Inflammation: Non-Steroidal Anti-inflammatory drugs (NSAIDs) and Alternatives

Inflammation underlies almost every process in the body associated with pain. Acute inflammation is part of the repair process and resolves as its associated injury resolves. Chronic inflammation does not lead to repair and is a sign of imbalance. Chronic inflammation is associated with long-term conditions such as arthritis, irritable bowel syndrome, chronic neck and back pain, allergies, asthma and autoimmune disease. Chronic inflammation is also associated with conditions without pain and is causally linked with heart disease, diabetes, depression, Alzheimer’s disease and many cancers. The understanding that inflammation underpins many diseases means that the goal of treating inflammation goes beyond managing pain alone.

For many years the treatment of choice for inflammation has been the NSAIDs such as aspirin, Ibuprofen (eg nurofen advil, brufin), diclofinac (voltaren), naproxen (naprosyn, naprogesic) and celecoxib (celebrex). While these drugs can reduce pain and inflammation, apart from Celebrex they can cause digestive irritation and bleeding as well. These medications are not usually recommended for people with high blood pressure or some other medical conditions. The safety of the NSAIDs is a contentious issue with a recent Danish study showing that common NSAIDs can increase the risk of cardiovascular diseases in otherwise healthy people. These effects are dose related leading to the recommendation that the lowest necessary dose should be used. Paracetamol also helps pain and inflammation and does not have the same risks as the NSAIDs. High doses of paracetamol are toxic to the liver though so it is essential to take the recommended dosage only.

Medications are not the only solution to inflammation. Obesity leads to inflammation as can food intolerances, so shedding excess kilos and cleaning up the diet is the first step. Some animal fats also result in inflammation so excess red meat should not be consumed. A pH in the body towards the acidic end of the scale also promotes inflammation – a simple urine test can measure pH and a more alkaline diet can often manage this factor. Acupuncture can reduce inflammation in the body, so along with stimulating repair and treating painful conditions, acupuncture can also help inflammatory and auto-immune conditions. There is much more to acupuncture than just treating pain!

Fish oil is an ideal source of anti-inflammatory Omega 3 fatty acids with large doses giving the best results. Both Chinese and western herbs have anti-inflammatory effects without the risks associated with the NSAIDs or paracetamol. Green tea, lycopene (from tomatoes), curcumin (turmeric), ginger, resevatrol (red wine, red and purple grapes), boswellia (frankinsence), sulforaphane (broccoli) and bromelains (from pineapple) all have well established anti-inflammatory properties with some being cancer protective. Natural anti-inflammatory approaches sometimes take longer to work than medications. The reward however for managing inflammation through diet, acupuncture and herbal medicine is a sense of wellbeing derived from addressing the underlying root of inflammation without the risks associated with symptomatic treatment with medications. Our Chinese medicine and naturopathic practitioners can help with individualised advice on managing inflammation