NSAIDs and Possible Alternatives

What should I be using NSAIDs for?

NSAIDs are often used for low grade acute pain like headaches, small injuries, or lower back pain (LBP). NSAID medications are well researched and proven; they are most effective for short-term use once in a while. Some doctors feel that drugs like NSAIDs are never necessary or advised because they feel there are better ways to treat the pain with no possibilities of harmful side effects. Most doctors have no problem with suggesting NSAIDs, but almost all doctors are against long-term use of NSAIDs. So, in short, you might want to consider NSAIDs if you have a day-long headache, or a week long injury. You should never consider NSAIDs as a pain management option for chronic conditions like back pain that you need to find a relief from every day for the next ten years. NSAIDs could have harmful side effects for you, but the chances of having severe harmful side effects is drastically increased after taking the drug 30 days or longer.

Harmful side effects of NSAIDs

Common side effects include high blood pressure, fluid retention, and kidney problems, but maybe the most notable side effects are upset stomachs, ulcers, or stomach bleeding. As the COX enzymes are blocked, stomach lining is often striped and causes these stomach issues. If you get any of these side effects, stop taking NSAIDs, the side effects are harmful and might cause long-term damage. Over the last few weeks I have met many people who took NSAIDs long-term for chronic conditions like arthritis. Now, many of them are living with the consequences and can never take NSAIDs again. Most described to me that toward the end of their time chronically taking the drug that they no longer felt relief because their body became so used to and resistant toward the drug. They had to decide to either take more pills, poison their bodies more and feel pain relief, or, stop taking NSAIDs altogether and find an alternative. When they stopped taking NSAIDs regularly, but attempted to take it on occasion, they were usually doubled over in pain with ulcers throwing up blood from their stomach. Their stomachs were stripped from any protective layer by the years of taking the drug, and they became over-sensitized to NSAIDs. These people were forced to look for alternatives to NSAIDs and have done so with success. One of my main goals of this project is to highlight some of the alternatives so that it is never necessary to take NSAIDs.

Some possible alternatives

The effectiveness of herbal medicines that relieve pain have been debated for decades. Some say they can be equivalent pain relievers to NSAIDs. Homeopathic treatments such as Arnica Montana, Devil’s Claw, and Willow Bark are all said to reduce swelling and relieve pain but are not as significantly proven as NSAIDs. It is very possible that Devil’s claw (Harpagophytum procumbens) and willow bark (Salix alba) could help reduce pain. The Devil’s Claw roots contain harpagoside, a substance that is believed to be an anti-inflammatory compound. Devil’s Claw’s effectiveness is much debated. Willow Bark contains the chemical salicin. Scientists believe that the chemical salicin is an anti-inflammatory ingredient, but it is not well proven. There is less evidence that either could help reduce inflammation. Both homeopathic remedies need to have further research done to have sufficient evidence to fully suggest that they are effective pain remedies. After there is sufficient evidence that they relieve pain, there would need to be studies on the ideal dosages, ideal forms of the plant for consumption, and adverse effects.

In Chrubasik et al., (1996), the lack of research toward herbal medicine was explained in a way that made sense. “Some herbal remedies that predated the need for randomized clinical trial have become established pillars of contemporary therapeutics, while others of more recent popularity are regarded with condescension by the medical establishment because they have not yet been put to the conventionally approved test.” Some believe in the herbal remedies because they have been used since ancient times, while others need to see recent and approved evidence that supports the claims. Presently, there needs to be more research to definitively show that devil’s claw and willow bark relive pain, but there is a good start in that direction.

There might be huge advantages to homeopathic pain relievers. Standard drugs like NSAIDs can have harmful side effects, especially on the gut, but other more natural options might have fewer. “The plant extract does, however seem to be free of side effects,” (Chrubasik et al., 1996). This is great news. But, again, this too needs to be researched more thoroughly. Some articles addressed above suggested that there could be adverse effects to the gut as well. “It is recommended that the use of Salix (salicin medication) preparations be avoided in patients who are sensitive to salicylates,” (Chrubasik et al., 2000). Some patients in that study were reported with gut problems. But in the same study, willow bark was suggested to those who can’t handle NSAIDs. “These drugs [PAIDs (Phyto-anti-inflammatory drugs)] produce potent analgesia with a significantly lower risk of gastrointestinal toxicity,” (Chrubasik et al., 2001). Through the studies I’ve read and analyzed, both plant-based relievers, Devil’s Claw and willow bark, showed positive tendencies. Clearly more research is necessary to have more concrete evidence and answers, but overall, I would suggest Devil’s Claw and willow bark as alternatives to NSAIDs for pain relief.

As a side note: if you are interested in reading my literature review on Devil’s Claw and willow bark, feel free to contact me via email.

Chrubasik, S., et al. "Effectiveness of Harpagophytum procumbens in treatment of acute low back pain." Phytomedicine 3.1 (1996): 1-10.

Chrubasik, Sigrun, et al. "Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study." The American journal of medicine 109.1 (2000): 9-14.

Chrubasik, S., et al. "Treatment of low back pain with a herbal or synthetic anti‐rheumatic: a randomized controlled study. Willow bark extract for low back pain." Rheumatology 40.12 (2001): 1388-1393.