Pain Erasure

Pain may be a part of life, but it is a part we do our best to evade. Most of us have used some sort of pain reducing agent whether prescribed by a doctor or taken over the counter. Recently there has been a change in recommendations regarding the use of acetominophen, the ingredient in Tylenol as well as many other over the counter remedies.

The FDA recommended that health care professionals discontinue prescribing agents containing acetominophen at levels greater than 325mg per dose. They cited that there was no data showing that additional benefits were derived from dosages higher than this and plenty of compelling evidence showing an increased risk of liver damage. Liver damage the likes of which could lead to liver failure, cause the need for liver transplant, and even death.

Now this sounds like it would a situation where someone would have to take a lot of acetominophen for a negative event to occur, but actually damage was occurring from relatively low dosages. Just 12 regular strength Tylenol is considered the upper limit in a 24 hour period and that may be too high for some. Large dosages are more the problem, but there are reports of people who took relatively small dosages for a long period of time ending up with liver damage. Cases of severe liver injury with acetaminophen have occurred in patients who took more than the prescribed dose of acetominophen in a 24 hour period; took more than one product that contained acetominophen at the same time; drank alcohol while taking acetominophen products.

So, let’s all just stop taking acetominophen products like Tylenol and avoid products like cold remedies that contain it as well. Of course if this is the only thing you can take for pain then use the lowest dosage, watch out for your cumulative dosage in a 24 hour period and make sure you avoid alcohol while you are taking it and within a 24 hour period of usage.

Thankfully for most people there are other options for pain relief. I found this great chart that lists the common NSAIDs (non-steroidal anti-inflammatory drugs) here: 12 things you should know about pain relievers. Apparently this comes from a great little resource called the Harvard Medical School Family Health Guide. If you don’t have a good health reference, I highly recommend this one as it will never go out of date since they offer page and index searches for updated information on every entry. Oh sure, we can look something up on the internet, but what if there is a power outage and you need to know more about that skin rash? Using a reference like this can also help you make better decisions about your health care.

But back to the NSAIDs. I learned something valuable as I was looking into a report from Medscape with an interview by Dr. McCarberg who wrote a recent article in Pain Medicine (abstract) “NSAIDs in the older patient: balancing benefits and harms”. He stated that we tend to underestimate the potential health effects of over the counter NSAIDs in regards to their potential for harm to our GI system, cardiovascular health and risk of stroke. What he said in particular that naproxin was less potentially harmful to the cardiovascular system than ibuprofen. He emphasized that it was not safe, but rather safer.

Now I personally use Advil (ibuprofen) as my go to pain reliever when my other natural pain relievers can’t cut the mustard. Advil has been the hero in my book from way back in the early 80’s when I found it could conquer my headaches in a way that aspirin could never accomplish. I have never given it much thought because I don’t use it that often, but what Dr McCarberg was saying caught my attention. I, like most people I know, am aging. I know, what a shock! So while I don’t consider myself an ‘older patient’ I do consider that my body is getting older (even though my sense of humor never grows up). Having cardiovascular issues in my family health history makes me have to consider strategies that keep me on the preventative end of this issue.

I have never taken naproxin (Aleve) before and wondered what difference there was between it an Advil. Thank you internet, now I know that they both work similarly, but that ibuprofen is faster acting. Ibuprofen is better at relieving fevers, headaches and migraines. Naproxin, although it works slower than ibuprofen offers a longer-term relief. It is also better for muscle tissue inflammations, sprains and strains. Naproxin is also less problematic to the heart.

Keep in mind though that all NSAIDs should be taken at the lowest dosage and used sparingly. They should be taken with food to lower GI risks and all can increase blood pressure. None should ever be taken with alcohol.

For those who are seeking more natural remedies to pain, there are a few things that you may want to check out. I have used these natural pain relievers to help with exercise induced aches and pains and they work well.

• Bromelain – this is an extract derived from the stem of pineapples and thought to have anti-inflammatory properties although there are no studies that verify its effectiveness on exercise induced pain. Some studies have found that used in conjunction with trypsin and rutin made it as effective as prescribed medications for osteoarthritis. It is also used as a culinary ingredient as meat tenderizer – nobody debates that. Have a care though if you are taking blood thinning agents as bromelain also has that effect.



• Curcumin – this is also known as the spice Turmeric which is a member of the ginger family. Some studies have shown that it has anti-inflammatory properties but also report it has poor absorption, rapid metabolism and elimination and poor bioavailability. There are no known side- effects except for potential nausea so it is best taken with food. I did not find a reference to it as a blood thinner, but I believe it also may have that effect since most anti-inflammatory products do. Watch out if you take other blood thinners.



• Omega 3 Fatty Acids – found in fish oil and flaxseed oil, this important essential dietary fat has anti-inflammatory properties. Studies have shown some evidence of its effectiveness for rheumatoid arthritis. It also has other health benefits involving cardiovascular and cholesterol issues, but studies are mostly inconclusive in this area. This supplement is best taken with a meal containing fat so that your body will absorb it.

As always, I hope you do not experience any pain, but in life that is unlikely. Remember that proper exercise can go a long way in relieving physical distress. Recuperative yoga is designed to help with muscular imbalance that can cause muscle or joint pain. Core conditioning can help increase strength levels which will prevent common injuries in exercise. All yoga is a great stress reliever and relaxation can help us further reduce stress which will lower our perceptions of pain. Hopefully you will take these preventative measures to ward off and resolve painful issues.

See you on the mat,
– Julie

Note: The information above is NOT medical advice and should not be relied upon to make medical decisions. Contact your doctor or pharmacist before making any medical decisions.