A Beginner's Guide to RA: NSAIDs

by Lene Andersen, MSW Patient Advocate

Once you get a diagnosis of rheumatoid arthritis (RA), the next thing that usually happens is that the doctor gives you a prescription for one or more medications. This can feel quite intimidating—what do the medications do? What about side effects? And wouldn’t it be better not to take pills? This article will discuss NSAIDs and cover some common side effects and how to manage them, as well as talk about why taking medication is a good thing when you have RA.

What are NSAIDs?

NSAIDs, or nonsteroidal anti-inflammatory drugs,are a group of medications that do exactly what that phrase describes: they deal with inflammation, but are not steroids.

There are many NSAIDs on the market. Some of the names you may recognize are Celebrex, naproxen, Voltaren, aspirin, and ibuprofen. Some NSAIDs are over the counter, some are prescription, and some are both. For instance, Aleve is a lower-strength version of prescription naproxen sold over the counter.

NSAIDs are used for the treatment of inflammation and pain in many conditions, including RA. It’s important to note, however, that NSAIDs only treat the symptoms, not the cause of the inflammation and pain. Although they can be an effective tool in helping to lower your experience of inflammation-related pain, they will not protect your joints against damage caused by RA. To treat the cause of the symptoms, you will need DMARDs (disease modifying antirheumatic drugs), such as methotrexate or one of the biologics.

Common Side Effects and How to Manage Them

One of the most common side effects of NSAIDs is gastrointestinal problems, such as nausea, constipation, or diarrhea. These kinds of drugs can be hard on your stomach. They can even cause stomach ulcers or gastric bleeding in some people.

There are a number of things you can do to prevent or manage the gastrointestinal side effects. One of the most important is to take these medications with food. Having a full stomach acts as a sort of cushioning buffer between the medication and your stomach lining. This can also help reduce the side effect of nausea. In addition, you may wish to talk to your doctor about using a Cox-2 inhibitor type of NSAID, such as Celebrex or Mobicox. Cox-2 inhibitors were developed with the specific goal of being easier on the stomach.

If you experience constipation, add more fiber to your regular diet by eating whole-grain breads and pasta, using hummus as a sandwich spread instead of mayonnaise, and snacking on trail mix and fruit. Should your constipation continue, prune juice can do wonders and you can also try an over-the-counter stool softener.

If you have diarrhea, eat foods that normally cause constipation, such as white rice, blueberries and beef. You can also use over-the-counter anti-diarrhea medications, such as Imodium. If either your constipation or diarrhea is severe, speak to your doctor about possibly trying another type of NSAID.

More rarely, NSAIDs can affect the functioning of your liver and kidneys. Although NSAIDs tend to be safe to use for a prolonged time, it’s important to do so under the supervision of a doctor and have regular blood tests to monitor liver and kidney function.

Should You Take NSAIDs?

Most people are able to use NSAIDs to manage their symptoms of RA inflammation and pain. However, NSAIDs are not for everyone. If you already have issues related to liver or kidney function, NSAIDs may not be the right medication for you. People who have a history of bleeding ulcers, or live with Crohn’s or ulcerative colitis, are not good candidates for this kind of medication. If you have a history of high blood pressure, heart disease or lung disease, they may also not be the right medication for you.

If you cannot take NSAIDs, there are other options for treating your pain. Ask your doctor for more information.. If you are having trouble getting your pain under control, you may also consider asking for a referral to a pain management specialist.

Why Take NSAIDs?

Taking medications on a daily basis can feel counterintuitive. Isn’t it better to be as natural and chemical-free as possible?

Chemicals aren’t universally bad. In fact, there are many chemicals that are incredibly helpful to us. When you have RA, medication can be your friend, not your enemy. Having a chronic illness and chronic pain is not normal. The goal of taking medication is to reduce the impact of RA and pain so you can live your life as well as possible. These types of medications can be very helpful in achieving a better quality of life. Whether you have chronic pain from RA, or are looking to control more sporadic symptoms, NSAIDs can be an important tool to help you manage your pain.

Lene  Andersen, MSW
Meet Our Writer
Lene Andersen, MSW

Lene Andersen is an author, health and disability advocate, and photographer living in Toronto. Lene (pronounced Lena) has lived with rheumatoid arthritis since she was four years old and uses her experience to help others with chronic illness. She has written several books, including Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain, and 7 Facets: A Meditation on Pain, as well as the award-winning blog, The Seated View. Lene serves on HealthCentral's Health Advocates Advisory Board, and is a Social Ambassador for the RAHealthCentral on Facebook page, facebook.com/rahealthcentral. She is also one of HealthCentral's Live Bold, Live Now heroes — watch her incredible journey of living with RA.