The use of both over-the-counter and prescription nonsteroidal medications is frequently recommended in a typical neurosurgical practice. But persistent long-term use safety concerns must be considered when prescribing these medications for chronic and degenerative pain conditions. This article is a literature review of the biochemical pathways of inflammatory pain, the potentially serious side effects of nonsteroidal drugs and commonly used and clinically studied natural alternative anti-inflammatory supplements. Although nonsteroidal medications can be effective, herbs and dietary supplements may offer a safer, and often an effective, alternative treatment for pain relief, especially for long-term use.

People who used an ointment that contains this plant-based extract for 5 days reduced the intensity of lower back pain by 95%, according to a 2009 study conducted by Merck (which manufactures the ointment). In comparison, a placebo group had a 38% reduction in pain during that same time, according to the study in the British Journal of Sports Medicine. Look for comfrey root ointment in health food stores or online. Just don't use it for more than 10 days at a time—it can be toxic.

"I love Elemental Herbs All Good Herbal Freeze with Arnica ($20; allgoodproducts.com) because the combination of menthol and arnica is incredibly cooling. Also, it's all-natural and super easy to just spray onto my sore areas. I also like Arnica Muscle and Joint Gel by Naturopathica ($28; naturopathica.com), which is a gel. You can rub it in and it really targets the sore muscles and joints." —Holly Rilinger, master Flywheel instructor, creator of LIFTED
"Arnicare Gel ($8; target.com) had me at first application. It not only works great to help relieve any muscle pain and swelling, but it also has no scent and isn't greasy. I can apply it at night or even before a workout." —Derek DeGrazio, celebrity trainer, Barry's Bootcamp Miami Beach (See his Barry's Bootcamp-Inspired Abs, Butt, and Core Workout.)
I’m not saying NSAIDs are useless. They have their place. If you’re recovering from surgery or a major injury, traditional over-the-counter pain relievers are good for controlling inflammation, swelling, and pain, but NSAIDs are far too powerful for over-the-counter, everyday use. Unlike a lot of natural pain relievers, NSAIDs also don’t address the cause of inflammation or pain; they just mask the symptoms.
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