January 13, 2023
At the first sign of pain, most of us don’t think twice about cracking open a bottle of ibuprofen, or a similar over-the-counter (OTC) medicine. After all, they’re commonly referred to as painkillers—as in, they are meant to relieve a variety of aches and pains including “headaches, sore muscles, [and] arthritis,” per the National Institutes of Health (NIH).
What’s more, in a 2022 survey of 2,000 U.S. adults conducted by OnePoll on behalf of Chirp, a company that manufacturers devices for back pain relief, 42% of respondents said they use OTC meds to try to avoid pain altogether. And when they are in pain, 34% of respondents reach for OTC medication.
Many of them reported taking OTC medications regularly. Twenty percent of respondents said they take pain relievers at least once a day, and 12% admitted to taking them “a few times a day.” But now, new research is shining a light on how this practice could be problematic.
The study—presented at the 2022 Radiological Society of North America (RSNA) conference last November—found that taking non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen for osteoarthritis may worsen inflammation in certain cases.
The study looked at 277 participants from the Osteoarthritis Initiative cohort with moderate to severe osteoarthritis of the knee who used NSAID treatment for at least one year, a press release explained.
For these patients, researchers looked at the link between the use of NSAIDs and synovitis, which is “the inflammation of the membrane lining the joint,” Johanna Luitjens, MD, the study’s lead author and a postdoctoral scholar in the Department of Radiology and Biomedical Imaging at the University of California-San Francisco, said in a statement. But the findings weren’t exactly promising.
“In this study, no structural long-term benefit of NSAID use in patients with [osteoarthritis] could be found,” the researchers concluded. “Furthermore, users showed more synovitis at baseline and change over four years, which may lead to an increase in pain and a decrease in joint function.”
Osteoarthritis is the “most common form of arthritis” and is sometimes referred to as “degenerative joint disease,” according to the Centers for Disease Control and Prevention (CDC). The agency estimates that this condition affects more than 32.5 million U.S. adults. But despite being so common, there is “no cure for this disease process,” Kelly Johnson-Arbor, MD, a medical toxicology physician and co-medical director of the National Capital Poison Center, tells Best Life.
“Treatments are limited to pain control and maintenance of joint function and stability,” Johnson-Arbor explains. “NSAIDs are often used to reduce the pain and acute inflammation of arthritis.”
But over time, the study says these meds might have the opposite effect, says Leann Poston, MD, a licensed physician and medical expert for Invigor Medical. “This suggests that NSAIDS may not reduce the structural changes found in the knee joint due to osteoarthritis and may actually lead to more pain and a decrease in joint function,” Poston explains. This is due to the potential for increase inflammation. “Inflammation typically causes pain, because the swelling and buildup of tissue starts pressing against nerve endings. This pressure sends pain signals to the brain, causing discomfort,” according to Garden State Pain and Orthopedics.
Luitjens said the study was “able to show that there were no protective mechanisms from NSAIDs in reducing inflammation or slowing down progression of osteoarthritis of the knee joint.” This indicates that the use of these pain relievers for treatment in these patients “should be revisited,” the lead researcher concluded.
But Poston, who was not involved in the study, cautioned against drawing any conclusions without more research. “This was a small study, and randomized controlled trials are needed to better advise patients about whether NSAIDs are a benefit or harmful in their case,” she says, advising patients to speak with their doctors about the best way to treat your pain.
Research contact: @bestlife