Part 1: Why taking NSAIDs for arthritis worsens the condition

Anyone who lives and walks around on this planet long enough gets at least some arthritis, but many suffer with severe, chronic pain and have developed the habit of relying on nonsteroidal anti-inflammatory drugs, NSAIDs, for arthritis pain.

The NSAID drug class includes aspirin, ibuprofen, naproxen and others, both prescription and over-the-counter varieties. Frequently taking NSAIDS for arthritis, using these drugs in order to function on a daily basis, is the exact wrong thing to do.

As a DC, you can and should do a much better job than the medical establishment typically does at giving these patients effective relief that doesn’t cause bothersome side effects or actual harm. Here’s why.

Dangers associated with NSAIDs

Prescription drugs are the third leading cause of death after heart disease and cancer in the U.S. and Europe. Around half of those who die have taken their drugs correctly; the other half die because of errors, such as too high a dose or use of a drug despite contraindications.¹

NSAIDs, specifically, have numerous side effects and negative outcomes associated with them, despite most people’s perception they are safe to take. A systematic review of 17 prospective observational studies found that 11% of preventable drug-related hospital admissions could be attributed to NSAIDs. Other research links pain medications to high blood pressure,² kidney failure,³ heart failure⁴ and ulceration of the gastrointestinal tract,⁵ and some drugs even interfere with bone repair.⁶

The most common side effects reported with NSAIDs involve the gastrointestinal tract. About 40% of NSAIDs users have stomach and intestinal symptoms, the most frequent being gastroesophageal reflux (regurgitation and/or heartburn). Other symptoms include belching, stomach pain or discomfort, bloating and nausea after eating.

One study found that in 2,000 arthritic patients, NSAID use increased ulcer risk tenfold. Almost 25% of NSAID users have ulcers.⁵ There is also a strong correlation between the use of pain medication and the symptoms of irritable bowel syndrome.⁷

NSAIDs can also be hard on the kidneys, and the connection between NSAIDs and kidney disease is interesting. On Jan. 29, 2002, the New York Times published an article discussing the prevalence of kidney disease in the NBA and basketball players’ tendency to take large amounts of ibuprofen to help deal with post-exertion aches and pains.

NSAIDs and oxidative stress

While patients can get effective temporary relief by taking NSAIDs for arthritis pain, NSAIDs perpetuate the very problem they are designed to treat, actually increasing the body’s oxidative stress — leading to further inflammation and pain. Research has demonstrated that NSAIDs interfere with protein synthesis¹¹ and the formation of cartilage,^8-10 so people taking NSAIDs for arthritis pain are actually making the underlying situation causing their pain worse.

What’s the alternative to NSAIDs for arthritis pain?

So, what can be done to relieve arthritis pain without using NSAID drugs?

Chiropractic care can help, of course, with its natural, drug-free manual therapy techniques. So can safe, effective biochemical solutions, which you can read about in part 2 of this article series.

PAUL VARNAS, DC, DACBN, is a graduate of the National College of Chiropractic and has had a functional medicine practice for 34 years. He is the author of several books and has taught nutrition at the National University of Health Sciences. For a free PDF of “Instantly Have a Functional Medicine Practice” or a patient handout on the anti-inflammatory diet, email him at paulgvarnas@gmail.com.

References

1. Gøtzsche PC. Our prescription drugs kill us in large numbers. Pol Arch Med Wewn. 2014;124(11):628-34. PubMed. https://pubmed.ncbi.nlm.nih.gov/25355584/. Accessed July 18, 2024.
2. Curhan GC, et al. Frequency of analgesic use and risk of hypertension in younger women. Arch Intern Med. 2002; 162(19):2204-2208. PubMed. https://pubmed.ncbi.nlm.nih.gov/12390063/. Accessed July 18, 2024.
3. Fored CM, et al. Acetaminophen, Aspirin, and Chronic Renal Failure. NEJM. December 20, 2001;345:1801-1808. https://www.nejm.org/doi/full/10.1056/NEJMoa010323/. Accessed July 18, 2024.
4. Feenstra J, et al. Association of nonsteroidal anti-inflammatory drugs with first occurrence of heart failure and with relapsing heart failure. Arch Intern Med. February 11, 2002;162:265-270. PubMed. https://pubmed.ncbi.nlm.nih.gov/11822918/. Accessed July 18, 2024.
5. Singh G, et al. Gastrointestinal tract complications of nonsteroidal anti-inflammatory drug treatment in rheumatoid arthritis. A prospective observational cohort study. Arch Intern Med. 1996 Jul 22;156(14):1530-6. PubMed. https://pubmed.ncbi.nlm.nih.gov/8687261/. Accessed
6. Simon AM, et al. Cyclo-oxygenase 2 function is essential for bone fracture healing. J Bone Miner Res. 2002 Jun;17(6):963-76. PubMed. https://pubmed.ncbi.nlm.nih.gov/12054171/. Accessed July 18, 2024.
7. Locke GR 3rd, et al. Risk factors for irritable bowel syndrome: role of analgesics and food sensitivities. Am J Gastroenterol. 2000 Jan;95(1):157-65. PubMed. https://pubmed.ncbi.nlm.nih.gov/10638576/. Accessed July 18, 2024.
8. Ding C, et al. Do NSAIDs affect longitudinal changes in knee cartilage volume and knee cartilage defects in older adults? Am J Med. 2009 Sep;122(9):836-42. PubMed. https://pubmed.ncbi.nlm.nih.gov/19699379/. Accessed July 18, 2024.
9. Collier S, Ghosh P. Comparison of the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on proteoglycan synthesis by articular cartilage explant and chondrocyte monolayer cultures. Biochem Pharmacol. 1991 May 1;41(9):1375-84. PubMed. https://pubmed.ncbi.nlm.nih.gov/2018569/. Accessed July 18, 2024.
10. David MJ, et al. Effect of non-steroidal anti-inflammatory drugs (NSAIDS) on glycosyltransferase activity from human osteoarthritic cartilage. Br J Rheumatol. 1992;31 Suppl 1:13-7. PubMed. https://pubmed.ncbi.nlm.nih.gov/1555049/. Accessed July 18, 2024.
11. McLaughlin T, et al. T-cell profile in adipose tissue is associated with insulin resistance and systemic inflammation in humans. Arterioscler Thromb Vasc Biol. 2014 Dec;34(12):2637-43. PubMed. https://pubmed.ncbi.nlm.nih.gov/25341798/. Accessed July 18, 2024.