 billion doses of NSAIDs are consumed annually in the United States alone.
Pain isn’t fun, and most of us will do anything to avoid it. Whether it’s niggling chronic pain, or acute sharp pain, or even just low grade systemic inflammation, pain isn’t something any of us want. Although pain, swelling and sensitivity at the site of injury can be uncomfortable and annoying, it's a necessary component of healing. Pain is an important symptom, and a powerful teacher, and the gung-ho approach to quelling pain and ‘killing pain’ fast, leaves much to be desired.
NSAIDs Should Never Be The First Step
While sometimes it may be necessary to switch off pain signalling to enable daily function, it’s not something we should encourage on a daily basis. Many of the problems with these drugs comes from chronic or unnecessary use, and it’s our opinion that there are several alternatives that offer a better solution for the body, both in the short term, and long term.
NSAIDs work to block the enzymes COX-1 and COX-2 which are responsible for creating postglandins which are chemical messengers that ignite inflammation. But postaglandins, are also beneficial as they assist healing by regulate blood clotting, protect the lining of the stomach and intestine and aid kidney function. So blocking prostaglandin function to relieve pain, can block important physiological functions and create damage.
The Problems With NSAIDs
Aside from mild symptoms like nausea, vomiting, gastrointestinal distress (diarrhea/ constipation), heart burn, ringing in the ears, decreased appetite, drowsiness, headaches and more, there are many known serious complications to these drugs:
Reduced immune function (suppression of antibodies)
Many people train while using NSAIDs which is a recipe for disaster because NSAID use in athletes has shown to have no affect on muscle soreness, and increases inflammation and endotoxemia as well as worsening kidney function and increasing oxidative stress. 'Ibuprofen aggravates exercise-induced small intestinal injury and induces gut barrier dysfunction in healthy individuals. We conclude that non-steroidal anti-inflammatory drugs consumption by athletes is not harmless and should be discouraged.” Because NSAIDS restrict blood flow, they can actually delay healing because blood carries healing plasma and leukocytes to the site of the injured tissue. Long term, chronic use can worsen the original problem by creating a viscous cycle of pain reduction, and delayed or compromised healing function.
Better Alternatives To NSAIDs
When Injury, inflammation or chronic pain strike, it's best to take an integrated approach to cover all aspects of diet, lifestyle and healing. Taking a pain pill may be necessary in certain cases, but of course this is treating the symptom, rather than getting to the root cause and healing the inflammation. The best treatment for quelling inflammation fast is an anti-inflammatory, nutrient dense diet, great hydration, quality recovery and sleep and expert management of your lifestyle and health hurters, and health promoters.
There are many factors in our environment that will increase inflammation and should be avoided or reduced accordingly to enhance the speed of recovery and reduce symptoms:
Toxic inflammatory diets full of high sugar, high processed carbohydrates, damaged industrial nut and seed oils, preservatives, poor quality factory farmed meat, alcohol etc.
Poor quality recovery and sleep
Physical, emotional lifestyle stress
poor gut health
Check out our blog on a 'Progressive Approach To Injury Management' where we recommended heat therapy, heat & cold combinations (not ice!), cold thermogenesis, subtle pain free movement within your pain threshold, vibration therapy, compression and a healthy anti-inflammatory diet.
For chronic pain (anything longer than 3 months) it's important to stop treating the site of your niggling pain and hunt for the root cause. Chronic pain can come from systemic inflammation due to poor health, stress, an inflammatory diet or over training or it can simply be from compensation patterns through your structure and posture than need addressing. If you are finding yourself getting the same treatment on a sore spot over and over, it's time to look at the whole body as a system and enhance efficiency. Seek out a movement specialist, coach or structural integration practitioner for best results in finding the root cause of your pain. In cases of chronic pain, it's imperative to move and enhance proprioception to the injured or sore part, to change the pain signalling patterns that can become stuck in the body.
Intelligent Anti-Inflammatory Options
The following recommendations are well proven to assist in healing and calming the inflammatory response. We suggest these of course, on top of a nutritious diet
EPA & DHA Omega 3 Fatty Acids
From a dietary perspective eating fish, particularly cold water fish like salmon, mackerel, tuna, anchovies etc, are a wonderful option for increasing anti-inflammatory omega 3 fatty acids. EPA and DHA have been shown to reduce inflammatory markers in a vast variety of conditions. The modern diet is high in omega 6 fatty acids, which have a pro-inflammatory effect, especially in combination with a low omega 3 intake. Increasing intake of these fish from wild caught sources, or supplementing with cod liver oil, or fish oil supplements are great ways to reduce inflammation.
Curcumin the active component of turmeric has abundant research about it's ability to down regulate inflammation, and it also promotes T-regulatory cell production and differentiation (immune function), and reduces oxidative stress. In order to get a therapeutic dose, the best supplemental form is a liposomal form which has the best bioavilalability, compared to traditional tablets or powders. Curcumin is a COX-2 pathway inhibitor, the same pathway NSAIDS block.
Boswellia / Frankincense
Boswellia is a gum resin botanical with great anti-inflammatory properties. The standard dose would be around 400mg per day unless using a more concentrated form of the most potent boswellic acid AKBA, in which the dosage would only be 100mg per day. Taking curcumin and boswellia together is a good idea because they enhance complementary pathways, so the combined effect is greater.
You can't go past vitamin C for a time tested way to reduce inflammation and oxidative stress, and improve immune function, cellular health and healing. With Vitamin C you can go up to bowel tolerance, which means taking continued doses until you saturate the bowel, and begin to notice symptoms like gas, loose stool etc, and then reduce the dose.
If connective tissue is damaged, increasing intake of grass fed, pasture raised meat sources is a good idea, especially increasing intake of collagen rich meat sources of meat of the bone, bone broth or supplementing with collagen powder to enhance the healing and restoration of your own collagen. Collagen powder is an anti-inflammatory, tasteless protein source that is easily mixed into fluids or with meals.