Non-steroidal anti-inflammatory drugs (NSAIDs) are
widely prescribed to treat acute and chronic pain in people with
rheumatism and arthritis.
Although they are effective analgesics, NSAIDs are associated
with a number of potentially serious side effects, including kidney
damage, exacerbation of asthma and gastric ulceration. More
recently, some of the newer NSAIDs – which were introduced
because they were less likely to cause intestinal bleeding –
were withdrawn due to an unacceptably increased risk of heart
attack and stroke. Most guidelines therefore recommend that doctors
first prescribe simple analgesics, such as paracetamol, before
moving on to NSAIDs. Even so, it is estimated that around 25
million NSAID prescriptions are issued in the UK each year,
resulting in 12,000 admissions to hospital to treat serious side
effects and as many as 2,600 deaths. If you prefer not to take an
NSAID or are advised to avoid them by your doctor, a number of
alternative remedies are available that have a useful
anti-inflammatory action and a much lower risk of adverse
events.
TURMERIC
The Ayurvedic spice, turmeric, contains curcumin, a powerful
antioxidant that lowers inflammation by reducing formation of
inflammatory substances. Like aspirin, it helps to reduce abnormal
blood clotting. Unlike aspirin and other NSAIDs, however, far from
causing peptic ulcers, turmeric has been used to successfully treat
gastric and duodenal ulcers, gastric erosions, gastritis and
dyspepsia.
"Bromelain is widely used to reduce the pain, swelling
and inflammation associated with arthritis..."
BROMELAIN
This is a digestive enzyme derived from the stem of pineapples. It
has a powerful anti-inflammatory action by reducing the migration
of white blood cells and damping down their release of inflammatory
chemicals. It is widely used to reduce the pain, swelling and
inflammation associated with sinusitis, bruising, sprains, wounds,
minor operations, burns and arthritis. Like turmeric, bromelain
also has a blood-thinning action due to its ability to stop blood
platelets clumping together.
GREEN LIPPED MUSSEL EXTRACTS
New Zealand green lipped mussel extract contains a number of
glycoproteins that damp down inflammation in arthritic joints.
Preliminary research suggests it is also helpful for inflammatory
bowel disease, asthma and peptic ulcers. Like bromelain, it
prevents white blood cells from moving into the inflamed joints,
where they would have released powerful chemicals making pain and
swelling worse. Green lipped mussel extract can significantly
reduce pain and stiffness and has been shown to outperform NSAIDs
such as ibuprofen and indometacin. In a trial involving 60 people
with osteoarthritis of the knee and hip, green lipped mussel
extract significantly improved all signs and symptoms within eight
weeks, with 80% experiencing significant pain relief and improved
joint function with no adverse effects.
DEVIL’S CLAW
This is helpful for low-back pain, osteoarthritis, rheumatoid
arthritis, gout and sports injuries. It contains harpagoside and
harpagide, substances that can reduce the production of white cell
inflammatory chemicals known as leukotrienes. A systematic review
of 12 clinical trials investigating its effects against
osteoarthritis, low-back pain and mixed-pain conditions found
strong evidence for its effectiveness at higher doses. Do not take
if you have peptic ulcers or indigestion, however, as it promotes
secretion of digestive juices.
GLUCOSAMINE
Essential for the production of new cartilage, glucosamine can
reduce joint inflammation by making synovial fluid – the
joint’s oil – thicker and more cushioning. A systematic
review of 20 randomised controlled trials found that, in people
with osteoarthritis, it was more effective than placebo with a 28%
improvement in pain and a 21% improvement in joint function. In the
four trials in which glucosamine was compared to an NSAID,
glucosamine was superior in two and equivalent in two. Although the
analgesic effects of glucosamine took longer to develop, the risk
of side effects was considerably lower and similar to placebo.
CHONDROITIN
Chondroitin sulphate becomes concentrated in knee tissues,
especially cartilage, and has anti-inflammatory actions by damping
down the migration of white blood cells and their release of
inflammatory chemicals. It may also modify the structure of
cartilage to make it stronger. Compared with NSAIDs, chondroitin
appears to be more effective at inhibiting these cell-related
inflammatory actions than in reducing swelling and has no damaging
effects on the stomach or kidneys. A clinical trial involving 120
people with osteoarthritis of the knee found that taking
chondroitin for three months twice a year significantly improved
pain and joint function, Importantly, X-rays showed significant
decrease in joint space width in those taking placebo, while those
on chondroitin showed no deterioration.
MSM (METHYL-SULPHONYL-METHANE)
MSM is a natural sulphur compound that reduces the formation of
free radicals by white blood cells. This is especially helpful for
reducing inflammation associated with hayfever. In a small,
double-blind, placebo controlled trial involving 16 patients with
osteoarthritis, those taking MSM experienced an 80% reduction in
joint pain after six weeks compared with an average improvement of
only 20% in those on placebo.
CONCLUSION
A number of food supplements have proven anti-inflammatory actions
which are at least as effective as those of non-steroidal drugs,
but with significantly less risk of serious side effects. Combining
these with physiotherapy and regular exercise can help to reduce
pain and improve your mobility if you are unable or unwilling to
take prescribed treatments. In some studies, supplements were given
together with prescribed painkillers and helped to reduce the dose
of drug needed. Always tell your doctor/pharmacist if you intend to
combine supplements with prescribed medication, however, and check
there are no known interactions.
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