Unfortunately, the side effects of these drugs are common. So, not only do we have the new findings. But, studies show that nearly all NSAIDs cause damage to the stomach and gut. They are promoting a leaky gut, bleeding, inflammation and ulceration. With thousands of people hospitalised every year with these complications.

The newer drugs cause less harm to the gut. Yet, they cause more cardiovascular problems such as stroke or heart attack. 

Alarmingly, another study suggests that 10% of kidney failures every year are due to the overuse of NSAIDs.

There are guidelines to minimise the chance of side effects. These recommend using NSAIDs at the lowest effective dose. And for the shortest possible time. But what are the options if you have a chronic and painful condition?

Osteoarthritis is a chronic and degenerative condition. It involves joint pain and inflammation. There is also loss or damage to the cartilage surfaces and changes to the bone structure. Affected joints are stiff, and movement is often restricted. Osteoarthritis is a condition that causes a lot of disability and reduces the quality of life. Yet conventional medicine is unable to halt its progression. Generally, the aim is to decrease symptoms and pain. But, NSAIDs do not reverse the condition. So, many people end up having steroidal joint injections or joint replacement.

So, is there any evidence of safe and effective alternatives to using NSAIDs?

The following alternatives are, according to scientific studies, safe and effective treatments or strategies for osteoarthritis. They are mostly related to osteoarthritis of the knee. Since this condition creates much disability and there are plenty of studies available.

It might surprise you to hear that certain foods can affect the amount of inflammation in your body. Most people have a high ratio of omega-6 to omega-3 fats in their diet, increasing inflammation. Increase the amount of omega-3 fats in your diet to reduce systemic inflammation.

Rich sources of omega-3 fatty acids are cold-water fatty fish. These include trout, sardines, mackerel and salmon. Other sources include nuts such as macadamias and walnuts.

Omega-3 fatty acids in fish oil lower inflammation and reduce cartilage destruction. In addition, studies show that fish oil supplements, especially EPA, may reduce the need for NSAIDs.

Have cold-water fatty fish twice a week, and supplement with omega-3 fatty acids EPA and DHA on the other days.

Avoid rich sources of omega-6 fatty acids. These include processed vegetable oils, like sunflower oil. These promote systemic inflammation.

Regular exercise reduces arthritic pain and improves joint function. But make sure to mix it up. A range of activities provides the most benefit. So, weight-bearing, aerobics and stretching are all necessary. Strengthening the surrounding muscles is vital to stabilise joints. It also prevents muscle weakness that promotes structural damage.

Weight-bearing exercise helps to prevent loss of cartilage and bone. Activities such as yoga that improve flexibility and range of motion also help. Water-based activities such as swimming or pool aerobics are a good option.

Aim for some physical activity on most days. A total of 150 minutes of moderate exercise per week, or 75 minutes of vigorous exercise, is a good guideline. Where possible, more training or higher intensity exercise is more beneficial.

Bromelain is a protein digesting enzyme, found in the stem and fruit of pineapples. It is available as a dietary supplement. Bromelain relieves osteoarthritis because it is an anti-inflammatory agent with analgesic properties. In fact, there are several studies supporting its use.

This amazing compound is effective for mild to moderate knee osteoarthritis. Reducing pain and stiffness and improving joint function. There was no difference between treatment with diclofenac and bromelain, at 4 weeks. Using 500mg/day bromelain, compared to 100mg/day diclofenac.

A study compared a combination product containing bromelain, with diclofenac. The analysis covers safety, efficacy and tolerability of both treatments for osteoarthritis. Interestingly, the combination product was superior to diclofenac. Therefore, researchers describe this product as suitable for high-risk patients. As well as for daily management of osteoarthritic joint pain.

Yet another trial tested a combination of three natural anti-inflammatory agents. These were bromelain and the herbs turmeric and devil’s claw. The combination reduced pain in acute and chronic osteoarthritis. Researchers declared there were no withdrawals from the trial due to side effects. Suggesting the combination was a safe and efficacious alternative to NSAIDs.

Acupuncture has been used to relieve pain for thousands of years. Yet it is difficult to produce gold standard research due to the lack of suitable placebo. Still, some studies are available.

In a huge study of electroacupuncture for knee osteoarthritis the treatment results were better than prescription drugs. Treatment was over a minimum of four weeks. Participants had less pain and more joint function. In addition there was a low risk of side effects.

A similar treatment to acupuncture is moxibustion. This treatment involves dried plant material, near the skin surface, at acupuncture points. A recent review of moxibustion treatment for osteoarthritis was compared to sham moxibustion. The treatment group had more reduction in pain. In fact, pain reduction was the same or better than steroid injection or topical drug treatments.

In another study, patients were taught to apply acupressure. Then, they applied self-acupressure for 5 days a week for 8 weeks. For a significant improvement in pain and physical function after 8 weeks.

These studies indicate that there are several possibilities for alternatives to NSAID use. While it is likely that combining some of these treatments will have an even better outcome.

Now, have you tried any alternatives to NSAIDs? Please share your experiences in the comments box.

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