ease arthritis pain, woman with knee and joint pain, your knee pain

Nonsteroidal Anti-inflammatory Drugs (NSAIDs) are among the most popular drugs in the pharmacy. Millions of people swallow ibuprofen (Advil, Motrin IB, etc) and naproxen (Aleve) that they buy without a prescription. Doctors also prescribe NSAIDs in large quantities. Some of their favorites include: celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin) and meloxicam (Mobic).

NSAID Popularity Waxes and Wanes:

Over the years we have watched as one NSAID after another became popular and then lost its luster as the newest one was aggressively marketed to physicians. Turn back the clock to the mid 1960s and indomethacin (Indocin) was king. It was followed by sulindac (Clinoril). Then piroxicam (Feldene) captured the limelight. These days meloxicam appears to be the number one NSAID prescribed by physicians.

How good are NSAIDs against the pain of arthritis? We recently had the opportunity to interview Steve Nissen, MD (February 4, 2017). He is chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at the Cleveland Clinic. Dr. Nissen was the lead author on a huge NSAID trial involving celecoxib, ibuprofen and naproxen. It was called the Precision Trial.

We suggested to Dr. Nissen that maybe NSAIDs were not as good at relieving pain as we might have been led to believe:

He confided to us that:

“They’re not as good. In fact we measured pain relief in the study and we measured it on a 100 point scale and the actual reduction in pain was about 13 points out of a hundred. So call it 13% if you will. It’s very modest…”

NSAID Complications:

Despite their popularity, such drugs have the potential to do a significant amount of harm. Here are just some of the comments that we have received about meloxicam (Mobic) in particular.

Dee shared this story:

“I am on high blood pressure medication and was prescribed meloxicam for a painful back sprain/strain from yard work. Within three days I was in the ER with extremely eleveated high blood pressure. Be careful if you take these types of drugs.”

This from I.H.:

“My doctor prescribed meloxicam (Mobic) for a rotator cuff injury. My blood pressure was normal the day that I saw him. Not long after I realized I was experiencing headaches. I happened to see my rheumatologist a week later and was told my blood pressure was high. I stopped taking the Mobic a day later. I am hoping my BP will return to normal.”

Another visitor asked:

“Is generic Mobic included in the category of NSAIDS possibly causing heart problems?”

High Blood Pressure

A little appreciated complication of meloxicam (as well as most other NSAIDs) is hypertension. For some, there may be only a little increase in blood pressure. For others, like Dee or I.H., the increase can be significant. Such drugs can cause fluid retention, which may in part account for the increase in blood pressure. This may be because such drugs can alter kidney function. But there may also be other cardiovascular risks.

Repeat Heart Attacks

Danish researchers identified nearly 100,000 patients over the age of 30 who had experienced a first-time heart attack sometime between 1997 and 2009. They were followed for up to 5 years after their initial heart attacks (Circulation, online, Sept 10, 2012). The scientists were especially interested in the post-heart attack use of nonsteroidal anti-inflammatory drugs.

Heart attack survivors who took an NSAID-type pain reliever were at a substantially higher risk of having another heart attack or dying than those patients who did not take such drugs. In their first year following a heart attack, about one-fifth of the NSAID users died, compared to 12 percent of those not taking an NSAID-type pain reliever. Over the five years of the study, NSAID users were about twice as likely to die as non-users. They were also at increased risk for another heart attack. The investigators concluded:

“It would seem prudent to limit NSAID use among patients with cardiovascular disease and to get the message out to clinicians taking care of these patients that NSAIDs are potentially harmful, even 5 years after MI [myocardial infarction or heart attack].”

When most health care providers think about side effects associated with NSAIDs they think GI toxicity. Here is an example of such a problem:

“I have had arthritis for over a decade. I am on methotrexate, folic acid, and meloxicam. Just recently (2 months ago) I started to have problems with my stomach: nausea. I thought it was some kind of bug but I was not sick, sick.

“I just recently had my 3rd major attack, and ended up in the emergency room. After 5 hours of tests, the diagnosis was inflammation of my esophagus. I have come to the to the conclusion that it is the medications that are making me sick.” CLC

NSAIDs can cause inflammation of the digestive tract. Symptoms may include nausea and bad heartburn. The distress can become unbearable and put people (like CLC) in the emergency department. Life threatening bleeding or perforated ulcers can result.

NSAID Side Effects

  • Heartburn, indigestion, abdominal pain, nausea, vomiting, constipation, diarrhea
  • Headache, dizziness, drowsiness, disorientation
  • Skin rash, sensitivity to sunlight, itching (potentially serious, so notify the MD!)
  • Fluid retention, edema, high blood pressure
  • Heart failure, heart attack, stroke
  • Ringing in ears, hearing changes
  • Visual disturbances
  • Ulcers, bleeding ulcers, perforated ulcers
  • Liver damage, kidney damage
  • Blood disorders, anemia
  • Worsening asthma symptoms

Other Ways to Relieve Pain

“I have burning in my legs. I do not have restless leg syndrome… but the burning is more noticeable at night. I do exercise and do stretches. I take meloxicam for knee pain but that has not helped. Rubs do nothing. Any other suggestions?” Lorrie

We offer dozens of non-drug options in our newly revised and expanded Guide to Alternatives for Arthritis. Herbs such as boswellia, spices such as cayenne or turmeric, supplements such as fish oil or vitamin D and foods such as grape juice with Certo, honey and vinegar, pineapple juice and tart cherries have all provided relief for some people with joint pain. The new guide is around 50 pages long and contains practical tips along with video links that will demo the preparation of our favorite home remedies.

Incorporating anti-inflammatory foods into tasty recipes is another approach to managing pain relief while limiting side effects. In our book Recipes & Remedies From The People’s Pharmacy, we offer instructions for remedies like cherry spritzer (p. 62), curcumin milk (p. 60), ginger pickle (p. 50), pineapple-cherry cocktail (p. 65), virgin raisins (p. 64) or anti-inflammatory curcumin scramble (p. 103). Adding fish to the diet in dishes such as favorite fish platter (p. 106), fish tacos with radish & lime (p. 120) horseradish-crusted salmon with cranberry catsup (p. 127), pescado al cilantro (p. 137) salmon with fava bean & spring pea mash (p. 141) or spicy fresh tuna salad (p. 143) puts anti-inflammatory power into everyday meals, and adds heart benefits rather than risks.

Please use NSAIDs like ibuprofen, meloxicam, naproxen and diclofenac cautiously. Such drugs may ease pain a bit, but the list of side effects is scary. People who have had heart attacks are not the only ones at risk for serious, even life-threatening complications.

We would love to hear your story about the pros and cons of NSAIDs. Have they worked without problems? Have you experienced side effects? Have you tried non-drug approaches for pain relief such as acupuncture or one of the herbs we mention in our new guide?

Share your experience with meloxicam or Mobic below and thanks.

Revised 3/9/17

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  1. Linda

    I was prescribed Meloxicam in Jan due to horrendous pain from hip osteo, trochanteric bursitis I refused to take the pill as I have been trying physical therapy and heating icing unfortunately nothing at all has helped the pain so severe could hardly walk — I finally took 1 7.5 dose last night and maybe I’m crazy but I feel some relief. I will not take 2 a day will try 1a day

  2. Tina

    I have been taking Meloxicam for 8 months for osteoarthritis, but have recently been stricken with severe itching in one area of my upper arm. Feels like thousands of ants crawling under skin. Dr. has no suggestions. In the meantime I have spent numerous sleepless nights administering ice packs on the area. After reading side effects, I am stopping the drug as of today. Any comments?

  3. Lisa

    I was prescribed meloxicam back in 2015 for arthritis in the hips. Took it twice daily I noticed my ankles began swelling in summer of 2016. I never had high BP before but about around the same time BP became evaluated. The pain in my hips became worse I got a mri and was told I had avn in both hips not arthritis. The pain was unreal could not walk or get out of bed without help.

    Meloxicam helped me walk and eased my pain some but only enough to tolerate it without screaming. I had to have both hips replaced at the same time Jan 2017. But before surgery I noticed both ankles swelling with heat an ulcer was on my left ankle. I started having weight gain from water retention. After surgery my right ankle went down to normal no problem but the left ankle still has an ulcer and swelled with heat even after I elevated them. I was still taking meloxicam until today. Had test done no blood clots.

    I think that I have been taking them far to long now that all the negative side effects are coming out. High BP, swelling of ankles, water retention, ulcer and extreme tightness with heat on ankle, shortness of breath. I have good sugar so the edema is not from that. I feel shot term use is good but any longer is very dangerous to your health. I’ll touch back with you and let you know if everything go’s back to normal or if I developed any more health issues since I stopped taking Mobic.

  4. carol

    I have taken meloxicam for arthritis for 4 years and it has made my life worth living again after 9 years of suffering. I was taking turmeric and boswellia and vitamin E. They did nothing except cause an upset stomach. I had to stop for 6 weeks for orthopedic surgery and my arthritis got much worse until I started meloxicam again. Most useful medication i have ever taken.

  5. M.J.

    I took Mobic. It really helped with the arthritis pain and also seemed to clear up my psoriasis but then I also had the problem with elevated BP and had to stop taking Mobic. I now rely on good old aspirin. I use the Bayer Plus which is supposed to be easier on the stomach, and my BP seems OK at this point.

  6. Laurie
    Lafayette, NJ

    I took meloxicam for 9 days. Then I did aerobics, and the next day my feet and hands felt on fire and were swollen. My legs felt like I ran 10 miles. Went to my neurologist who did an EMG. I have neuropathy because of this drug Stay away from it. It ruined my life forever!

  7. Kathy

    I had taken meloxicam for about a year or longer without any perceivable negative effects, however, the benefits were negligible. I decided to make a switch to high doses of turmeric and within 2 days my RA pain was about 90% gone. Turmeric worked very well for keeping the pain away until I took a fluoroquinolone antibiotic (Levofloxacin but there are at least 20 others that negatively affect many people) 15 mos ago. My pain increased dramatically and spread all over where before it was just fingers & toes. It took about a year to recover from the effects of the antibiotics and after that poisoning I’d never take an RX or OTC drug again unless there is a life threatening condition that there is no natural treatment for. Turmeric is again keeping me pain free. We should use natural treatments and diet for most of our medical conditions, synthetic drugs are toxins and eventually will do harm.

  8. Angela R

    Hello there, I have been on meloxicam for about a month now. I just notice my body feeling different. I had a procedure done yesterday and they check my blood pressure and it was very low to be concern. So they nurse told me to keep a check on it until I could get back to my doctor.

    So tonight, I check it again because I am not feeling better I did both arms. L was 168/117 , R 153/97. My blood has never been like this until I started taking meloxicam and I take my blood pressure meds every morning. So I believe it is the meloxicam that is elevating my BP.

    • Linda
      Tupelo MS

      I am taking tumeric along with the meloxicam. Which brand supplement do you take or can you get pure tumeric powder. I still have some pain and am afraid of what will happen if I discontinue nsaid.

  9. Janice
    Hillsborough, NC

    Magnesium has been helpful for some people relieving pain.

  10. Sandy

    My hair fell out when I took Mobic.

  11. John
    Houston, Texas

    I was prescribed Meloxicam for my Arthritis. I loved it, but had to give it up because it gave me hives, as did Celebrex and other NSAIDS!

  12. Ec

    I have been taking meloxicam for about 10 years. My pcp wanted me to try methotrexate and to stop the mobic. 8 days off and my ankles, fingers, wrists and my back are hurting so bad I can hardly get out of bed. My PCP seems to think I have a fatty liver because of my long term use of meloxicam. Anyone else have same opinion?

  13. Sue

    I had been prescribed Meloxicam 7.5 for knee pain. I was only taking it occasionally and my orthopedic told me to take it daily. I started taking it religiously about 6 months ago. I have been having severe chest pain (left side) for almost 6 months.

    I’m finally seeing a cardiologist next week because my pcp has already had an ekg, endoscopy and stress test done and they all came back “normal” He doesn’t know what to check next. I’ve also tried Xanax to see if the pain is caused by anxiety but that has not helped. My blood pressure has also been elevated.

    I just got my prescriptions refilled and looked at the warnings for each of them and the Meloxicam warnings seemed to fit the problems I’m having. I stopped taking it as of today and will still see the cardiologist next week but I’m hoping that I’ll be feeling much better after the drug gets fully out of my system. After being in pain for months and worrying that I have heart problems or cancer I’ve got my fingers crossed that Meloxicam is the culprit and I’ll be feeling better in a few days!

    • Ram

      Did you have any improvements after stopping it? I am having similar side effects with panic attacks. I am wondering how fast the side effects subside after stopping.

  14. Bob
    kansas city

    Hello there. I was taken off meloxicam about 6 weeks ago. Since the day I got taken off of the medicine. I have bilateral swelling to my feet and extreme tightness and pain in both of them.

    Specifically tight on the lateral sides of the foot and the achilles tendon is extremely tight. This is bad enough that I spent a night in the hospital. I have had tests done on my kidneys and everything was negative. Any thoughts?? Any similar situations? Recommendations??

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