NSAIDs or non-steroidal anti-inflammatory drugs, are over-the-counter pain killers. NSAIDs are commonly used by those with rheumatoid arthritis for pain relief. However, there is evidence that NSAIDs cause more problems than they solve. So what do NSAIDs do and are there alternatives to NSAIDs for Arthritis pain?
NSAIDs for Arthritis Create More ‘Leaky Gut’ (Intestinal Permeability)
Many common rheumatoid arthritis medications also increase intestinal permeability. Therefore, in some cases, the pharmaceutical treatment of rheumatoid arthritis symptoms exacerbates the underlying cause. This leads to loss of intestinal integrity, more crossover of luminal contents into the bloodstream, and contributing to the persistence of the disease.
The worst offenders are NSAIDs which can increase leaky gut [1]. Increased small intestinal permeability caused by NSAIDs is also probably a prerequisite for NSAID enteropathy (damage or irritation of the small intestine) which may be a source of morbidity in patients with rheumatoid arthritis [2]. All NSAIDs cause leaky gut [3], including aspirin [4].
This study tested intestinal permeability in controls and in patients with active rheumatoid arthritis and found that ‘intestinal permeability in the patients was found to be significantly increased in comparison to controls’ [5]. In the study, 79% of patients taking prescribed NSAIDs had increased intestinal permeability, while 86% not taking any prescribed NSAIDs had normal results.
Is Celebrex A Good Option For Rheumatoid Arthritis?
Celebrex is meant to be better for the stomach than ‘normal’ NSAIDs. Yet one researcher said that ‘the short-term effects of (COX-2 inhibitors) on the pain and swelling of inflammation and arthritis may be achieved at the cost of an increased propensity to long-term tissue damage with which these cytokines have been associated [6].
NSAIDs Create Severe Gastrointestinal Problems – Especially If You’re Also Taking Steroids At The Same Time
As if the leaky gut issue wasn’t enough, the NSAIDs are associated with a 400% increased risk of upper gastrointestinal complications [7]. Patients using steroids alongside high-dose NSAIDs had the highest risk of upper gastrointestinal complications.
Researchers said ‘whenever possible, anti-inflammatory drugs should be taken on their own and at the lowest effective dose to reduce the risk of upper gastrointestinal complications’.
The risks are clearly higher with the NSAID and prednisone combination. A study also concluded that patients who are taking NSAIDs and prescription corticosteroids have a seven-fold increased risk of gastrointestinal bleeding [8].
Alternatives to NSAIDs for Arthritis Pain
The goal is not to stop taking NSAIDs cold turkey. The goal is to find alternatives to NSAIDs for arthritis pain that are less harmful for your body. Or even better, make different changes so that you don’t need as many (or perhaps not at all).
Change Your Diet To Lower Pain Fast
The best solution of all is to lower your pain with your diet. Then you’ll need less NSAIDs. This is hands down the most sensible solution. Most users can get off NSAIDs within a week. For more than a decade, Angelika had been taking NSAID’s for her Rheumatoid Arthritis and was able to come off them in just a few weeks by following the Paddison Program for rheumatoid arthritis.
Dusty is another user who was taking NSAID’s and prednisone together, along with a biologic drug. In this post you’ll learn how to approach using the Paddison Program when on multiple RA drugs.
Exercise So That You Sweat
By far my preferred way of reducing daily pain is to exercise. Cardiovascular exercise for more than 30min per day in which you begin to sweat will lower pain levels, guaranteed, every time. The ideal level of exercise is one in which you break a light sweat for the duration of the exercise period.
Bikram or restorative yoga is ideal. Stationary bike excellent. Swimming, rowing machine, or any other exercise that is low impact and raises your heart rate is going to be a good way to go. In addition to offering the pain relief aspect, exercise has the advantage over pills (of natural or artificial nature) because it gets the joints moving. This is good practice for preserving joints long term.
Curcumin
This has a mild effect on pain reduction for some people. Didn’t do a lot (if anything) for me. However, some clients have reported excellent pain relief from this by-product of turmeric. I see curcumin as a way of trying to transition away from NSAIDs, or at least a way of reducing the dose.
Milder Pain Relief
Some GP’s who have some general awareness of gut problems with NSAIDs recommend paracetamol instead of NSAIDs. Note that paracetamol is not really regarded as an ‘anti inflammatory’ and accordingly the pain relief also tends to be much less than NSAIDs.
Reverse The Damage NSAIDs Have Done
It is possible to reverse the damage that NSAIDs have done, even if you have been taking them for a long time. Like a wound on the outside of the body, so too does the gut heal. It does, however, take a little longer. You can heal the damage from the NSAIDs and improve your gut tremendously using the Paddison Program for Rheumatoid Arthritis.
Conclusion
NSAIDs will forever hold you back in your attempt to heal. In fact, it’s worse than this since they also actually make your rheumatoid arthritis worse. The issue is, of course, that if you’re in serious pain then you need pain relief in some format. Well, if you’re not yet on the Paddison Program to reverse your rheumatoid arthritis symptoms, then start by finding more harmless substitutes to the NSAIDs rather than coming off them cold turkey.
The best substitute is exercise. A lot of of it. You’ll turn your life around if you can substitute a bunch of NSAIDs each day for 30min+ of steady, sweaty exercise. I promise. Find an exercise that you can do each day that doesn’t aggravate your rheumatoid arthritis and start small and gradually increase each day.
References
[1] INTESTINAL PERMEABILITY AND INFLAMMATION IN RHEUMATOID ARTHRITIS: EFFECTS OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS, The Lancet, Volume 324, Issue 8413, 1984, Pages 1171-1174, ISSN 0140-6736
[2] Bjarnason I, Fehilly B, Smethurst P, et al Importance of local versus systemic effects of non-steroidal anti-inflammatory drugs in increasing small intestinal permeability in man. Gut 1991;32:275-277
[3] Sigthorsson G, Tibble J, Hayllar J, et al Intestinal permeability and inflammation in patients on NSAIDs Gut 1998;43:506-511
[4] Bjarnason I, Williams P, Smethurst P, et al Effect of non-steroidal anti-inflammatory drugs and prostaglandins on the permeability of the human small intestine. Gut 1986;27:1292-1297
[5] R. T. JENKINS, P. J. ROONEY, D. B. JONES, J. BIENENSTOCK, R. L. GOODACRE, INCREASED INTESTINAL PERMEABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS: A SIDE-EFFECT OF ORAL NONSTEROIDAL ANTI-INFLAMMATORY DRUG THERAPY?, Rheumatology, Volume 26, Issue 2, April 1987, Pages 103–107
[6] Penglis PS, Cleland LG, Demasi M, Caughey GE, James MJ. Differential regulation of prostaglandin E2 and thromboxane A2 production in human monocytes: implications for the use of cyclooxygenase inhibitors. J Immunol. 2000 Aug 1;165(3):1605-11. doi: 10.4049/jimmunol.165.3.1605. PMID: 10903770
[7] Sonia Hernández-Díaz, Luis Alberto García Rodríguez, Steroids and Risk of Upper Gastrointestinal Complications, American Journal of Epidemiology, Volume 153, Issue 11, 1 June 2001, Pages 1089–1093
[8] Ulcers and Gastrointestinal Bleeding: Protecting Your Health, American College of Gastroenterolog