Are Anti-Inflammatory Pain Relievers Safe for You?
Here's help weighing the benefits and risks of NSAIDs, from aspirin to Celebrex
Sorting Through Conflicting Advice continued...
"We act as if heart disease, gastrointestinal problems, and chronic pain
are all completely unrelated conditions," says Cryer. "But there's a
lot of overlap, especially in older people."
If you're seeing a number of experts, you might be getting a lot of
contradictory advice. Cardiologists who treat heart problems tend to focus on
the risks of NSAIDs. Rheumatologists who treat arthritis tend to focus on the
"We don't have the same perspective as cardiologists and other
specialists," says rheumatologist Klippel.
The problem is that your body can become the battleground for these
"I'll have patients with heart failure who are doing fine for
months," says cardiologist Goldberg, "and then all of a sudden, their
symptoms get worse. Their blood pressure goes up or their ankles are swollen.
And we eventually figure out that it's because their orthopedic specialist
prescribed an NSAID."
"Getting these people the correct medicine requires a careful balancing
act," says Goldberg.
The Bottom Line: Coordinate Your Treatment
Because specialists have different perspectives on your health, it's
important to get them all on the same page.
"If you're confused by conflicting advice about NSAIDs from specialists,
get them to talk to each other about your case," says rheumatologist Scott
Zashin, author of Arthritis without Pain and Clinical Assistant Professor at
the University of Texas Southwestern Medical School.
You might ask your primary care physician to coordinate the advice from all
the different specialists. If your primary care doctor does not have the time,
keep a list in your wallet of all the medications you take, and show the list
to every doctor at every appointment. In a rush? Just throw the bottles in a
bag and bring them along, says Goldberg.
Once your doctors understand the bigger picture, there are ways that they
can collaborate to avoid or reduce the side effects from NSAIDs.
For instance, if you have a high risk of gastrointestinal problems, Cryer
says that you may be able to take an NSAID along with a strong stomach acid
blocker -- such as Nexium, Prevacid, or Prilosec -- to reduce the risk of GI
If your doctor thinks that NSAIDs simply are not safe for you, discuss
whether you should consider regular Tylenol (acetaminophen) or prescription
narcotics like OxyContin, Percocet, and Vicodin. When used carefully under a
doctor's supervision, the risk of addiction to narcotic painkillers is lower
than most people believe, Klippel says.
Zashin also suggests that people explore other ways of relieving pain.
"Patients should also look for techniques to reduce pain that don't rely
on medication," he tells WebMD, "like biofeedback, acupuncture,
hypnosis, and yoga." Depending on your condition, physical therapy,
exercise and weight loss -- if you're overweight -- can also improve your