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What are anti-inflammatory drugs?

These are a class of drugs that block enzymes and pathways that cause inflammation in the body, including steroids and NSAIDs (non-steroidal anti-inflammatory drugs). Steroids are very power anti-inflammatroy drugs that require a prescription but they have many risks. We are focusing on the NSAIDs many of which can be obtained over the counter. Examples include ibuprofen (Advil, Motrin), naproxen (Alleve), Aspirin, diclofenac, Celebrex, meloxicam, voltaren, Toradol, etc. Though some of these drugs are over the counter, these drugs can have many serious side effects and risks. This does not refer to supplements that help inflammation.

Do NSAIDs such as ibuprofen help sports recovery?

Many people that work out may have some intermittent pain. They may think that its no harm or that it may even help. Is there an evidence that they help recovery for working, sports and athletics? One study compared ultra-marathoners who took ibuprofen the day before and day of the race and it did not show any difference in race times, pain during the race, or post-race soreness between the 2 groups. Furthermore, the ibuprofen group had higher blood markers for inflammation and kidney stress compared to those runners who took no meds.

What are the risks of NSAIDs?

If NSAIDs don’t help recovery or pain, since they are over the counter, at least they may be safe to use for temporary pain relief? Wrong! There are NUMEROUS studies that show detrimental affects of NSAIDs. These include impaired stem cell function, impaired tendon, bone fracture and muscle healing, and impaired cartilage formation. Not to mention the risks of heart disease, stroke, GI bleeds, kidney injury, hormone imbalances, sudden death etc.

My recommendation

Taking anti-inflammatory drugs to prevent pain while exercise is a bad idea. Pain is a good indicator something is wrong, and you need to check it out. Also taking it for just soreness can have detrimental effects on the musculoskeletal system and risks damages to many different organs. Try Natural alternatives that I have outlined below. Turmeric/Curcumin in particular has evidence it can help with arthritis pain similar to NSAIDs like diclofenac without the risks. If you are having more serious pain, then have an evaluation by a well-trained musculoskeletal doctor such as the ones at the Centeno Schultz Clinic or Regenexx to address the problem at the source.

NATURAL ANTI-INFLAMMATORY DRUG ALTERNATIVES

• Curcumin: From the Turmeric spice, it has anti-inflammatory properties and helps with arthritis as well as many other health benefits. Take 500 -750mg 2-3 times daily. Take with black pepper or bioperprine to help absorption. See “Regenexx Turmeric Curcumin Complex” that can be found in our office or online.

• Omega 3’s: Have anti-inflammatory properties and can help with arthritis pain at high doses. Take 3-4 grams of a mix of EPA and DHA per day divided 2-3 time per day. Don’t take if it has a rancid odor. Best if taken with mixed isomers of vitamin E or a mixed antioxidant supplement to decrease the risk of oxidation.

Best brands of Omega 3’s are:
o Regenexx: Super Concentrated Omega 3 Fish Oil
o Nature’s Bounty: Triple Strength Red Krill Oil or Dual Spectrum Omega 3s;
o Meijer Naturals: Omega 3 high EPA fish oil;
o Nature Made: Ultra Omega 3 Fish Oil or Burpless Fish Oil;
o Finest Nutrition: Cod Liver Oil or Double Strength Fish Oil;
o Simply Right: Fish Oil, Vit D-3 or Wild Alaskan Salmon Oil;
o Sundown Naturals; Plant Based Omega 3;
o Pure Alaska Omega 3: 100% Natural Omega Natural Omega-s Wild Alaskan Salmon Oil; and Purelife Naturals.
o See the least desirable brands.

• Glucosamine: Building block for cartilage. Helps with mild to moderate arthritis. Take combined with chondroitin +/-MSM. Take 1500mg daily divided in 2-3 doses in a day as it may cause stomach upset if taken all at once. This is in the Regenexx Stem Cell Support supplement as well.

• Arnica: homeopathic medication can be taken orally or topically. It helps with acute traumas, bruises, soreness, and arthritis. Take 2x daily for 1 week. If no improvement after 1 week, then stop.

• Bromelain: A pineapple extract and a natural anti-inflammatory. As a tablet take 500mg 2-3 times daily. In capsule formulations: 2,000MCU per 1000mg or 1,200 GDU per 1000mg.

• Capsaicin Cream: Made from hot peppers and decreases substance P which leads to decreased pain. Helps with pain in superficial joints and muscles. Apply a moderate amount of 0.025% or 0.075% cream up to 3 times daily. I recommend using gloves or washing hands very thoroughly after use because the cream can burn. Do not touch eyes, nose, mouth, or genitals after use as it can cause irritation and burning.

• Vitamin D: hormone made from exposing your skin to sunlight. Most People are chronically deficient which can contribute to chronic pain. I recommend 2-5,000 IU daily. This is in our Regenexx Stem Cell Support supplement as well.

• Ginger: Has been shown to help treat migraines, and menstrual cramps. Take ¼ teaspoon of ground ginger 3x’s daily at the onset of migraine or cramps.

• Cherries: Can reduce incidence of gout flares. Eat ½ cup of fresh or frozen cherries daily or table spoon of cherry juice concentrate 2x’s daily.

Allow 1-4 weeks to notice a difference in pain for Bromelain, fish oil, glucosamine and turmeric. If you take any prescription medications or have any medical conditions discuss with your physician before taking any of the above products. For turmeric and fish oil, discuss with your doctor if you take any blood thinners such as Plavix or Coumadin because it may increase the risk of bleeding. Stop fish oil at least 2 weeks before any surgeries and at least 3 days before any other procedures/injections, but can restart immediately after a Regenexx procedure.

References

1. Nieman DC, Henson DA, Dumke CL, et al. Ibuprofen use, endotoxemia, inflammation, and plasma cytokines during ultramarathon competition. Brain Behav Immun. 2006;20(6):578–584. doi:10.1016/j.bbi.2006.02.001