The NSAID Myth (Part 1): The undeniable Adverse Effects

Reference:Fosb�l EL, et al Cause-specific cardiovascular risk associated with nonsteroidal antiinflammatory drugs among healthy individuals. Circ Cardiovasc Qual Outcomes. 2010 Jul;3(4):395-405. Epub 2010 Jun 8.
Mass� Gonz�lez EL, et al Variability among nonsteroidal antiinflammatory drugs in risk of upper gastrointestinal bleeding. Arthritis Rheum. 2010 Jun;62(6):1592-601.
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Chou R, Huffman LH; American Pain Society; American College of Physicians. Medications for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007 Oct 2;147(7):505-14.
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Here is a short 3 part article on this topic for which I am quite passionate about. I?ll call it The NSAID Myth! Feel free to share this email and the references below with your patients.

This 2010 study involved 4.7 million (Yes that?s almost 5 000 000!) healthy individuals from the Danish population and concluded that the use of specific NSAIDs is associated with an increased risk of cardiovascular death. There was also a trend for increased risk of fatal or nonfatal stroke associated with ibuprofen treatment! Another 2010 study involving 1 million healthy people showed that the selective COX-2 inhibitors as well as diclofenac are associated with anincreased risk of death or myocardial infarction.

A recent 2010 systematic review clearly concludes that basically all NSAIDs significantly increase the risks of upper GI bleeding/perforation!

A 2008 review suggests that limited clinical data support the hypothesis that certain NSAIDs significantly delay fracture healing.

In experimental studies, researchers produce an acute injury in animals, then give them NSAIDs or no NSAIDs and subsequently sacrifice them (Ethics committee will not allow humans to be used in these studies!) They confidently conclude that certain NSAIDs hinder to tissue repair and impair mechanical strength return following acute injury to bone, ligament and tendon.

Yet sadly, evidence-based medicine recommends NSAIDs as most “effective” strategy for the management of acute musculoskeletal pain such as low back pain. In fact the American College of Physicians clinical practice guideline strongly recommend NSAIDs for low back pain. Even the Cochrane database review (2008) suggests that NSAIDs are effective for SHORT-TERM symptomatic relief in patients with acute and chronic low-back pain without sciatica.

So what?s the problem? Not one study has ever looked at LONG-TERM recurrence rates!!!!!

Personal Comment:Sure NSAIDs help in the short term, but could their excessive use be A CONTRIBUTING FACTOR to chronic musculoskeletal pain such as osteo-arthritis and low back pain!

Posted on: November 22, 2010

Categories: Modalities / Meds / Supplements

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