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Alternatives to Pain Medicines  

by Hemant Yagnick, M.D., Walton Pain Center

There are alternatives to using over-the-counter and prescription drugs. There are many different herbs and spices that are used as anti-inflammatory agents and to help reduce pain.

Recently, a lot of media coverage has focused on the withdrawal and recall of very popular and widely prescribed pain medicines like Vioxx and Bextra. Drugs like Vioxx, Bextra and Celebrex were the fifth largest se

lling drugs in North America. Its maker, Merck Pharmaceuticals, voluntarily took Vioxx off the market last fall because users in a long-term study were doubling their risk of heart attacks. The New England Journal of Medicine also questioned whether any COX-2 inhibitor drug is safe. Bextra by Pfizer has also been recently pulled off the market following similar findings in a study.

There are a number of other drugs that work just like Vioxx and may be used as a Vioxx alternative. Other pharmaceutical companies who offer similar medicines have not had sufficient cause to recall their own pain relievers. Because these alternative medicines work in much the same way as Vioxx, you may wish to consult a medical professional before taking these medications, to be sure they are right for you.

Patients can take Motrin, as it is just as effective as Vioxx at reducing pain and inflammation if given in adequate doses. Aleve is also very effective, and there are numerous other drugs in the same category, the NSAIDs, that are effective.

However, a minority of patients cannot take NSAIDs because of an increased risk for gastrointestinal complications associated with these drugs. These patients could be directed to Celebrex, another COX-2 inhibitor.

COX-2 inhibitors such as Celebrex fight inflammation without affecting the digestive tract. Alternatively, NSAID sensitive patients could take an NSAID plus a pill to help prevent gastrointestinal symptoms. A combination like Motrin plus Prilosec, is as good as Vioxx or Bextra. Drugs like Vioxx, Bextra and Celebrex were the fifth largest selling drugs in North America.

Dietary supplements are available to help control the inflammatory COX-2 enzyme without blocking the beneficial COX-1 enzyme. Plus, these supplements will also block another inflammatory enzyme, 5-LOX, that's not affected by many of the pain-relief drugs. For example, SAM-e, a dietary supplement, provided the same level of functional knee health as COX-2 inhibitor Celebrex in a study done by the University of California.

Glucosamine is primarily used to treat osteoarthritis. Research indicates that glucosamine is as effective as low doses of nonsteroidal anti-inflammatories such as ibuprofen. It appears to relieve pain and improve movement. It also slows the progression of the disease and protects joints from further damage. In some studies, x-rays have shown that glucosamine prevents progressive damage to the joints. MSM is a compound normally found in foods. It is believed to relieve the pain of osteoartritis and help strengthen collagen in the joints. An anti-inflammatory and digestive aid, Bromelain has been used traditionally in Japan, Hawaii, and Taiwan, which stimulated interest by researchers in Europe. Now, Bromelain is one of the top single herbal products sold in Germany.

Using anti-inflammatory spices and herbs as alternatives to medications is another option. Boswellia, ginger, turmeric, holy basil, green tea extract, resveratrol and bromelain are commonly used for the above reasons. Some herbal complexes with these ingredients include: Kal's COX-2 Control Body Comfort, New Chapter's Zyflamend, Now Food's D-Flame and Source Naturals' Inflama-Rest. These gentle formulas may not work as quickly as drugs, but are safe enough to take indefinitely. If you wish to switch from drugs to natural therapies, share this info with your health practitioner.

The use of any alternative pain medications to Vioxx and Bextra should be discussed with your doctor prior to beginning new treatment. If you had been taking the above for pain, there are a number of alternative medicines that do not carry the same risks as Vioxx or Bextra.


About the Author

Hemant Yagnick, M.D., is an Interventional Pain Specialist and Medical Director of the Walton Pain Center in Augusta, GA. Dr. Yagnick believes that chronic pain is a complex medical condition influenced by biological, physical, behavioral, environmental and social forces. For more information visit www.wrh.org or call 866-4-WALTON.

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