Alternative Treatments: Non-steroidal Anti-inflammatory Medications (NSAIDs)

Non-steroidal anti-inflammatory medications (NSAIDs) are used to treat swelling around, and effusions within, joints. The benefit in using these medications is that the pain following injuries and surgeries often is caused or exacerbated by swollen tissues. Reducing the amount of swelling will have a direct impact on the amount of discomfort that is caused. The use of these medications has recently increased substantially. New preparations of these kinds of medications are being developed yearly and are having an increasingly beneficial effect for most people, while simultaneously reducing the side effects that they cause. The original medication in this class of drugs is every day aspirin. While aspirin is still used as an anti-inflammatory medication its large number of side effects and less specific effect on inflammation and swelling makes its use less common today.

NSAIDs work to inhibit the production of prostaglandins. Prostaglandins are the primary mediators of inflammation and swelling. While this sounds simple, prostaglandins also have other beneficial effects within the body, including protecting the lining of the stomach. While inhibiting prostaglandin production, NSAIDs will lessen the protective effect that they have in the stomach. This is the reason that the primary side effect of NSAIDs is an upset stomach and possibly some nausea.

These GI side effects can occur in approximately seven percent of individuals, and are rarely severe and usually reversible. More serious side effects occur from continual usage of NSAIDs or in individuals who have previous history of significant GI ulcer disease. For this reason, it is appropriate to monitor kidney and liver function with long-term use of NSAIDs and to be very judicious in use of NSAIDs in people with ulcer disease.

The most common anti-inflammatories used today are ibuprofen and naproxen. These go by the trade names of Advil, Motrin IB, and Aleve. These medications are sold over the counter at lower than prescription levels and are sold primarily for their pain relieving effect. At these doses they can not be assumed to have anti-inflammatory effects. Other NSAIDs include Relafen, Lodine, Voltaren, Celebrex and Vioxx. These newer generation NSAIDs have some theoretical benefits in reducing GI side effects, however the risk of these side effects has not been completely eliminated. Other medications such as Arthrotec include the active anti-inflammatory ingredient combined with a stomach protection medicine. These also reduce GI side effects but do not completely eliminate them. Use of these medications in treatment of musculoskeletal injuries is usually done for short periods of time. The use in this situation is safe, often effective and a common adjunct to standard physical therapy or activity modification treatments.

Use of NSAIDs for longer periods of time is often done for systemic arthritic problems or degenerative joint diseases. In these settings, surveillance of kidney and liver function, as well as care to be sure that exacerbation of existing ulcer disease problems do not exist, is important.