Side Effects of Painkiller
The Side Effects of Using Painkillers for Musculoskeletal Pain.
Did you know that musculoskeletal disorder is the leading cause of disability in the U.S.A.? In fact, of the just over 300 million people in the U.S.A. Musculoskeletal Pain Disorders (MSD) affects about 126 million people.1
Want to hear another shocker? Think about this: More people suffer from chronic joint pain than metabolic and cardiovascular diseases.1
What Are Musculoskeletal Disorders?
When you think of musculoskeletal disorders think in terms of “musculoskeletal disorder” is the name that actually describes the problem.
In other words, it is joint pains that often come from joints being injured or overused. Some other names for musculoskeletal disorder are:
- Overuse injury
- Repetitive motion injury
- Repetitive stress injury
- Chronic Joint Pain
Do Over-The-Counter and Prescription PainKillers Really Work?
Painkillers are unfortunately the “go to” solution for musculoskeletal disorders such as joint pain.
Over-the-counter painkillers as well as prescription painkillers are basically ways to cover-up the pain, but they do not help you improve the results of the injury or the root cause of the pain.
The temporary solution of ‘tricking your body’ into thinking the pain is gone is really all that painkillers accomplish and this does have a place in terms of gaining quality of life. But it is a temporary solution.
FACT: Temporary solutions should only be used TEMPORARILY. (You may want to read that again).
What Are The Most Common Joint Pain Conditions?
Here are some of the most common causes of pain that would fall under the category of musculoskeletal disorders:
- Degenerative Disc Disease
- Ruptured / Herniated Disc
- Carpal Tunnel Syndrome
- Tendonitis
- Knee tendonitis
- Elbow tendonitis (Tennis/Golfer’s Elbow)
- Muscle / Tendon strain
- Ligament Sprain
- Knee ACL
- Tension Neck Syndrome
- Thoracic Outlet Compression
- Epicondylitis
- Radial Tunnel Syndrome
- Digital Neuritis
- Trigger Finger / Thumb
- DeQuervain’s Syndrome
- Mechanical Back Syndrome
- Chronic Joint Pain
Is Arthritis A Musculoskeletal Disorder?
According to the Arthritis Foundation you can experience musculoskeletal pain caused by arthritis and the pain will occur in your muscles, ligaments, tendons, and bursae.
Chronic musculoskeletal pains are debilitating. They negatively affect movement, work, relationships, and lifestyle.
Even worse, they increase the risk of depression and anxiety. All these reasons explain why people quickly take painkillers for their chronic back pain and knee pain.
Statistically, painkillers are the commonest drugs prescribed by primary health providers. 2
The Big Reason People Take PainKillers?
From an outward perspective, it looks easy. You feel that gnawing pain in your back or knee, you pop two tablets of Advil and the pain is gone in a matter of minutes.
But there’s more to it than meets the eye.
Although painkillers “successfully” treat pain, and I use the word success here very loosely because I’m talking about in terms of the speed in which you no longer feel pain after taking painkillers, there are lots of side effects that come with it, so much so that most times it is better if your PCP never prescribed a painkiller in the first place.
The Problem with Painkillers
Painkillers are not curative. All painkillers, regardless of their mode of action, do not treat the underlying cause of pain. They only disrupt your body’s perception of pain by manipulating the natural concentrations of certain hormones and neurotransmitters.
That’s right. Painkillers TRICK YOUR BODY INTO THINKING THE PAIN IS NOT THERE.
Take for instance non-steroidal anti-inflammatory drugs like ibuprofen (Advil) which works by inhibiting the enzymes (COX 1 and COX2), responsible for the synthesis of prostaglandin, an inflammatory mediator.
By preventing the secretion of prostaglandin, Advil reduces the painful swelling of affected joints and muscles.3
This does not in any way treat the cause of the swelling and if you don’t treat the cause then you will soon be in pain again. And then what do you do? You guessed it. You take another pill which is why too many times in healthcare the goal is not to remedy the cause because if they do then you won’t keep buying their temporary solutions.
How many people are aware of this?
Millions of Americans take painkillers more than they are supposed to, and in more increasing doses until they end up in the ER with a perforated stomach, an opioid addiction, or worse.
Let’s take a closer look at some of the dangerous side effects of painkillers.
The Side Effects of NSAIDs
Many people have not ever heard of NSAIDS. But they know the names they are called if they were buying them form the store. Here are some of the most common NSAIDs:
- Ibuprofen
- Diclofenac
- Celecoxib
- Aspirin
- Acetaminophen
A big challenge with NSAIDs is they can cause gastritis severe enough to land you in the ER with upper GI bleeding. Remember what I said about prostaglandins?
Although the reduction of prostaglandins can help you feel less pain, prostaglandins are also needed to protect your stomach from gastric acid. The pH of gastric acid is about 4. It is so acidic that it burns tissues that come in contact with it. This is how your food, particularly protein gets digested.
This is where prostaglandin comes in. Prostaglandin forms a thick mucus that coats the part of your stomach that is close to gastric acid. As the prostaglandin is used up, more prostaglandin is secreted for continuous protection. When NSAIDs stop prostaglandin secretion, your stomach walls are exposed to gastric acid which eats into it until you start feeling that hot discomfort in your chest. If left unchecked it eats into blood vessels and causes bleeding.
That sounds scary because it is scary. But it gets even worse!
NSAIDs increase the risk for hypertension and renal diseases.
As a matter of fact, NSAIDs are classified as nephrotoxins and are avoided in patients with existing kidney diseases. It all comes back to NSAIDs inhibitory action on prostaglandin.4
Prostaglandins increase blood flow to the kidneys. As more blood flows to the kidneys, it is purified and urine is excreted. So what happens when prostaglandin is reduced? Blood flow to the kidney is reduced, and the quantity of urine production is also reduced.
What happens then to the urine that should be excreted?
They accumulate in the body and cause edema. The kidneys try to compensate by increasing the pressure of blood flow. In the long run, this compensation causes harm because it triggers hypertension. Another side effect of NSAIDs is poisoning from an overdose. NSAIDs aren’t a controlled drug but acetaminophen and aspirin overdose are very common in the US.
The most common cause of liver failure in the The US is acetaminophen overdose.
The Side Effects of Corticosteroids
Corticosteroids kill pain by doing a couple of things. They inhibit the secretion of hormones and enzymes that cause and sustain inflammation and they inhibit the direct action of white blood cells.
Chronic use of corticosteroids causes Cushing syndrome, an endocrine disorder in which affected persons experience skin atrophy, striae, hypertension, hyperglycemia, fungal infections, obesity, and bone weakness. 5
The Side Effects of Opioids
The US is the largest consumer of opioids and the largest spender on interventions for people with opioid overdose, dependence, and withdrawal. 6
This should not be a surprise.
Unlike NSAIDs and corticosteroids, opioids do not inhibit inflammation. Their action is way up in the pain and pleasure centers in the brain. Opioids increase the secretion of feel-good hormones like dopamine, epinephrine, and norepinephrine. This is where the problem lies.
The control of the pleasure centers in the brain is so tight that once pleasure receptors are stimulated, they become less sensitive to the initial stimulus. To initiate subsequent pleasure, you need a higher stimulus.
You should see by now that we can’t alter the natural state of the body without reaping consequences.
Because people who take opioids require higher doses to not feel pain, they become susceptible to addiction and overdose. People with addiction develop withdrawal symptoms that are severe enough to require admission into the ER.
The ones who recover begin the slow, and most times unsuccessful journey to recovery. In the Covid-19 pandemic last year, overdose-related deaths skyrocketed to over 2000 deaths than normal because people with opioid addiction struggled with isolation and anxiety and had no access to rehabilitation facilities and emergency units. 7
How to Protect Yourself from the Side Effects of Painkillers
The first thing you can do is to consider alternative and curative treatments for chronic musculoskeletal pain. Treatments like umbilical cord tissue therapy are curative because they may replenish depleted lubricants like collagen, hyaluronic acid, and glycosaminoglycans.
Other treatments like calisthenic exercises, pilates, and yoga strengthen your muscles, increase blood flow, and improve your perception of pain.
The second thing you can do is to use non-systemic routes to administer your painkillers. For example, rather than pop Advil now and then, you can massage NSAID-containing ointments on sore and inflamed joints.
In conclusion, although painkillers provide rapid relief to musculoskeletal pain, they are not the best options. They alter the balance of existing hormones and neurotransmitters and cause all sorts of side effects.
Alternative and curative treatments like umbilical cord tissue therapy and strengthening exercises do not disrupt the body’s ecosystem. Instead, they may help your body to replenish what is lost and go a long way in helping you live a healthy life with less pain.
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References
- https://www.boneandjointburden.org/fast-facts
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949301/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478398/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034033/
- https://www.ncbi.nlm.nih.gov/books/NBK531462/
- Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013. Med Care. 2016;54(10):901-906.
- https://www.commonwealthfund.org/blog/2021/spike-drug-overdose-deaths-during-covid-19-pandemic-and-policy-options-move-forward