Long Term Use of NSAIDs for Chronic Pain & Its Potential Side Effects
Long-term use of NSAIDs is worse than most people realize. While you can walk into most grocery stores and pharmacies and find dozens of NSAID products to choose from, they may not actually be a good option for chronic pain. Keep reading to discover more about the long term use of NSAIDs for chronic pain and its potential side effects.
What are NSAIDs
NSAIDs are short for non-steroidal anti-inflammatory drugs, and they're a therapeutic class of drugs that most people use for pain. The way these pills work is that they help combat:
- Fever
- Pain
- Inflammation
- Blood clots
Statistically, 96% of people aged 65 or older use NSAIDs at some point.
While most people will get over-the-counter NSAIDs, others will opt for prescription-strength versions, which are meant for even higher levels of pain.
Since inflammation decreases and pain subsides, NSAIDs can be very effective for some people. However, studies show that over the long term, you can suffer from some very serious side effects.
Why Long-Term Use of NSAIDs Isn't Recommended
On a deeper level, this medication blocks Cox-1 and Cox-2 enzymes in the body. These two enzymes are responsible for your body producing prostaglandins, which is responsible for pain and swelling in the body,
NSAIDs are believed to cause 41,000 hospitalizations in older adults annually.
Typically, the main areas of the body that are important to monitor when using these medications over long periods of time are:
GI Risks
Gastrointestinal risks are a major concern, and decades of research have been done on this issue. One study, linked previously, notes that when NSAIDs are taken, they can increase your risk of developing fatal peptic ulcers by fivefold.
Additionally, the risks of severe complications from these ulcers increases 300% to 500%.
It's estimated that 15% to 35% of all complications from peptic ulcers are due to the use of NSAIDs. Additionally, this medication may also lead to gastric bleeding, which is a life-threatening issue if it's not addressed rapidly.
Renal Risks
Renal risks are widespread when taking this type of medication. Some of the risks that increase are:
- Acute renal failure
- Decrease in glomerular perfusion and filtration rate
For many, the risk of acute renal failure rose by 200% when NSAIDs were used. Doctors must take a person's risk of renal failure into account when determining whether this type of medication is a good option for them or not.
Annually, over 2.5 million people in the United States alone have side effects from these medications relating to renal risks.
Cerebrovascular Risks
Cerebrovascular (CV) risks are equally concerning and seem to rise when a person uses NSAIDs that specifically target the COX-2 enzymes. Major concerns exist with certain NSAIDs that cause a rise in systolic blood pressure and impact many antihypertensive drugs.
In older adults, heart failure is exacerbated when taking this medication, too.
CNS Risks
Studies also link NSAID usage with CNS side effects. Cognitive impairment is a primary concern in the CNS category, but it does seem that indomethacin versions of the medication are the main CNS concern.
Potential Side Effects of Using NSAIDs for Chronic Pain
The side effects listed previously are a major concern during the long-term use of NSAIDs. Unfortunately, there are many other side effects that are far less concerning but still exist even with moderate use.
Some of the many side effects to concern yourself with are:
- Allergic reactions
- Drowsiness
- Dizziness
- Headaches
- Indigestion
- Diarrhea
- Stomach ulcers
- Much more
If you pick up a bottle of this medication in the store or at the pharmacy, you'll find the list of side effects to be quite extensive. It's crucial that if you're taking medication, especially for hypertension, that you consult with your doctor before using this group of medications.
In some cases, NSAIDs will negate the effectiveness of your medication and make your condition worse. It's crucial to stop usage at any sign of side effects or issues with medications not working properly.
Different NSAIDs May Be an Option
Taking medication for chronic pain is never an easy decision because you're masking the pain rather than finding the root cause of it. Many people don't realize that there are multiple forms of NSAIDs, each with its own set of risks, because they work slightly differently.
A doctor is best suited to help you find a pain medication that works for your condition.
However, some of the main types of NSAIDs that may be given to you are:
- Celecoxib. A common medication given to people with mild-to-moderate pain. Low dosages can help combat pain, but higher dosages are known for CV and GI side effects. This is a low-level Cox-2 inhibitor.
- Etoricoxib. Compared to Celecoxib, this class of medication has 14 times greater Cox-2 selectivity. Acidity is higher, yet the half-life is double that of Celecoxib, making this a better choice for severe pain.
- Rofecoxib. Rofecoxib is stronger than Celecoxib yet nowhere near the strength of Etoricoxib. Acidity is moderate, too.
Depending on your health and the pain you're experiencing, your doctor may try to prescribe different NSAIDs to minimize long-term side effects. Additionally, dosage variations and duration may be necessary to minimize the risk of side effects.
Final Thoughts
Since there are some concerns with medication and NSAIDs, be sure to consult with a physician if you plan on taking this medication or want to try any other form of pain relief.
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