On September 30, 2004, Merck Research Laboratories announced the global withdrawal of rofecoxib (Vioxx), its primary selective COX-2–inhibiting NSAID.[52,90,122] Analysis of the results of the Adenomatous Polyps Prevention on Vioxx study (known as the APPROVe study) showed that there was double the risk of serious thromboembolic events, including myocardial infarction, which became apparent after 18 months of Vioxx treatment.[26] Selective COX-2 NSAID’s thrombotic mechanism of action is based on COX-1’s unopposed action to continued platelet synthesis of thromboxane. Thromboxane is a thrombogenic and atherogenic eicosanoid. Prostacyclin prevents formation of platelet clotting. By inhibiting COX-2 that blocks production of prostacyclin (PGI2) there is unopposed thromboxane which will increase the clotting risk. Thus, inhibiting prostacyclin led to the increased risk of thrombotic cardiovascular and cerebrovascular events.[5,26,73,123]
The benefits of heat therapy are twofold: it increases the flow of healing oxygen and nutrients to the damaged area, and it suppresses pain signals. Some find that wearing a heat wrap, such as those from ThermaCare, is best because it releases a low level heat for several hours and can be worn under clothes so you can remain mobile. You can also combine the benefits of aromatherapy and a heat by adding an essential oil to the hot pack; you can experiment by making your own microwaveable heating pad at home and adding different essential oils to see what works best for you.
One of the problems with pain relief creams is that application can become messy. It can be difficult to keep the cream contained to the area of skin that needs treating, and if you get the product on your hands, it’s easy to accidentally rub it into the eyes, which can be painful! To the rescue: Roll-on formulas, like Outback All-Natural Pain Relief, which allow for hands-free and targeted pain relief. The product contains just four ingredients: tea tree oil, vanilla, eucalyptus, and olive oil. The ingredients ease pain by reducing inflammation.
Zeng C, Wei J, Persson MS, et al. Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies. Br J Sports Med. 2018 Feb. PubMed #29436380. “Topical NSAIDs were effective and safe for OA. Diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal AEs were observed in trials or the general population.” BACK TO TEXT
In summer 2018 I had my first personal experience with dramatic relief from Voltaren Gel (topical diclofenac). It’s not the first time I have found it useful, but it was the first time it was amazing. I’d been having some unexplained knee pain intermittently for several weeks when it kicked up a notch or two and became constant and even started waking me up at night. When I finally remembered to try Voltaren Gel — I’m not sure what took me so long — things were bad enough that it was going to be obvious if it worked. And it was! After many days of constant discomfort ranging from 3-6 on a 10-scale, it just ended: half an hour after applying the stuff, I simply didn’t have that problem anymore. Hallelujah! It’s been weeks since then with no relapse. Although the pain was not terrible, this is actually one of the clearest examples of pain relief from any treatment that I’ve ever enjoyed.
ASU is a vegetable extract made from the oil of avocados and soybeans that is said to slow the progression of osteoarthritis. It slows down the production of inflammatory chemicals in the body and thus the breakdown of cartilage in the joints. It has also been found to spur new cartilage cell growth. It is available in capsule form at a recommended 300 mg daily.
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]