Tired of Medication! Chiropractic Can Help!

Chiropractic Alternative to NSAIDs for Back Pain

Arlington, Va.–People suffering from back pain should consider first trying chiropractic services and other non-drug therapies in light of a new research review that found common over-the-counter and prescription pain medications have limited effectiveness for back pain and raise the risk of side-effects, according to the American Chiropractic Association (ACA).

The review, published this month in Annals of the Rheumatic Diseases, examined 35 randomized, placebo-controlled trials, encompassing 6,000 patients, to determine the effectiveness and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for spinal pain. The authors of the report found that NSAIDs provided “clinically unimportant effects” when compared with patients who received only a placebo. Meanwhile, those who used NSAIDs had a 2.5 times greater risk of experiencing gastrointestinal disorders.
“At present, there are no simple analgesics that provide clinically important effects for spinal pain over placebo,” the authors noted.

The news about NSAIDs follows reports last year that prescription opioids also have limited effectiveness for back pain—one of the most common causes of disability worldwide.

“The American Chiropractic Association urges people to try non-drug approaches to back pain relief first, before resorting to over the counter or prescription medications,” said ACA President David Herd, DC. “In addition to spinal manipulation, chiropractors can offer a range of non-drug therapies for back pain and recommend exercises and important lifestyle changes to help prevent future back pain and injury.”

According to a 2016 Gallup survey, more than 35 million people visit a chiropractor annually.

About the American Chiropractic Association
The American Chiropractic Association (ACA) is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of ethics and patient care, contributing to the health and well-being of millions of chiropractic patients. Visit us at www.acatoday.org to find an ACA chiropractor near you.

NSAIDs: Non-Steroidal Anti-Inflammatory Drugs

Every day, an estimated 30 million people worldwide take a non-steroidal anti-inflammatory medication, or NSAID.

These versatile medications, available in over-the-counter and prescription strength, treat both pain and inflammation. Inflammation is a contributing factor in most back pain conditions, so reducing inflammation is important to alleviate the pain.

See Lower Back Pain Symptoms and Causes and Causes of Upper Back Pain

NSAIDs are used to address acute (short term) as well as chronic back, neck, and muscle pain.

See Pain Management for Chronic Back Pain

Painkillers for Back Pain and More:

Common uses for NSAIDs include treatment for:

• Mild or moderate back pain, tenderness, inflammation, and stiffness
• Activity-related pain or discomfort (e.g. pain that follows sports or activities such as housework, shoveling snow, or other exertion)
• Pain related to muscle strain in the low back and elsewhere
• Neck stiffness related to muscle, ligament, or tendon strains or damage
• Osteoarthritis joint pain
• Rheumatoid arthritis
• Ankylosing spondylitis
• A number of other forms of arthritis pain

This article provides information on how non-steroidal anti-inflammatory medications can be helpful against back, neck, and other pain, as well as several potential risks and complications to be considered.

Most Common Types of NSAIDs:

NSAIDs comprise a large class of drugs that act by hampering body substances called prostaglandins, which trigger feelings of pain, giving NSAIDs fever-reducing, pain-relieving, and anti-inflammatory properties. There are many types of non-prescription (over-the-counter) and prescription NSAIDs. The four NSAIDs most often used to treat many types of back and neck pain are:

• Aspirin (brand names include Bayer, Bufferin, and Ecotrin, St. Joseph)
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve, Anaprox DS, Naprosyn)
• Celecoxib (Celebrex)

Other Forms of NSAIDs:

In addition to the above, NSAIDs come in forms other than those taken by mouth. For example:

• Ketorolac can be given as an intravenous, intramuscular, or intranasal drug, making it useful after surgery or if the patient cannot eat.
• Diclofenac is available topically as a gel (Voltaren), patch (Flector), or solution (Pennsaid). The medication is applied directly to the area of pain. Topical forms reduce gastrointestinal and other potential side effects of NSAIDs.

NSAIDs: Non-Steroidal Anti-Inflammatory Drugs

Common NSAIDs for Back Pain
Potential Risks and Complications of NSAIDs
Types of NSAIDs
Anti-Inflammatory Medications for Back Pain Relief Video

Effective Use of NSAIDs:

Taking NSAIDs continuously, rather than just at the onset of pain, helps build up the body’s anti-inflammatory blood level, resulting in a better healing environment in the affected area. The efficacy is markedly lower if NSAIDs are taken only when experiencing pain.

See Using Medication to Manage Pain and Reduce Sleep Problems

Other Points To Be Aware Of While Taking NSAIDs:

• Checking with the doctor. Because NSAIDs have risks and complications, it is important to keep the doctor informed. People taking NSAIDs for long periods are advised to see the doctor regularly so any side effects can be monitored. In some cases, a change in medication may be required.
• Using as little as possible. The U.S. Food and Drug Administration advises that the lowest effective dose of NSAIDs be used, and then for only as long as necessary.
• Combining with acetaminophen. NSAIDs and the pain relief medication acetaminophen (e.g. brand name Tylenol) work differently, so sometimes doctors recommend taking both medications. This often offers better pain relief than taking one type of pain medication. Some people find it also helps lessen the pain as one dose wears off, alternating between the two—for example, taking a dose of ibuprofen, then 3 hours later taking a dose of acetaminophen.

Any adverse reactions from taking an NSAID, or any other medication, should be reported to the doctor without delay.

When NSAIDs Are Not Advised

People having a lumbar fusion surgery are typically advised not to take NSAIDs for at least 3 months after surgery due to concerns about the impact NSAIDs may have on bone healing.

Many doctors also tell patients to stop using NSAIDs prior to other types of surgery because the medication poses an increased risk of bleeding.

Low Vitamin D Linked to Increased Headache Risk

News Bite: Vitamin D may be a component factor in headache a new study demonstrates.

More research is adding to the literature of a link between vitamin D deficiency and headaches, at least for men living in colder climates.

Data from 2600 middle-aged men from Finland who participated in the Kuopio Ischemic Heart Disease (KIHD) Risk Factor Study showed that those with the lowest levels of serum 25-hydroxyvitamin D (25[OH]D) were more than twice as likely to report having chronic headaches as those who had the highest vitamin D levels. In addition, reports of chronic headache were significantly more frequent in months other than the summer months (June through September).

The investigators note that although past studies have examined the link between vitamin D and headaches, the results have been “inconclusive” because many included small sample populations. When the KIHD study originally started, men in this part of Finland had the highest prevalence of heart disease in the world, and it was looking at risk factors for cardiovascular disease.

During the baseline examinations, questionnaires asked the participants to report headache status during the previous 12 months. “Frequent headache” was defined as a daily or weekly occurrence — and was reported by 9.6% of the full group.

Also at baseline, fasting venous blood samples were collected during morning hours and 25(OH)D concentrations were measured.

Interestingly, the mean concentration of serum 25(OH)D for the study group was 43.4 nmol/L, which is below the 50-nmol/L threshold generally considered to be a marker of vitamin D deficiency. In fact, 67.9% of the group had levels that were less than 50 nmol/L.