Non-steroidal Anti-Inflammatory Medications (NSAIDs): The Good, the Bad and the Ugly

Non-steroidal anti-inflammatory drugs (NSAIDs), e.g. aspirin and ibuprofen, are the most commonly prescribed medications for treating conditions such as arthritis, bursitis and tendonitis.

Everyday more than 30 million people take over-the-counter and prescription NSAIDs for pain relief, headaches and arthritis.

Each year, the side effects of long-term NSAID use cause nearly 103,000 hospitalizations and 16,500 deaths.

More people die each year from NSAIDs-related complications than from AIDS and cervical cancer in the United States.

The Good (if you can call it good)

NSAIDs block pain.

Is this really good or just a “band aid” that is not without consequences? READ ON…

The Bad

NSAIDs work by preventing an enzyme from doing its job. The enzyme is called cyclooxygenase, or COX, and it has two forms.

COX-1 protects the stomach lining from harsh acids and digestive chemicals. It also helps maintain kidney function.

COX-2 is produced when joints are injured or inflamed.

Both COX-1 and COX-2 are necessary for tissue healing.

Traditional NSAIDs block the actions of both COX-1 and COX-2, which is why they can cause stomach upset and bleeding as well as ease pain and inflammation.

COX-2 inhibitors e.g. Celebrex, target only the COX-2 enzyme that stimulates the inflammatory response. These medications generally do not cause the kind of stomach upset or bleeding that traditional NSAIDs do, however they can increase the risk of a heart attack.

The Ugly

Studies have indicated that NSAIDs have a delaying effect on connective tissue, cartilage and bone healing, which can result in incomplete wound healing and arthritis

In addition, there are numerous side effects and potential reactions due to their effects on the digestive system, nervous system, immune system, liver and kidneys:

Upset stomach, nausea, vomiting, heartburn, headache, diarrhea, constipation, drowsiness, fatigue, swelling of the feet or ankles, ringing in the ears, vision changes, joint pain, muscle pain or weakness, easy bruising or bleeding, persistent sore throat and fever, changes in amount or color of urine, yellowing of the eyes or skin, black stools, vomit that looks like coffee grounds, rash, itching, swelling, dizziness, trouble breathing.

Natural Alternatives for Treating Inflammation

Fortunately, there are numerous alternatives to treat inflammation. Some of these include:

  1. Contrast hydrotherapy (alternating hot/cold)-  increases circulation and helps to pump out inflammatory chemicals and pump in nutrition  (For the first 24-48 hours use cold only)
  2. Acupuncture- stimulates the immune, circulatory, nervous and endocrine systems to aid in tissue healing. Also stimulates the production of “natural pain killers” by the body
  3. Supplements– there are many supplements that help reduce inflammation while simultaneously stimulating tissue healing. Some of my favorites include:


High potency multiple vitamin/mineral: Contains anti-oxidants that balance the free radical damage caused by the inflammatory process

Vitamin C and Bioflavonoids- helps with connective tissue repair

Fish oil– increases anti-inflammatory chemicals

Bromelain (from pineapple)-  blocks pro-inflammatory chemicals

Curcumin (from the Indian spice turmeric)- blocks pro-inflammatory chemicals

Glucosamine Sulfate-aids in connective tissue and cartilage repair

Dr. Lecovin is a chiropractor, naturopathic physician and acupuncturist. He graduated from Los Angeles College of Chiropractic in 1990, earned a Masters in Nutrition from the University of Bridgeport in 1992, and then went on to complete the naturopathic and acupuncture programs at Bastyr University in 1994. He holds additional certifications in exercise from the National Strength and Conditioning Association, National Academy of Sports Medicine and International Society of Sports Nutrition.

Dr. Lecovin specializes in treating musculoskeletal pain and sports injuries by integrating trigger point acupuncture, soft tissue release, joint manipulation, corrective exercise and nutrition. In addition, he combines exercise and nutrition for weight loss, weight gain and performance enhancement. His clinic, located in Bellevue, WA, offers naturopathic medicine, chiropractic, acupuncture, massage and infrared sauna therapy. He can be reached at Evergreen Integrative Medicine at (425) 646-4747 and his website address is

About the Author

Dr. Geoff LecovinNaturopathic Physician/Chiropractor/Acupuncturist/Certified Strength and Conditioning Specialist/Corrective Exercise Specialist/Performance Enhancement Specialist/Certified Sports Nutritionist/View all posts by Dr. Geoff Lecovin