Some manufacturers inflate nutraceutical products’ claims and may not cite possible side effects and potential drug interactions. Bleeding complications are associated with white willow bark, ginger, garlic, and others. Therefore, such medicinal preparations are not without risk. Products such as omega-3 essential fatty acids (EFAs) (O3) do have strong scientific support to be considered as an alternative and/or complementary agent to NSAIDs. Published studies have shown the effectiveness of O3 to successfully treat spine-related pain. Capsaicin, oil of camphor, and other natural topical preparations are commonly used for muscle soreness and local application for painful traumatic injuries.[12,16,80] The subsequent sections will review many of these products and discuss both their efficacy and safety issues. As with any drug or natural compounds, additional caution should be used when considering these treatments for children, pregnant or lactating mothers or any other clinical or disease condition that could increase possible risk of side effect or complication.
Schematic showing that when a cell membrane is injured the arachidonic acid pathway is activated to initiate the local inflammatory response through the production of prostaglandins, thromboxanes, and leukotrienes. Their activation requires the enzymes COX and LOX. The NSAIDs can block COX action and thereby prevent the formation of the COX-derived inflammatory mediators. 5-HPETE = 5-hydroperoxyeicosatetraenoic acid; LTC4 = leukotriene C4; PGE2 = prostaglandin E2; PGF2 = prostaglandin F2; PGI2 = prostacyclin; TXA2 = thromboxane.
In the case of topical creams, many individuals may suffer from allergies that they weren't even aware of until they encounter a negative reaction. These reactions can range in severity from mild skin irritation to more severe issues such as inflammation and increased pain. Remember to check all the ingredients for any topical medication you buy in order to avoid potential allergens and irritants.
Aquatic therapy is essentially physical therapy in a pool. Instead of using weights for resistance, patients use the resistance of the water. Studies show it may help alleviate lower back pain. In one 2013 study, sedentary adults who underwent aquatic therapy five times a week for two months saw reductions in pain and increases in quality of life. One smaller study found that aquatic therapy also helped pregnant women who were experiencing aching lower backs.
Diclofenac is also available as a 3% gel (Solaraze; generic) that is applied to the skin to treat actinic keratosis (flat, scaly growths on the skin caused by too much sun exposure). This monograph only gives information about diclofenac gel (Voltaren) and liquid (Pennsaid) for osteoarthritis. If you are using diclofenac gel (Solaraze, generic) for actinic keratosis, read the monograph entitled diclofenac topical (actinic keratosis).
"Having excess weight pulling on your back all day (except when you're lying down) is just bad news for your back," says Lauri Grossman, DT, a licensed chiropractor in private practice in New York City. "Often times, when people who wrestle with back pain for a lifetime lose a few pounds, they find that the pain that they've taken a million medications for and a million vitamins for just goes away." If you're having trouble shedding extra pounds, consider consulting with a registered dietitian or personal trainer.
The usual dosage of standardized turmeric powder is 400–600 mg taken three times per day. Side effects are few, but with extended use, this agent can cause stomach upset, and in extreme cases gastric ulcers may occur at very high doses. Caution should be used if the patient is taking anticoagulant medications or high doses of nonsteroidal drugs. Studies have shown that curcumin may be used in combination with lower doses of nonsteroidal medications.[7–9,11,21,40,87,111,121]
PharmacyTimes.com [Internet]. Fudin J. Should Topical NSAIDs Have Strict Heart Risk Warnings?; 2018 March 10 [cited 18 Jun 12]. Although this article’s title implies concerns about topical NSAID safety, it ends up answering that concern with very reassuring data, and it turns into a piece suggesting that the FDA needs to make it clearer that only oral NSAIDs are of concern, while topical is an extremely safe alternative! “ … all topical vehicles of diclofenac delivery result in only a small fraction of the diclofenac that actually reaches the systemic circulation compared with the oral route.” BACK TO TEXT
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.