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The Cure for Chronic Pain How You Can Help Yourself Heal Series Drugs Found Guilty of Causing Pain Nancy S. Moore, PhD, RN March, 2011 Copyright 2011 By Natural-Healing-Health
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Table of Contents Drugs Found Guilty of Causing Pain Personal Experience and Supporting Evidence
Be Informed —Take Control Sources and Resources Drugs Found Guilty of Causing Pain On January 1, 2008, the FDA (Food and Drug Administration) released a drug alert warning of possible severe and sometimes incapacitating bone, joint, and/or muscle pain in patients taking bisphosphonates (drugs treating osteoporosis). On October 25, 2008, an entry on a Wall Street Journal blog, “Osteoporosis Drugs Can Cause Bone-Crushing Pain” read: “I’m shocked and worried to learn that my very sore hip joints (two weeks now) and sore upper arm - can not lift above shoulder height and feels heavy, can in fact be due to the Boniva [a bisphosphonate] I’m taking. I also have had severe indigestion - and these are all Boniva Side effects - I’ve taken this drug for about six months now! Am worried how long this pain will last!” These osteoporosis drugs are but one of a growing list of drugs now found guilty of causing pain. The use of pharmaceuticals to cure our ills is so prevalent in mainstream medicine that we have become blind and numb to their dangers. Further, seduced by pharmaceutical commercials and a cultural mindset that doctors know best, we forget (or never were aware of) our amazing in-born ability to heal. Too often and too quickly, we jump to outside sources for a quick fix when all along the secret to our health lies within us. Drugs are not all bad or always bad. They have their place and time. For example, antibiotics have saved the lives of thousands. Yet because of their overuse, “super bugs” such as methicillin-resistant staphylococcus aureus bacteria (MRSA) have evolved. These bacteria strains are more dangerous than ever. Antibiotics now stand powerless against them. Pharmaceuticals are by their very nature not natural. Their manufacturers design them to address specific symptoms. The problem is that the drugs rarely affect only the symptom. They affect every organ and system in your body. They call these changes “side effects.” All medications have side effects. Pharmaceutical companies are required to list these effects on their product’s package insert. Only, most of us don’t read the package insert because they are often listed in small print. Or, if we do read them, we somehow don’t think they really could happen to us. Here are those most suspect so far: Bisphosphonates, marketed as Actonel, Actonel+Ca, Aredia, Boniva,
Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa;
Statins, marketed as Lipitor, Zocor, Mevacor, Pravachol, Crestor; Cortisone, a steroid hormone, some times referred to as a corticosteroid; and Nonsteroidal Anti-inflammatory Drugs (NSAIDs), marketed as Advil,
Aleve, Motrin, Clinoril, Voltran, Clebrex.
Here is an example of a listing of side effects from the Advil® insert:
Dyspepsia, gastro-intestinal intolerance and bleeding may occur. Other side-effects include nervousness, skin rash, pruritus, tinnitus, oedema, depression, drowsiness, insomnia, blurred vision and other visual field defects. Sensitivity reactions, abnormalities of liver function tests, impairment of renal function, agranulocytosis and thrombocytopenia have been observed. Acute reversible renal failure has been reported. ADVIL should be used with care in patients with impaired renal function.
You may trust that your physician is fully aware of these side effects and would not prescribe a medication unless it was safe for you. But doctors may overlook them or fail to make important considerations for your specific health condition. As one woman replied to another blogger’s plea for advice on how to convince her doctor that the statin drugs she is taking might be causing her extreme fatigue and joint pains: “Please listen to your body, if your cardio [cardiologist] won't listen to you, then find one that will. If we don't actively promote our own health and concerns, I am discovering that most docs don't either.”
Top of the list to get your concerns addressed when you think drugs may be guilty of causing your pain, is to become knowledgeable about your condition and medications. Here’s a basic rundown with some personal experiences and supporting research.
Personal Experience and Supporting Evidence Bisphosphonates
One woman who took Boniva for seven months said she was not “fully advised of the side effects.” She wasn’t too concerned when she experienced flu like symptoms after her fist dose. The brochure said to expect these types of symptoms. She just “toughed it out.” Then, about 10 hours after the 7th dose she was “overwhelmed with bone pain.” She felt discouraged and wondered what to do as her pain continues. Another, who has been taking Boniva for more than a year, reported having muscle and joint pain for several months. She believes Boniva is “the culprit” and plans to discuss it with her doctor. Another woman wrote, “I wish I would have read all the postings on the net about Boniva. I would NOT ever take it. I am suffering right now. I took my first pill (one-month pill) last Wednesday and tonight I can barely move… I will not take Boniva ever again and I will not recommend it to anyone.” In their January 7, 2008 alert, the FDA advised that biphosphonates may be responsible for severe muscle, bone, and joint pain. They advised health professionals to stop the drug if pain develops. Even after stopping the drug, some patients may have slow or only partial relief of their pain. Statins
On another blog, a woman reported that since she started taking Lipitor, then Zocor, she has joint pain in her shoulders, hips, knees, ankles, and hands. She feels so exhausted she has trouble functioning at times. Another reported she has been on Lipitor for eight years. She has continual body aches, joint pain, and flu like symptoms. Again, an FDA ALERT originally posted in March 2005 and updated in August 2009 warns of serious muscle damage and possible kidney failure in patients taking Crestor as well as other statin drugs. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs relieve pain, but they also may stop your natural healing process by blocking the first phase of healing, inflammation. When you’re injured your body responds with an awesome sequence of events called the healing cascade. The
injured cells sound an alarm that signals the increase of blood flow to the site bringing nutrients and specialized cells. These specialized cells perform a host of functions such as control of blood clotting and even gobbling up bacteria and removing damaged components. One type of cell releases substances that cause the surrounding vessels to become leaky, allowing immune cells to move into the area. Fluid accumulates at the site and the signs of inflammation occur: redness, heat, swelling, and pain. The most frequent response to this pain in our culture is to take a pain pill, most often a nonsteroidal anti-inflammatory drug, such as Motrin or Aleve. Some physicians, such as Ross A. Hauser, MD, an author and natural health expert, believe that the widespread use of NSAIDs may be contributing to the chronic pain epidemic. It’s estimated that 50 million people suffer with chronic pain. By stopping the first phase of healing, these drugs may affect the entire healing process. In the case of sprains and strains it can lead to weak and loose ligaments and tendons that never get the chance to heal, thus leading to damaged cartilage and joints as well as chronic pain. Ligaments and tendons are rubber band like structures that hold joints together and enable their movement. One example of research supporting this belief is a 2001 animal study of the effects of NSAIDs on injured shoulder joints published in the American Journal of Sports Medicine. In this study, researchers found that the drugs celecoxib (Celebrex or Celebra) and indomethacin (Indocin) significantly decreased tendon to bone healing. Further, the use of NSAIDs like ibuprofen is so common that you may not realize how deadly they can be. They have serious side effects such as kidney and/or liver damage. They cause gastric irritation and ulcers, leading to bleeding that kills some thirty thousand people a year. The newer drug brands like Celebrex cause less gastric ulceration but may cause a heart attack in those with previous heart attack or heart failure. The larger the dose and the longer the duration of NSAID use, the greater the chance of these side effects. Cortisone
King of the anti-inflammatory medications, cortisone may help with short-term joint pain but it also may cause serious long-term harm to your joints. Cortisone achieves its pain relief by suppressing the immune system, thus reducing inflammation and its associated swelling. Some believe that the widespread use of steroids such as cortisone may be contributing to the alarming rise in arthritis rates. Here is a graph showing the prevalence of arthritis based on 2003 – 2005 National Health Interview Survey as noted by the National Center for Chronic
Disease and Health Promotion (CDC) website.
Estimated Number of Adults with Doctor- Diagnosed Arthritis Adults with Arthritis
47,838,000 51,879,000 55,725,000 59,409,000 63,209,000 66,969,000
Dr. Hauser in his 2009 Journal of Prolotherapy scientific editorial said that corticosteroid injections into normal and arthritic knees accelerate the arthritic process. He added, “It is this author’s opinion that there is no doubt that the rise in osteoarthritis, as well as the number of hip and knee replacements, is a direct result of the injection of corticosteroids into joints.” The American College of Rheumatology reported, “It is generally recommended, although not well supported by published data, that injection of corticosteroids not be performed more than three to four times in a given year because of concern about the possible development of progressive cartilage damage through repeated injection in the weight-bearing joints.” In addition, the Mayo Clinic Website warns of deterioration of cartilage within the joint with repeated cortisone injections. They list tendon weakening or rupture and death or thinning of nearby bone among other risks of cortisone shots.
Be Informed — Take Control
There are many resources for gaining knowledge on your condition and medications. In the online environment, You can Google your condition along with key words like organizations, support groups, or one of the more popular medical information sites such as the Mayo Clinic. You can also visit government sites listed at the end. Resources also include your local library or bookstore. Or you may want to subscribe to a relevant magazine or newsletter. Consult with Your Doctor
If you think a drug prescribed by your doctor is causing pain, consult with her or him before stopping it. Every person is unique and what works or hurts one person may do the opposite for another. The medication you are on may be the best solution for you. If you are experiencing side effects, another brand of the medication or a different medication may help. Besides some of these medications may have severe side effects if stopped abruptly. When physicians know of your concerns, they can work with you to find alternatives. If they don’t want to work with you its time to find another doctor who will.
Try Natural Methods
Try natural methods to help your condition and relieve your pain.
Proteolytic Enzymes. Dr. Hauser recommends natural pain relievers that speed healing such as proteolytic enzyme combinations containing bromelain (found in pineapples). Glucosamine. Julian Whitaker, MD, editor of the Health & Healing Newsletter, reported on a study comparing glucosamine sulfate (1,500 mg daily) with therapeutic levels of the NSAID, ibuprofen. It found that although ibuprofen was more effective in alleviating pain initially, glucosamine surpassed it after two weeks and its benefits continued even after patients stopped taking it. Zyflamend. This combination of natural anti-inflammatory compounds including turmeric, ginger, and boswellia may work as well as aspirin or ibuprofen for treating osteoarthritis, according to Andrew Weil, MD. Blueberries. “A flavonoid in blueberries, pterostilbene, lowered cholesterol as effectively as the commercial drug ciprofibrate (Lipanor) in clinical studies." said Dr. James A Duke, former chief of the National Medicinal Plant Laboratory. "And I know people who find turmeric, the root from which curry is derived, to be more effective that celecoxib (Celebrex) for treating arthritis pain.” Ice and Heat. Applications of ice and heat can sooth pain too.
Chose a Healthy Life Style
Focus on a long-term health plan that supports your natural healing system. You might think of this plan as your investment in the lowest cost and best health insurance in the world! The science is clear. Eighty to Seventy percent of your risk of developing a crippling chronic disease is due to how you live your life. A healthy life style includes not smoking; eating a healthy diet, such as the Mediterranean diet; taking the right nutrients, vitamins and minerals; daily activity; and managing stress. If you already have a chronic disease such as heart disease, multiple sclerosis, or rheumatoid arthritis, you may not be able to cure it but you certainly can improve it with a healthy life style. Investing in a healthy life style gives you the absolute best chance of protecting your health or even regaining your health. It costs a pittance compared to surgery or pharmaceuticals and it positively affects every dimension of your life: body, mind, and spirit. Making life style changes usually means changing old habits. Most people find it helps to get support by joining in a group or an internet-based program. You can usually find these programs at your local hospital, university, or groups offered by disease specific organizations. Look for more of these science-based health reports that support your healing and health. They will include easy “how to” instructions for using your mind’s power to reduce stress and pain. You’ll also learn how you can correct nutrient and vitamin deficiencies proven to cause chronic diseases such as cancer, heart disease, and others. Most importantly take action now. If you think your medications may be causing pain, take control of your health. Take charge of your care using your doctor as a consultant and invest in the only health insurance with a guaranteed return… a healthy life style!
Sources and Resources
Andrew Weil, “Bone Up on Supplements,” WeilMonthly Update (September, 2007).
Center for Alternative and Complementary Medicine at http://nccam.nih.gov/health.
David B. Cohen, et.al., “Indomethacin and Celecoxib Impair Rotator Cuff Tendon-to-Bone Healing,” The American Journal of Sports Medicine, 34 (2006): 362-369.
FDA US Food and Drug Administration, “Information for Healthcare Professionals: Crestor (Rosuvastatin Calcium),” FDA Alert (03/2005) at http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124906.htm. FDA US Food and Drug Administration, “Information on Bisphosphonates (marketed as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa)” at http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm101551.htm. James A. Duke, The Green Pharmacy Guide to Healing Foods, (Rodalestore.com: Rodale, 2008).
Julian Whitaker, “Dr. Whitaker’s Recommendations for Treating the Top Health Conditions,” Health & Healing (Healthy Directions: 2007).
Mayo Clinic Staff, “Statins: Are these cholesterol-lowering drugs right for you?” at http://www.mayoclinic.com/health/statins/CL00010.
Medline Plus at http://www.nlm.nih.gov/medlineplus. Nancy Moore, The Cure for Chronic Pain, (Peoria AZ: Intermedia Publishing Group, 2009). National Institutes of Health at http://health.nih.gov. Ross A. Hauser, “The Deterioration of Articular Cartilage in Osteoarthritis by Corticosteroid Injections, Journal of Prolotherapy, 1, no. 2 (May. 2009). Shirley S. Wang, “Osteoporosis drugs can cause bone-crushing pain,” Wall Street Journal Blogs at http://blogs.wsj.com/health/2008/01/07/osteoporosis-drugs-can-cause-bone-crushing-pain.
Women’s Heart Support Community, Inspire at http://www.inspire.com/groups/womenheart/discussion/statins-and-joint-pain-am-i-crazy.
Tzvi Novick COV&R Summer 2010 The Jewish festival of Purim, which takes place annually around March, commemorates the story of the book of Esther: how the Jewish community of Persia in the 6th or 5th century BCE escaped the threat of genocide and took vengeance on its would-be persecutors. The book is self-executing, mandating, in chapter 9, verse 22, how it is to be celebrated, na
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