Medicine Talk

Arthritis – Life Beyond Vioxx

If there is a need for stomach protection, anti-inflammatory medicines can now be paired with proton pump inhibitor drugs such as Prevacid or Nexium or misoprostol as co-therapy to minimize stomach upset or bleeding. This is particularly important for those who used or still use the COX-2 family of anti-inflammatories, which did have the advantage of better stomach lining protection. Non-anti-inflammatory pain medicines like tramadol can be considered for those who are not using SSRI-type antidepressants (Paxil, for example), and who have no history of seizures. Local joint injections with cortisone, lidocaine, or the expensive hyaluronic acid, can be done up to 3 times a year on average.

Last, but not least: what about plant medicine and supplements? Some things to consider and collaborate on with your health provider about include:

White Willow Bark. This well-known traditional remedy of the East Coast tribes contains salicin, natural aspirin. It has modest pain relief effects for chronic low back pain at salicin doses of 240mg a day. Various brands have been studied and found effective, such as Reumalex and the German liquid extract Phytodolor (90-120 drops per day).

SAM-E (S-adenosylmethionine). At doses of 400-1200 mg a day, this natural protein has proven effective for osteoarthritis pain, and allowed people to reduce their use of prescription medicines. At doses above 800mg, it acts more like an antidepressant due to stimulation of serotonin chemical receptors. For this reason, persons with associated depression may benefit, but should be monitored for side effects. One disadvantage is its cost - $40 for 90 tablets of the 200mg strength at warehouse stores, not covered by insurance.