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Arthritis Sufferers Caught In Dilemma

Posting Date: 09/05/2005

Pity anyone with pain that lasts more than 10 days. That?s how long the FDA says you can safely take an over-the-counter analgesic such as Advil, Aleve or Tylenol on your own.

The trouble is that one in three adults (66 million people) suffer chronic joint pain. That means millions need something to ease their discomfort almost every day.

One reason the FDA limits the use of nonprescription pain relievers is that many of them can irritate the digestive tract. Doctors have estimated that more than 100,000 people land in the hospital each year with drug-induced ulcers and over 15,000 die from complications of these medicines.

A study from Spain shows that one-third of the hospitalizations and deaths from gastrointestinal bleeding in that country are due to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin. Even low doses of aspirin can cause serious problems (American Journal of Gastroenterology, Aug. 2005).

Worries over NSAID complications fueled the development of medicines like Bextra, Celebrex and Vioxx. These COX-2 inhibitors were designed to protect the digestive tract from damage while providing pain relief.

Unfortunately, the cardiovascular complications of these drugs have often outweighed their benefits. That?s why Vioxx has been taken off the market and Celebrex has a prominent warning about heart attacks and strokes. As a result of the COX-2 debacle, researchers are now scrutinizing other NSAIDs to see whether they also have cardiovascular complications. Preliminary data suggest that drugs like ibuprofen, naproxen and prescription NSAIDs may pose a risk. Aspirin is the exception.

Acetaminophen seems like the ideal solution to this dilemma. It relieves pain but does not irritate the digestive tract. New research suggests, however, that regular use may elevate blood pressure.