Water, Menthol, MSM, Glycerin, Dipropylene Glycol, Celadrin, Camphor, Cetearyl Alcohol / Cetearyl Glucoside, Beeswax, Microcrystaline Wax, Butylglycerin, Kyounin Yu, Macadamia, Integrifolia Seed Oil, Glyceryl Stearate / PEG-100 Stearate, Dimethicone, Hyaluronic Acid, Portulaca Oleracea Extract, Allantoin, Licorice Root Extract, Arginine, Carbomer, Lavender Oil, Peppermint Oil, Disodium EDTA, Polyacrylate-13/Polyisobutene / Plysorbate 20
Acetylsalicylic acid works by irreversibly disabling the COX enzymes to block the cascade [Figure 1]. NSAIDs have evolved from blocking both COX-1 and COX-2 to selectively only blocking COX-2 in order to inhibit the inflammatory response and reduce the production of inflammatory prostaglandins and thromboxanes. The major push to develop the selective COX-2 inhibitors has been the recognition of significant complications associated with the nonselective COX-1 and COX-2 NSAIDs. Nonselective NSAIDs’ major side effects include significant gastrointestinal upset, gastritis, ulceration, hemorrhage, and even death. By locking COX-1, which also normally acts to protect the gastrointestinal mucosa, nonselective NSAIDs and aspirin can cause significant gastric tissue damage.[34,51,78,91,3,101,115]

Cognitive Behavioral Therapy (CBT). In CBT, a psychotherapist helps you identify problematic behaviors (like becoming less active or doing fewer fun activities in response to pain), negative thoughts (about self, others and the future) and feelings (depression, guilt, anxiety). This can increase your awareness of how problematic patterns develop and help you understand the connection between thought patterns and feelings. You are then trained in pain coping skills, such as relaxation techniques, imagery, and goal setting, encouraging you to have an active role in managing and controlling pain. CBT can increase your ability to control pain while acknowledging that there may be occasionally flares beyond your control.
Traditional wisdom says that NSAID pain relievers only damage your gut lining if you take them every day for a long time, but recent research disagrees. High-level athletes with stress-related intestinal damage tried taking ibuprofen to improve muscle soreness and recovery. Ibuprofen ended up damaging their gut lining even further after just a couple weeks; it increased inflammation and made their original pain issues worse.[3] In fact, a single dose of aspirin can significantly increase your intestinal permeability.[4]
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