Problems With NSAIDs

Pain Management Options and Issues

What are my options?

Why Drug Pain Relievers Aren’t the Solution

Pain relievers such as Tylenol or Ultram can be used to relieve pain, but they do not decrease inflammation, and have proven dangerous to your liver. In fact, FDA research has shown that acetaminophen, the active ingredient in Tylenol, is the leading cause of liver failure in the United States.

As a result, on April 30, 2010, the FDA issued a recall for more than 40 types of liquid formulations of Johnson & Johnson infant and children’s Tylenol, Motrin, Zyrtec and Benadryl products.

Full Tylenol, Motrin, etc. Recall List

Tthe FDA is looking into reports of at least 775 serious side effects from drugs recalled by McNeil. It is also investigating the reports of seven deaths since May 1, when the FDA Johnson & Johnson McNeil recall was announced.

In addition, the FDA is requiring the manufacturers of many other popular over-the-counter (OTC) pain drugs, such as Motrin, Advil and aspirin, to include prominent warnings on their labels about potential side effects like internal bleeding and liver damage.

The warnings will apply to any medications that include acetaminophen, the active ingredient in Tylenol, or drugs that are in a class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin (marketed as Bayer), ibuprofen (marketed as Advil and Motrin), naproxen (marketed as Aleve, Naprosyn, Anaprox and Naprelan) and ketoprofen (marketed as Orudis and Oruvail).

Problems with NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

(Such as: Ibuprofen, Motrin, Advi; aspirin; Naproxen,Aleve, Prevacid)

Anti-inflammatory medicines inhibit the healing process of soft tissues. The long-term detrimental effects far outweigh the temporary positive effect of decreased pain. When a ligament or tendon is injured, prostaglandins are released which initiate vasodilation in non-injured blood vessels. This enables healthy blood vessels to increase blood flow and immune cell flow to the injured area to begin the repair process. The use of anti-inflammatories inhibits the release of prostaglandins thus ultimately decreasing the blood flow to the injured area. 28

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay treatment for acute ligament and tendon injuries, yet efficacy in their usefulness is lacking.29 Worse yet is the long-term use by people with chronic pain. Studies in the use of NSAIDs for chronic hip pain revealed an acceleration of arthritis in people taking NSAIDs. 30,31,32

In one study, 84% of the people who had progressive arthritis were long-term NSAID users. The conclusion of the study was “this highly significant association between NSAID use and acetabular destruction gives cause for concern.” 33

Eventually the medicine does not stop the pain because the arthritis process is actually accelerating while taking the medicine. Even long-term aspirin use has been associated with accelerating hip damage from arthritis. 34

Osteoarthritis and other chronic pain disorders are not a Motrin or NSAID deficiency. This is why the use of these drugs will never cure any disease. In summary, their chronic long-term use will not cure, and will hamper soft tissue healing, and will accelerate the arthritic process.

To alleviate your pain, it is recommended to seek treatments that increase blood flow and immune cell migration to the damaged area which will aid in ligament and tendon healing.

Better Options?

Physical therapy, massage, and myofascial release all improve blood flow and assist soft tissue healing. However, physical therapy, massage, and myofascial release are expensive, time-consuming, and can even increase pain and discomfort.


27 Mishra, D. “Anti-inflammatory medication after muscle injury: A treatment resulting in short-term improvement but subsequent loss of muscle function.” Journal of Bone & Joint Surgery. 1995; 77A:1510-1519.

28 Hardy, M. “The biology of scar formation.” Physical Therapy. 1989; 69:12

29 DuPont, M. “The efficacy of anti-inflammatory medication in the treatment of the acutely sprained ankle.” The American Journal of Sports Medicine. 1987; 15:41-45.

30 Newman, N. “Acetabular bone destruction related to nonsteroidal anti-inflammatory drugs.” The Lancet. 1985; July 6: 11-13.

31 Serup, J. and Oveson, J. “Salicylate arthropathy: accelerated coxarthritis during long-term treatment with acetyl salicylic acid.” Paxis. 1981; 70:359.

32 Ronningen, H. and Langeland, N. “Indomethacin treatment in osteoarthritis of the hip joint.” Acta Orthopedica Scandanavia. 1979; 50:169-174.

33 Newman, N. “Acetabular bone destruction related to nonsteroidal anti-inflammatory drugs.” The Lancet. 1985; July 6: 11-13.

34 Serup, J. and Oveson, J. “Salicylate arthropathy: accelerated coxarthritis during long-term treatment with acetyl salicylic acid.” Paxis. 1981; 70:359.