NSAIDs are popular painkillers that many people use to manage pain, including the aches associated with arthritis. There has been a lot of press recently about the potential harm that taking excessive amounts of NSAIDs can cause, some of which needs significant clarification before we jump to conclusions! However, for many people living with chronic conditions like osteoarthritis, NSAIDs can help them get by. So how do NSAIDs work and should you use them if you have arthritis?
What are NSAIDs?
Non-steroidal anti-inflammatory drugs (NSAIDs) are common painkillers used to relieve pain, bring down high temperatures, and lessen inflammation. They are typically used to help with cold and flu, period pain, headaches, sprained or strained muscles and toothache etc. NSAIDs are available as capsules, tablets, creams, gels, injections and suppositories. You can buy lower doses of some NSAIDs from shops and pharmacies, and you can also be prescribed stronger NSAIDs if necessary.
Ibuprofen is the most commonly known NSAID, and is an everyday painkiller used for minor aches and pains, colds, inflammation and arthritis. Other types include Naproxen (used to reduce fever and mild swelling and pain in the joints), Diclofenac (often used for aches and pains, as well as problems with joints, muscles and bones) and Aspirin (used for aches and pains, toothache and headaches).
How do NSAIDs work?
We experience pain because of the electrical signals our nerves are sending to the brain. When we get hurt, our body releases prostaglandins, which are hormone-like fatty compounds called lipids which coordinate different functions in the body. Unlike hormones, which are produced by the endocrine glands, prostaglandins are made by the tissues in the damaged area.
They can, among other things, increase pain perception, activate or inhibit blood clots, and cause fever. Prostaglandins trigger an inflammatory response, which in the short term helps your immune system heal the affected area. Sometimes, however, the body produces too many prostaglandins, which can lead to lingering inflammation and chronic pain.
NSAIDs block specifically the effects of Cox-1 and Cox-2 enzymes, which make prostaglandins. So NSAIDs reduce pain by stopping the body making too many prostaglandins.
How can NSAIDs help osteoarthritis?
For many people living with osteoarthritis NSAIDs can play a key role in their pain management of the condition. They do this by:
- Reducing inflammation in the joint impacted by osteoarthritis and therefore helping to manage the pain
- Reducing pain and therefore helping osteoarthritis sufferers move the joint more
Depending on the severity of the pain caused and the state of the cartilage in the joints some patients might be prescribed stronger NSAIDs in order to help manage the pain. But in most cases over-the-counter NSAIDs will be sufficient to help get through the pain of osteoarthritis.
What can be taken alongside NSAIDs?
If you’re living with a chronic pain condition, it can feel like pharmaceutical painkillers are the only option. For some they are not always an option as they may interact negatively with other medications being taken. For example, people taking blood thinners are advised against using NSAIDs. For those that can take NSAIDs, it’s worth exploring what might be able to be taken either alongside or instead of traditional painkillers.
If your current medication is contraindicated with NSAIDs, then alternative therapies such as exercise, massage, relaxation, acupuncture, hot and cold therapy, and eating a healthy, balanced diet rich in antioxidants and nutrients can all help with arthritic pain.
Drug free topicals (like patches or creams) containing capsaicin, menthol and/or camphor can ease aches and pains by blocking the nerves sending pain signals to the affected area.
FlexiSEQ is a topically applied gel that lubricates the cartilage in joints to relieve pain and stiffness and improve impaired joint function associated with all stages of osteoarthritis. FlexiSEQ contains billions of plant-based, oily droplets called Sequessomes™. Activated when the gel dries on the skin, these tiny, flexible droplets pass through the skin and into target joints, where they localise on cartilage surfaces to form a lubricating layer that protects damaged cartilage. FlexiSEQ is available in two formulations:
- FlexiSEQ Joint Wear and Tear – is the mildest formula and helps to restore joint function, relieve pain and improve mobility in adult patients who have received a diagnosis of osteoarthritis or joint wear and tear
- FlexiSEQ Max Strength – is the strongest formula that contains the maximum concentration of Sequessomes™, and helps to restore joint function, relieve pain and improve mobility in adult patients who have received a diagnosis of osteoarthritis and need maximum strength relief
Both formulations are drug free and can be used long term and alongside medications without drug interactions or exacerbating pre-existing conditions and are suitable for all synovial joints.
What are the potential risks of NSAIDs?
You should speak to your doctor or pharmacist before taking NSAIDs if:
- You are over 65
- You are pregnant or trying to get pregnant
- You have asthma
- You have had a previous allergic reaction to an NSAID
- You have had stomach ulcers
- You have any issues with your blood pressure, circulation, bowels, kidneys, liver, or heart
- You are taking other medications
NSAIDs do sometimes come with side effects. These side effects are more common with higher doses that are usually prescribed, while over-the-counter NSAIDs usually have less side effects. This is a key point to remember as many people living with osteoarthritis will be able to get by with over-the-counter NSAID products and therefore the risk of side effects is reduced.
Possible side effects associated with NSAIDs include:
- Around 40% of people who use NSAIDs have upper gastrointestinal (GI) symptoms like regurgitation, heartburn, bloating, and belching, according to a 2022 survey. People can also get other indigestion related symptoms, like diarrhoea
- There’s a correlation between the use of pain medication and irritable bowel syndrome (IBS)
- Stomach ulcers
- Headaches
- Dizziness
- Drowsiness
- Allergic reactions
- In rare cases, strokes, heart attacks, heart failure, and other problems of the liver, kidneys, heart, and circulation
- It is possible and very dangerous to overdose on NSAIDs. Call your doctor or 111 immediately if you take too many, and call 999 if you start losing consciousness, having seizures, or are having trouble breathing
- NSAIDs can also interact unpredictably with other medications, including other NSAIDs, diuretics, lithium, methotrexate, and selective serotonin reuptake inhibitors (SSRIs)
The key to managing a chronic condition like osteoarthritis is to find a pain management regime that works for you. That might be taking NSAIDs combined with something like FlexiSEQ and seeing if, over time, you can reduce the amount of NSAIDs needed. If not, just ensure you are only taking them when the pain becomes too much to bear. And in these instances you must be sure to follow the instructions on the pack. Most over-the-counter NSAIDs recommend they should not be taken for more than 10 days straight.
What do you think of NSAIDs? Do you use NSAIDs to help manage your arthritis pain? Let us know on Facebook!
