ease arthritis pain, woman with knee and joint pain, your knee pain, pharmaceutical-grade chondroitin, increase your cholesterol

Roughly one out of five Americans takes an NSAID (nonsteroidal anti-inflammatory drug) regularly. That includes medications like celecoxib, diclofenac, ibuprofen, indomethacin, meloxicam and naproxen (European Society of Cardiology, Aug. 28, 2017). There’s a reason so many people take NSAIDs. There are over 50 million Americans with diagnosed arthritis. This does not count the millions of people who suffer in silence and don’t bother to ask their doctor why their fingers ache or their knees creak and crackle. They know arthritis pain up close and personal. But what can you do if you can’t tolerate NSAIDs? This reader speaks for many:

Arthritis and Heart Trouble Is a Bad Combo!

Q. I am caught in a terrible situation. I have arthritis that affects my fingers, knees, hips and back. I also have a family history of heart attacks and strokes. Five years ago I had two stents because of blockage.

My doctors told me that I cannot take NSAIDs for inflammation because of my heart condition. My rheumatologist will no longer prescribe hydrocodone for the pain. Without pain meds, my blood pressure goes way up and I cannot sleep. What can I take to ease this agony without harming my heart?

Between a Rock and a Hard Place!

A. You are caught in a classic double bind. The FDA has warned that NSAIDs like diclofenac, ibuprofen, meloxicam and naproxen have been linked to an increased risk of both heart attacks and strokes (July 9, 2015). Here is the recommendation from an FDA advisory committee regarding prescription NSAID labeling:

  • “The risk of heart attack or stroke can occur as early as the first weeks of using an NSAID. The risk may increase with longer use of the NSAID.
  • The risk appears greater at higher doses.
  • It was previously thought that all NSAIDs may have a similar risk. Newer information makes it less clear that the risk for heart attack or stroke is similar for all NSAIDs; however, this newer information is not sufficient for us to determine that the risk of any particular NSAID is definitely higher or lower than that of any other particular NSAID.
  • NSAIDs can increase the risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease. A large number of studies support this finding, with varying estimates of how much the risk is increased, depending on the drugs and the doses studied.
  • In general, patients with heart disease or risk factors for it have a greater likelihood of heart attack or stroke following NSAID use than patients without these risk factors because they have a higher risk at baseline.
  • Patients treated with NSAIDs following a first heart attack were more likely to die in the first year after the heart attack compared to patients who were not treated with NSAIDs after their first heart attack.
  • There is an increased risk of heart failure with NSAID use.

“We will request similar updates to the existing heart attack and stroke risk information in the Drug Facts labels of OTC non-aspirin NSAIDs.”

Read the entire FDA post at this link.

Is Anyone Paying Attention?

A lot of older people with arthritis pain also have heart disease. We wonder whether rheumatologists, internists and family practice physicians take the FDA’s warnings seriously. After all, physicians have been prescribing NSAIDs for all sorts of aches and pains for decades. If someone experiences a heart attack or dies after a stroke, it is unlikely that anyone will attribute the tragic event to the ibuprofen, naproxen or meloxicam that was was prescribed for arthritis pain or lower back discomfort. The chances that it would end up on the death certificate as a contributing factor are slim to none.

High Blood Pressure and NSAIDs:

It has been estimated that more than 40% of Americans with osteoarthritis also have hypertension (Science Daily, Aug. 28, 2017). That means a lot of people with arthritis pain are likely taking an NSAID to function. Does anyone (physician, nurse, pharmacist) warn these patients that drugs like ibuprofen may actually raise blood pressure?

If you would like to read an article about the latest research on this topic, here is a link:

Will Your Pain Pill Boost Your Blood Pressure?

Imagine this scenario:

  • A patient (64 years of age) goes to the doctor with hip and knee pain. This person is otherwise in good health with a blood pressure (BP) reading of 125/84.
  • The diagnosis: osteoarthritis.
  • A prescription is written for diclofenac.
  • A return visit six months later reveals a blood pressure of 148/95.
  • Does anyone consider the NSAID responsible for the new diagnosis of hypertension?

Real Stories from Readers:

Most health professionals would probably discredit such a bump in blood pressure as resulting from an NSAID prescription. Here are some stories from visitors to this website:

Tom in Michigan reports:

“For sure, NSAIDs have bumped up my pressure. I recently had a tooth refilled and it has been giving me some throbbing pain at times. I tried a few Advils and they made me feel different. My blood pressure spiked up about 40 points. I tried some Tylenol, and it wasn’t nearly as bad. I do not like taking anything for pain like these pills and rarely use them.”

Bonnie in Naperville, IL, shared this story:

“I can attest to the dangers of too much use of a drug like ibuprofen (which is great at controlling pain, however). I have arthritis in my right knee, and sometimes would have to drag the leg up the stairs. I have a good tolerance for pain meds, but began taking 1800 mg of Advil per day. That’s 9 pills in an 18-hour period.

“Eventually, I became dizzy & unsteady – went to my doctor and the BP was 188/108. He told me to take Tylenol instead and prescribed BP meds for me.”

Sheila in the state of Washington wrote:

“I have been taking ibuprofen for a few days for acute back pain. BP has shot up to 160s and 140s over high 80s, from its usual 120s over 70s. I am also having frequent palpitations.

“I thought this was due to pain, but it may be the ibuprofen too. I have struggled for many years to achieve normal BPs; cannot risk any more damage to CV system. Will discontinue.”

Marilyn in New Mexico had a scary reaction to a low dose of ibuprofen:

“My blood pressure is usually normal. IF I am stressed it’s borderline high. I have been taking 2 Advils daily for two months for pain in my knee. A few nights ago, I took my blood pressure, and it was 201/113.

“I thought of what I had been doing differently to raise my pressure to this scary number, as I was feeling relaxed and not stressed at all. I went online and checked out NSAIDS & BP and then checked out how to lower blood pressure fast. I drank a ton of water, and water fasted the next 2 days with a tiny bit of food. Today is day 3 and BP dropped to 153/83. Hope the top number will drop more in next few days.”

Most health professionals would doubt that such low doses of ibuprofen could contribute to a rise in blood pressure. We suspect that the FDA would also be surprised. One possible explanation, though, is that some people are especially susceptible to this complication. They may have reduced kidney function or some other risk factor that makes them particularly prone to hypertension after NSAIDs. We encourage anyone who is taking an NSAID to monitor blood pressure before, during and after treatment for arthritis pain.

People with Stents, Be Extra Careful!

If you were put on antiplatelet therapy to prevent a blood clot after stents were placed in arteries, NSAIDs could raise your risk for gastrointestinal bleeding (Medicine, Jan. 2015). Again, this is a catch 22 at work!

Here’s the rub: Stents are metal scaffolding. These mesh tubes are designed to keep arteries from closing after angioplasty. But pure metal mesh can become clogged. That puts a heart patient back in harm’s way.

Manufacturers created drug-eluting stents to prevent blockage of arteries. But there is a trade off. Though they reduce the risk of scar tissue formation and reclogging of coronary arteries, there is a risk of blood clot formation. In other words, a blockage could occur inside the stent and lead to a fatal heart attack.

To prevent that, doctors often prescribe anticlotting drugs such as clolpidogrel (Plavix), prasugrel (Effient), ticagrelor (Brillinta) or ticlopidine (Ticlid). Not infrequently, aspirin is added to one of these antiplatelet therapy.

This dual antiplatelet therapy (DAPT) reduces the likelihood of blood clots forming inside the stents. But, if you have arthritis pain and add an NSAID like diclofenac or ibuprofen, there is an increased risk of a life-threatening bleeding ulcer.

Other Options for Arthritis Pain:

With all these constraints surrounding NSAIDs, you may want to consider nondrug options such as ashwagandha, boswellia, bromelain or tart cherry juice. Acupuncture or apitherapy (bee stings) may also provide some benefit.

To learn more about these possible approaches to easing joint pain and inflammation, you may wish to read our online resource, Graedons’ Guide to Alternatives for Arthritis. This 56-page document is available at PeoplesPharmacy.com.

Before you start on any supplements, however, make sure to check with your physicians about the potential for interaction with any of your medications. For example, we worry about taking turmeric together with an anticoagulant. We have heard from people who have experienced significant changes in bleeding times because of a combination of warfarin and turmeric or curcumin.

Share your own story about NSAIDs below and any nondrug approaches that have helped you.

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  1. Mary R

    Tylenol is useless
    i am so sick of prescribers using acetaminophen as a suitable choice for severe pain.
    It has never been scientifically proven to help pain nor by statistical research. Tylenol is nothing more than a placebo for headaches?

    NSAIDS are nasty for the heart, nasty for the renal system and the stomach.

    What’s left other than opioids or cannabinoids?

    The latter are far safer for the average stable minded pain patients.

    its time to stop the war on chronic pain .

  2. KATE
    Wales, uk.

    I am really stuck. I have acute arthritis in my knees that precludes sleep, and walking is almost impossible. I just about get around in the house. Stairs are a nightmare. I have multiple allergies confirmed by NHS consultants. Already, my diet is salycylate, gluten, and chemical free. I eat only home cooked food with no additives. Can’t use termeric, etc., as they are high salycylate. Steroids, NSAIDs make me whole body ill; antihistamines make me high. My current medical advice tells me to dissolve all medication and take a teaspoon at a time until a thereapeautic dose is achieved. So far, I’ve had no success with anything. Do we just have to grin and bear it? It’s a tough call with high pain levels and immobility. Any ideas out there? Any one else with this total allergy situation?

  3. karem


    I was diagnosed of Parkinson disease in January 2015,then my mom was diagnosed of Rheumatoid Arthritis (RA) and my father was diagnosed of ALS me and my family was so frustrated till one day my father came across a forum where so people was writing about Dr George (Good health herbs home), who sells herbs supplements to cure different kinds of deadly diseases,so me and my family decided to give it a try . We contacted Dr George (Good health herbs home) immediately and purchased herbal supplements for Parkinson Diseases,ALS and Rheumatoid Arthritis (RA). He sent the herbal supplements to me through courier service and i received it within 2days. i used it as instructed and me and my family was totally cured of Parkinson Diseases,ALS and Rheumatoid Arthritis (RA) within 5 weeks of usage, all thanks to Dr George (Good health herbs home) God bless.
    please contact him with the following details below;

  4. Patricia
    Melbourne, FL

    I have arthritus in both knees, both hands, neck and two toes on left foot. My doctor recently told me to increase the Tylenol 8 hr from two in am to three in am and also take three 8 hours later. I also take two Tylenol pm at bedtime, which he approves of. I have tried everything I have ever read in PEOPLE’S PHARMACY and nothing else helps. I use Biofreeze roll-on on my neck as it is the only thing that doesn’t sting/burn my neck. I also use the Two Old Goats (thanks for that tip) on my hands as anything else stings/burns. I found the best for knees and two toes is Ben Gay Ultra. I believe over the years I have tried every over the counter ointment and pill and only the above gives any relief. I am 81 and still do all my own housecleaning, yard work and wash the car. I also regularly keep my son’s yellow lab, which gives me company and a nice walking companion.

  5. Paul

    Background: 84 year old male. R A since 1963. Osteoarthritis in back, cervical spine and considerable pain in both hands/wrists caused by R A damage. For the past year arthritis in both knees causing considerable stiffness and pain.

    About 5 weeks ago I bought a 2 oz. bottle of CBD marajuana cream ($29.00) and applied it to the cervical spine and hands, finger joints and wrists. Within ten minutes the pains stopped. The cervical spine issue has plagued me for over ten years. Now I need only use the cream once each day and recently have been able to reduce usage to once per day applied every 2 or 3 days.

    I guess I have used about 20 percent of the 2 oz bottle so five weeks of relief has cost only about six dollars! The CBD cream is non-hallucinating and is available at Amazon and other websites.

    Again, Joe, thank you for providing this forum where we can discuss such issues and help each other.

    Paul P


  6. Susanne

    Ibuprofen is a great pain killer, and the only thing my dentist recommends. Had to take it daily for 2 weeks after oral surgery, and I wound up with stomach inflammation that was really painful. Dentist has no other recommendations for pain, so now what?

  7. Annette

    I have osteoarthritis in my knees mostly, and more recently a little in my neck and some fingers. What helps me a lot is an enzyme I take on an empty stomach called Wobenzym N. My friend’s doctor recommended it during her recovery from breast cancer to counteract her feelings of stiffness, and apparently, the Germans have been using it for decades for arthritis. I also take supplements with tumereric and Boswellia in it which seem to help. Additionally, I’ve been doing tai chi for years, including weekly classes, and more recently, I do a round in the AM and PM which helps tremendously not only physically, but mentally and emotionally as well. If learning a full round is too much, even learning the first third of the round is very beneficial.

  8. Barbara
    Hickory, NC

    I have been reading about Boron and arthritis. I did take it and get some relief ( like a pain pill) for short time. I have not been taking it long enough to to say how much it helps.

  9. Steve

    Some arthritis like symptoms in my hands and fingers. Doc immediately wanted to put me on basically a lifetime prescription. Green lipped mussel oil has done the job without the side effects. And at least for me, it helped me out and then I could cut back and go back on it (admittedly it is not fast acting..takes a couple of weeks) when the pain and stiffness flair up again.

  10. Amy
    Portland, OR

    I had to stop taking recommended doses of ibuprofen, because my kidneys were basically one step from failure according to lab tests. My doctor told me to quit taking the ibuprofen and any related OTC drugs. No problems since. I have been taking aspirin since then, but have also discovered a curcumin and boswelia based supplement called Curamin which for me is surprisingly effective for arthritis pain.

  11. Charles
    Burleson Tx

    I get good relief from topical DMSO. Can’t take NSAIDs due to being on eliquis blood thinner. Does DMSO affect Eliquis?

  12. Chuck

    My situation is different. I had blood clots after an accident 25 years ago and again “out of nowhere” 6 years ago. In the latter case, I had clots in my lungs, so was lucky not to have serious consequences. The upshot is that I am on warfarin ( or some other anticoagulant) for the rest of my life. I also have arthritis, mainly in my right thumb/wrist, but cannot take NSAIDs. Suggestions?

  13. Chaela

    Having had two femur fractures and a hip replacement, I have been using capzasin-HP creme available at all drug stores OTC with terrific success and inexpensive cost. For a higher price point salves of CBD’s and THC are excellent at stopping arthritic pain in a few minutes time. Over ten years, cannot imagine another choice as safe and effective. (Capzasin is best purchased in the red and white box; store brands with same ingredients listed seldom as effective.)

  14. S. H.

    Turmeric has been a lifesaver for me. It has seriously reduced the inflammation in my joints.
    Also, one of the best decisions I have made is to go on a gluten-free diet. While I have not had a test that shows I am positive for Celiac, I certainly have a sensitivity to gluten. The help for my arthritis was a very pleasant surprise. I originally went gluten-free due to gi issues and a chronic eczema-like rash.

  15. ladyliza

    Try Prolotherapy for knee or shoulder and hip pain. It took a couple of months after the injections to realize I was no longer experiencing knee pain. The injections stimulate the collagen in your knee to regrow. I had mine about 5 years ago, and my knees have been great since I had it. My internist gave it to me, and my insurance company paid for it. Doctors and chiropractors who deal with a lot of sports injuries will offer this.

  16. ladyliza

    I read somewhere that if you eat a grain free diet, you can improve all kinds of arthritis, if not all of it. The book by William Davis, MD is a good place to start. Then you wouldn’t need the painkillers at all. I have been on this plan only 4 days, but I hope good things will follow.

    • Terry Graedon

      This may be helpful for some people, but not for others. It is worth doing the experiment for six weeks or so to see how you respond.

  17. Jane

    Medical Cannabis in the legal States sure helps with arthritis pain and any other pain. Just google it. (You can use it w/o getting ‘high’ due to the CBD’s in it.)

  18. Sunny

    White willow bark. Works.

  19. Pris
    Mount Vernon WA

    I won’t take scary NSAIDS for the arthritis pain in both knees, but since I live in Washington state, I was able to buy some topical salve at a local cannabis store. Smells good (not like pot) and won’t get me high, and does relieve the pain to some extent.

  20. Carolyn

    I too am caught between a rock and hard place. I have rheumatoid arthritis and the joint pain that goes with it. Enbrel, Humira, and now Orencia injections, have helped but I have not gotten complete remission. I take Tramadol at night when the pain is the worst and try to avoid Aleve and Motrin and have tried all the home remedies with little success. I retired because the joint pain was too much but would still like to garden, walk and travel. It is presently too painful to do much gardening or the nature trails. Massage, whirlpool, stretching and and chair yoga keep me moving. Hopefully there will be an answer soon for all of us in this situation.

  21. Dona

    I have no stake in this product but I have used “Australian Dream” a cream for arthritis, on my knees for stiffness and it really works! It was recommended to me by a friend who also had great results with it. I don’t need much and use it every other day or so.

  22. Peggy

    I started taking one teaspoon of vinegar (apple cider vinegar) and 1 tsp of honey in a
    a glass of water three times a day. Taking this vinegar honey combination not only helped my tendonitis but it also worked for my arthritis and leg cramps (Charlie horses in other words).

    I read in the People’s Pharmacy that turmeric, black pepper and garlic powder was good for inflammation and pain. I used it while I was in the hospital and cut down on the pain medication sooner than everyone expected. I slowed up on the use of the seasoning until last week when I decided that maybe it would help my hand and fingers. I no longer have that problem.

    I drink vinegar honey water, eat 9 golden raisins a day, and use the seasoning constantly and I am once again happy and pain free. I also drink beet juice for my blood pressure. Oh yes I am 76 years old and continue to do all my own work in the house and the yard.

    • Colleen

      I wish that I could buy a 10000 billboards and tell people that some/much arthritis is caused by food allergies. For me, it is sugar and dairy. Began in my 40s with achy knees. Five years later, I did the Elimination Diet. I woke up about 22 days into it, pain free!
      This change set me on a mission to understand the uniqueness of my body. At 64, I seldom hurt. If I do, I know it is food and become a detective. We can be our own doctors for some problems!

  23. Annie

    Back prior to 2011, I had horrible arthritis pain in my back and saw a holistic neurosurgeon. She told me to eliminate inflammatory foods — no more gluten, sugar or cow dairy. No more chemical additives. I followed this protocol strictly and within a few days my pain disappeared. I have been on it ever since.

    • Anna

      Why not try CBD oil..It works for me and has no side effects and can be purchased online or at some health food stores. It can be taken with any other meds or foods. Can be purchased in either oil or capsules. Boswellia also works good and Glucosamine with MSM and Condroitin which are all natural products that work for most people..CBD oil can be available through your Dr now in Canada as well.

  24. Jake
    Winston-Salem NC

    Get rid of the fluoride! My arthritis kept getting worse. I couldn’t take NSAIDs because of stomach upset. Curcumin and tart cherry juice helped a little. Three months ago, I read that fluoride causes osteoarthritis. I began using a Zero Water filter to remove fluoride for drinking and cooking. I installed a fluoride filter on my refrigerator to remove it from ice. Within 2-3 weeks my arthritis improved 80%. I kid you not: Eighty percent. Cutting out fluoride was the ONLY change I made to diet and supplements. I am age 61, and feel like I’m 41.

  25. Carolyn

    Why is aspirin never mentioned in these articles? Other than stomach upsets that NSAID’s also cause, what are the side effects of taking aspirin for arthritis pain? It’s a pain reliever and anti-inflammatory and works great for me.

    • Pam

      I also wonder why aspirin is not mentioned. I understand that it can also have side effects but for most people it seems safer than other nsaids.

    • Mary
      Louisville, KY

      I’m with you – I can’t believe aspirin is never mentioned in these discussions. Ironically, aspirin is also good for your heart – I take a baby aspirin every night as a preventive measure. I’ve given up NSAIDs just because, and acetominophen because it can damage the liver (I enjoy my two glasses of wine every night). If I’m having some arthritis pain, I generally take three aspirin with a full glass of water, then follow that with some caffeine, which gives it a boost. Works well for me. But, of course, check with your doctor first.

    • Cheryl

      Aspirin is also a NSAID. People with certain conditions cannot take even aspirin due to the blood thinning properties.

    • Mary R

      Aspirin is much better than Tylenol in fact 10000% better, because Tylenol is a placebo that does nothing except placate doctors and damage the liver.
      Aspirin whilst less problematic for the cardiac system can, in the quantities needed for significant pain, cause severe stomach , oesophagus and duodenal issues. However it should be considered as an add on to non NSAID pain relief in the normal population but NOT taken with NSAIDS.

  26. Michael

    I started to see symptoms of arthritis in my right hand about 8 years ago. The owner of a local health food store recommended Curcumin. The pain went away, and I’ve been taking it ever since with good effect. Now, I occasionally get a small twinge in the index finger, but am otherwise pain free. So far, no other joints have acted up, so the curcumin may have a prophylactic effect as well, although my physical therapist thinks my “back pain” is really arthritis in my hips (contrary to what the physiatrist who recommended the PT said).

  27. Dorothy

    I stopped taking NSAIDs after I read that they could affect your mental (dementia) condition. I am 80 and experiencing problems remembering things . The acetaminophen pills are not as effective for pain relief as the NSAIDS… and I don’t know if they have effects on memory or not.

    • Mary R

      That’s rubbish im afraid. If anything NSAIDS actually increase curculation which means that whikst risky for the heart they are not likely to cause dementia or Alzheimer’s.

      Be careful what you hear or what you read.

  28. Tony

    A lot of people with heart problems take anti coagulants. So they can’t take NSAIDS
    I have accupuncture for pain, it works even better trhan NSAIDS

  29. Janie
    Ft Wayne IN.

    Good day. I am 62. For over three years I had suffered with bouts of extreme diarrhea. At time’s I couldn’t even leave the house it was so bad. Finally in 2016 I went to a gastroenterologist. After trying different treatments for some time we did a colonoscopy, which showed I had collogenous colitis. The Dr said there was a very good chance it was caused by the ibuprofen I had been taking for osteoarthritis. I stopped Ibuprofen in Dec of 2016 and have had no bouts with diarrhea since. Also, I have had episodic bouts of A-fib which started in 2005 and since stopping the ibuprofen I have had no problems with the A-fib either. My blood pressure has dropped to the 115/70 area as well. Ibuprofen is a wonderful pain reliever but the side effects are dangerous.

  30. Terry

    I am surprised that you did not mention marijuana as a very effective pain reducer. I understand that it is still illegal in some states, but in those states where it is legal, people should know about it. I had AVN ot the top of my femur, and was overdosing on Dilaudid. After starting to eat a very small amount of marijuana, I was down to 2 Dilaudid a day.

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