Surgeries skyrocket due to NSAIDs
by Dr. Fred G. Arnold —
If you have ever had a painful joint, such as the hip, knee, shoulder or low back, your doctor may have prescribed a non-steroidal anti-inflammatory drug (NSAID). These drugs are among the most commonly used drugs in the world for the treatment of osteoarthritis (OA) symptoms. What you may not have been told is that NSAIDs have been shown to cause osteoarthritis and accelerate the breakdown of cartilage in joints, such as the knee, hip and low back.
Each year, more than 70 million NSAID prescriptions are given to patients in the United States, 20 million in Great Britain and 10 million in Canada. These statistics do not include the 30 billion over-the-counter (OTC) tablets sold each year in the United States alone.
The worldwide pain management prescription drug market totaled approximately $24 billion in 2002 and passed $30 billion by 2006. Some of the most common NSAIDs, both prescription and OTC, include aspirin, Celebrex®, Advil®, Motrin®, Aleve®, Toradol, Relafen, Daypro and Clinoril.
Of the people who are taking NSAIDs, 20 to 30 percent are over the age of 64, and in developed countries, these numbers are expected to rise as baby boomers age.
Numerous scientific studies
Numerous scientific studies have shown that patients who use NSAIDs to treat OA have a faster rate of cartilage breakdown that leads to the need for joint replacements. It is the massive use of these medications in patients with OA during the past 40 years that has lead to the rapid rise in the need for hip and knee replacements.
Between 1997 and 2005, the number of knee surgeries climbed by 69 percent, from 328,000 to 555,800, and hip replacements rose 32 percent, from 290,000 to 383,500. During this time period, spinal fusion surgeries also increased by 73 percent, from 202,100 procedures to 349,000 per year.
Recommendations on the use of NSAIDs
Organizations such as the International Cartilage Repair Society and Osteoarthritis Research Society International have made recommendations regarding the use of NSAIDs. They recommend these drugs to be used at the lowest effective dose, long-term use be avoided (if possible), and not be used as a first-line therapy for OA. The International League Against Rheumatism and the World Health Organization have recommended any drug used to treat OA should not have damaging effects on the joint cartilage. If this recommendation was followed, the vast majority of NSAIDs, if not all, would be immediately taken off the market and no new medications would get approved.
Other side effects of NSAIDs
In addition to accelerating OA, more than 100,000 people are hospitalized for gastrointestinal bleeding, and of those, 16,500 people die from NSAID toxicity each year. People are at higher risk if they are age 60 or older, have had stomach ulcers or bleeding problems, take a blood-thinning agent or steroid drug, and have three or more alcoholic drinks every day.
Alternatives to NSAIDs
Because doctors are frequently taught treatment approaches supported by pharmaceutical companies, it is also the responsibility of the patients to make themselves aware of the dangers of and alternatives to NSAIDS.
1. Other pain medications. There are pain medications that are not anti-inflammatory and do not cause the breakdown of articular cartilage. Tylenol® (acetaminophen) is an example of this type of OTC pain medication. Numerous other pain medications can be prescribed that are not anti-inflammatory.
2. Limit the dose and time period that NSAIDs are taken. Take the smallest dose possible for the shortest period of time. NSAIDs at higher dosages and taken for extended periods of time will cause joint damage.
3. Consider natural alternatives for the treatment of joint inflammation. Many natural alternatives are available, including an anti-inflammatory diet and numerous supplements, such as fish oil, vitamin D, resveratrol and curcumin.
4. Regenerative medicine injections. Proven regenerative medicine injections are available that can regenerate and repair arthritic joints, such as prolotherapy, prolozone, platelet rich plasma (PRP) and stem cell therapy.
Numerous scientific studies clearly show that NSAIDs actually can worsen OA, even though they are most commonly prescribed for it. Long-term use can lead to the need for hip and knee joint replacement, along with spinal fusion surgeries.
It should be noted that there are other proven alternatives to the use of NSAIDs as a first-line therapy for OA and joint pain without the severe side effects caused by NSAIDs.
Unless a restriction is placed on the use of NSAIDs, as has been recommended by many organizations, there will continue to be an exponential rise in degenerative arthritis and subsequent musculoskeletal surgeries for decades to come.
It is the responsibility of each patient to be aware of the risks and benefits of medications, and to discuss any concerns with a knowledgeable physician.
Hauser, Ross A., The acceleration of articular cartilage degeneration in osteoarthritis by nonsteroidal anti-inflammatory drugs, Journal of Prolotherapy, Volume 2, Issue 1, February 2010.
Fred G. Arnold, N.M.D., has more than 20 years of clinical experience and specializes in pain rehabilitation services. He is certified in prolotherapy by the American Association of Orthopedic Medicine, is a Fellow in Anti-Aging & Regenerative Medicine, a Fellow of American Academy of Ozonotherapy and certified in chelation. He is one of the few physicians in the nation with both a naturopathic medical degree and chiropractic degree. 602-292-2978 or prolotherapyphoenix.com.
Reprinted from AzNetNews, Volume 35, Number 1, February/March 2016.