Pain, NSAIDs and Wearing out your Body…

Herein I present a strategy of NSAIDs and Chiropractic Care for Back Pains, joint stiffness and muscular restriction. Several NSAIDs exist, yet for the short-term symptomatic relief of back pain no-one NSAID has shown to be superior[1] to the others. It’s a question of using NSAIDs in the short term before the analgesia of Chiropractic Care has kicked in, for those with severe pain.

Regular use of non steroidal anti inflammatory drugs NSAIDS (eg Naproxen, Ibuprofen, Diclofenac) could increase the risk of contracting cardiovascular disease [2] and liver toxicity seems a high price to pay to cover up poor joint and muscle health. A cover up that could lead to cartilage failure. For example OA (wear and tear) used to be thought to occur due to the spontaneous failure of joint cartilage as one aged, but now we know it is not always about age related cartilage failure, it is about muscular imbalance learnt and subconsciously reinforced over decades that leads to joint cartilage break down[3]. OA has long been thought of as a minor condition but has recently been proven to carry a greater disease burden than rheumatoid arthritis (RA)[4].

Is it time to check your haematocrit or creatinine..?

In a new study reported online[5] from the Journal Arthritis and Rheumatology, taking NSAIDs long term increases the risk of contracting cardiovascular disease if you have OA. Persons at high risk who wish to continue to manage their muscle and joint aches pains and stiffness with NSAID medication need to consider NSAID toxicity. For example, males who are over 55 with cardiovascular disease or hypertension or diabetes (DM), who smoke and take statins could help them-self by looking at their haematocrit and creatinine levels in their blood to notice NSAID toxicity[6]. That being said Ibuprofen followed by Naproxen are the most common NSAIDs to overdose with[7].

Continue with the strategy of NSAIDs for long enough and multiple systems may fail. I say this as a warning to the most common strategy for managing back pain[8] is to carry on doing nothing, riding the wax and wane of painful body experiences without regard to body function or wear and tear. Inadvertently learning inefficient movement patterns meaning your usual departs from normal.

Joints are very useful in the body as they enable movement to occur in a three-dimensional (3D) way. As in my last article[9] where I mention a link between a lack of joint centering and wearing out of joints with the progressive loss of movement in 3D as a result. Not really something we haven’t seen time and time again in older adults. Watching as their motion becomes more and more difficult over time.

If I were behaving proactively, I might look to aid my muscles and joints with the help of a trusted Chiropractor. Such a healthcare professional could inform me that Chiropractic Care and NSAIDs are both independently better than placebo for acute low back pain. Meaning that a potential combination of NSAIDs initially to take the edge off the pain whilst Chiropractic improves function could well be the answer to pain reduction in the short term and more efficient movement patterns in the long run. A type of preventative Care for your muscles and joints as you age[10].

Your well-informed Chiropractor might also tell you that Chiropractic Care was found to be superior to NSAIDs when comparing the two approaches independently [11] (considering time to return to work, patient satisfaction, function and amount of rescue medication needed to be taken) for pain, stiffness and discomfort. Make your choices wisely and your body may just last you a lifetime!


[1] Van Tulder MW et al (2000) Non Steroidal Anti Inflammatory Drugs for Low Back Pain. Spine 25 (19) 2501

[2] Kelly JC NSAIDs May increase CVD Risk in OA. Medscape August 12th 2019 Accessed 18.08.2019 

[3] https://fasciafirstchiropractic.co.uk/2019/07/24/muscular-imbalance-leads-to-osteoarthritis/

[4] Chua JR et al (2019) Disease Burden in Osteoarthritis is Similar to that of Rheumatoid Arthritis at Initial Rheumatology Visit and Significantly Greater 6 months later. Arthritis and Rheumatology 71 (8) 1276

[5] Arthritis and Rheumatology August 6th 2019

[6] Soloman D et al (2019) Derivation and validation of a Major Toxicity Risk Score Among Non Steroidal Anti-inflammatory Drug Users Based on Data From a Randomised Controlled Trial. Arthritis and Rheumatology Journal 71 (8) 1225

[7] Hunter LJ et al (2011) The Patterns of Toxicity and Management of Acute NSAID overdose. Emergency Medicine 3 39

[8] “American Physical Therapy Association (2012) Most Americans Live with Low Back Pain – and Don’t Seek Treatment. [Online] Available from: http://www.apta.org/Media/Releases/Consumer/2012/4/4/, accessed February 2, 2018

[9] IBID ref 2

[10] Eklund A et al (2018) The Nordic Maintenance Care Programme PLOS One 13(9) e0203029

[11] Von Heyman WJ et al (2013) Spinal High Velocity Low Amplitude Manipulation in Acute non-Specific Low Back Pain. Spine 38(7) 540

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.

+
%d bloggers like this: