What alternatives to NSAIDs are available?
It may be easier to choose an alternative for a short-term problem than for a long-standing one. For chronic pain, it is important to consult a doctor or pharmacist about medication.
This article will examine two extremely common conditions for which people take NSAIDs: Headaches and lower back pain.
NSAID alternatives for a headache
There are many options to treat a headache.
NSAIDs, such as ibuprofen, are a treatment option for a headache.
Ibuprofen and similar drugs are effective options if a headache is accompanied by other symptoms, such as a running or blocked nose, other aches and pains, or a fever.
However, overuse can lead to side effects, such as a chronic headache. NSAIDs can also have effects on the heart and digestive system.
Acetaminophen, such as Tylenol, is a widely available alternative to NSAIDs that targets pain rather than inflammation.
As stress can also be a factor in the development of headaches, relaxation techniques, such as meditation or long baths, can help reduce symptoms.
For chronic headaches, researchers are exploring new avenues of long-term pain management that do not require the potentially harmful long-term use of NSAIDs. The electrical stimulation of deep-brain structures has been studied in terms of its ability to address pain sensation and perception pathways in the brain.
Different researchers carried out a very limited study on the effects of acupuncture that found an association between these alternative treatment options and reduced symptoms of chronic pain in children.
NSAID alternatives for lower back pain
Other options to manage lower back pain include CBT and occupational adjustments.
NSAIDs are frequently used to treat lower back pain and are particularly useful for new or short-term instances.
Back pain can last for years in some cases, however, and it is usually not safe to take NSAIDs for this long.
Occupational adjustments can be made to improve back support, including:
- adapting elements of the workspace, such as desks and chairs positioning
- adjusting the tasks normally involved in the job and avoiding responsibilities that can make back pain worse, such as heavy lifting
- changes to working hours
Cognitive behavioral therapy (CBT), including individual and group sessions, can also help to educate people who experience back pain in strategies to cope with pain and how to change their behaviors in a way that amends posture and reduces the risk of future flare-ups.
CBT can help the following behaviors that might exacerbate lower back pain:
- too little physical activity
- making pain seem worse than it is
- not engaging in activities and exercises that might support the back, such as yoga or pilates, due to a fear of pain
Various healthcare professionals can also assist in back pain, including psychologists, occupational therapists, nurses, and physical therapists.
Acupuncture, physical therapy, and yoga can all help to manage back pain and the risk of flare-ups reducing the need to take NSAIDs.
Pain management plans
Pain management plans can help handle pain without NSAIDs.
A useful approach for managing long-term pain without overusing NSAIDs is a pain management plan, although NSAIDs may well form part of a pain management plan for short periods.
A team of doctors and specialists can recommend a multi-layered approach that gradually steps up the treatment options for difficult pain conditions that become long-term.
The idea of this approach to management is that it takes account of the different layers of the individual's experience of long-term pain and their response to it. It is effective for problems lasting longer than 3 months, not including cancer pain.
Stepped care for long-term pain includes dealing with the "biopsychosocial" elements of pain. It not only the pain itself that can affect daily living, but also the emotional strain of coping with constant pain, as well as the social impact of pain-induced behaviours and routine.
An effective pain management plan takes the following into account:
- Measuring the pain: The individual will regularly rate both the intensity of pain and the level of interference with quality of life.
- Measuring the mood: The treating doctors will assess psychological distress, anxiety, depression, and screen for mental health problems, such as post-traumatic stress disorder (PTSD).
- Sleep impact: Doctors treat some chronic pain conditions with opioids. However, these drugs have been associated themselves with disorders, such as sleep apnea, so there may also be an assessment for this.
The doctor or team of physicians will assess and manage the risks and possible benefits of any prescribed or OTC medication, including NSAIDs.
Short-term use of NSAIDs, however, is still safe and recommended for the treatment of many instances of pain and inflammation.