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Whether it is chronic or acute, pain affects the quality of life of millions of Americans every day. Pain varies in severity, based on its cause and other factors. It is felt when special nerves that detect tissue damage send signals to transmit information about the damage along the spinal cord to the brain. Literally, billions of dollars are spent each year by consumers who are trying to “interrupt” this signal with non-prescription, over-the-counter (OTC) medications.

The Consumer Healthcare Products Association estimates that more than 2.9 billion retail trips are made each year for OTC medications and the average U.S. household spends about $338 per year on these non-prescription drugs. Among the most popular of these OTC medications are those that are used to treat pain including Ibuprofen, such as Advil® and Motrin ®, and acetaminophens, such as Tylenol®.

Professional Athletes: Setting an Example

Some physicians believe that the popularity of Ibuprofen is being driven by professional and amateur athletes who use it. Dr. Craig Lankford of Texas Back Institute feels this presents a dangerous situation.

According to the Wall Street Journal, “Ibuprofen has long been popular among athletes not merely to treat pain but to ward it off. But several studies in recent years have highlighted potential side effects including an increased risk of heart attack or stroke, kidney and gastrointestinal problems and even lower male fertility.

“Some doctors and academics argue that the widespread, casual use of Ibuprofen to pre-empt pain is a problem to which most athletes are blind.”

An Expert Looks at Ibuprofen

Dr. Lankford specializes in physical medicine and rehabilitation. Many of his patients are unable to function properly because of unrelenting pain caused by conditions such as arthritis and injuries. His experience with OTC medicines makes him an excellent source of information about the advantages and dangers of these drugs.

“Ibuprofen is in a class of pain treatments that are nonsteroidal anti-inflammatory drugs,” Dr. Lankford said. “It is commonly used for treating inflammation in the back and joints, which is often caused by arthritis.

“Even though it is readily available and, in most cases, effective, Ibuprofen comes with many medical dangers. It can cause damage to the stomach in the form of bleeding or perforated ulcers. Plus, if the patient has kidney disease, taking too much Ibuprofen can cause permanent damage to this organ.

“Ibuprofen also has some of the properties of a medication called Vioxx ™. This medication was used about ten years ago and was a very powerful anti-inflammatory drug.”

According to numerous news reports, including one from National Public Radio, “Shortly before the FDA approved Vioxx in 1999, the drug’s maker launched a study it hoped would prove that Vioxx was superior to older painkillers because it caused fewer gastrointestinal problems. Instead, the study would eventually show Vioxx could be deadly, causing heart attacks and strokes. Five years after its launch, the drug was withdrawn from the market. But by that time, billions of dollars of the drug had been sold worldwide.”

“As a result of these problems,” Dr. Lankford said. “Medical researchers took a closer look at a broad range of anti-inflammatories, including Ibuprofen.”

How Much is Too Much?

If professional athletes are seen using Ibuprofen constantly, how does an amateur athlete know when he or she is taking too much of the medication?

“Reading the label is a good place to start for an answer to this question,” Dr. Lankford said. “The Ibuprofen that is sold over-the-counter is composed of 200 milligrams in each pill. The directions on the label advise that a person should take no more than one or two tablets every six hours. Following these directions can help keep the medication dosage in line with what would be considered a healthy use.

“We would prefer that the patient avoids taking that level of medication every day. I get concerned when my patients take three Ibuprofen tablets, four or five times a day. This is certainly too much medication.”

Alternative Pain Relievers

Is there something that works as well as ibuprofen without the side effects?

“An alternative to Ibuprofen is acetaminophen or Tylenol,” Dr. Lankford said. “This drug does not have the same stomach irritation, kidney damage and the potential for stroke or heart attack. However, Tylenol has the potential for causing liver damage. As a result of this, its manufacturer has changed the dosage recommendations for this drug.

“Once again this shows the importance of reading the label of every drug, even those that are sold over the counter.

“For a more holistic treatment of pain, there are supplements that do not require a prescription. Many of my patients have had success using the herb turmeric, which contains curcumin, a substance with powerful anti-inflammatory and antioxidant properties.”

Can common foods such as bananas help reduce pain?

“As we come to realize the deleterious effects of these medications, patients are searching for natural alternatives, such as bananas,” Dr. Lankford said. “There has been some basic research on this fruit, which is known to be an excellent source of potassium, and it suggests that it has anti-inflammatory properties. Fish oil is another naturally occurring substance that has been suggested to have anti-inflammatory properties for arthritic pain.

“While they might not work for every patient, nature has many remedies that we can use for pain relief and additional research is needed to determine their efficacy.”

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