What are Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)?

NSAID’s are nonsteroidal anti-inflammatory drugs. They are the most common treatment for arthritis and painful joints. NSAIDs can be taken orally. Unlike steroids, NSAIDs do not occur naturally in the human body. They are chemically synthesized medications, which have a similar anti-inflammatory effect. They also do not produce the side effects associated with prolonged steroid therapy. NSAIDs relieve pain, reduce fever, and prevent inflammation.

They work by  inhibiting the action of the enzyme cyclooxygenase, which helps produce prostaglandins throughout the body. Prostaglandins stimulate the inflammatory response in an arthritic joint. By limiting the action of cyclooxygenase, NSAIDs can reduce inflammation. There are two cyclooxygenase enzymes, COX-1 and COX-2. COX-2 is the mediator of the inflammatory response. COX-1 protects the lining of the stomach. An NSAID that affects both of these enzymes will reduce inflammation but also cause gastric or stomach upset.

Most NSAIDs block the action of COX-1 and COX-2. Some drugs are more selective and are COX-2 inhibitors only. Aspirin is the oldest and most common NSAID. Its chemical name is acetylsalicylic acid and was first synthesized more than 100 years ago. It is now available as a generic product from several companies. Aspirin also helps to prevent the action of platelets in the blood. It is the only NSAID that inhibits clotting. Some aspirin preparations are buffered to protect the stomach.

NSAIDs can be effective in relieving the pain of an arthritic joint. Their most common side effect is gastric upset. There are also risks of kidney damage, allergic response, and interference with blood pressure medication. Among the NSAIDs, aspirin is also known to cause tinnitus or ringing in the ears. NSAIDs can be taken on a regular or on an intermit-tent basis. If you find an NSAID that works for you, you may only want to take the medication on a bad day.

This might be a day when you are planning to walk long distances, to participate in sports or to be dancing at a party or family event. As your arthritis gets worse, however, you may need to take the medication on a regular basis. Not all NSAIDs work for every patient. You may, in fact, need to try several different drugs before you find one that is effective for you. You should not take NSAIDs if you have a history of stomach or intestinal problems, a blood clotting disorder, you are on blood thinners, you are pregnant, or you are breast feeding.

Make sure your doctor is aware of any medical conditions you might have before you start taking NSAIDs. If you cannot take NSAIDs, acetaminophen (Tylenol) may be an option. Tylenol is not considered an NSAID because it does not have an anti-inflammatory effect. It does, however, relieve pain and bring down fever. Its main side effect is liver damage when it is taken for a long period of time. Tylenol should not be taken if you are already taking an NSAID medication.

Some of the more common NSAIDs are:

Aspirin
Enteric-coated aspirin (Ecotrin)
Celecoxib (Celebrex)
Diclofenac (Voltaren)
Diflunisal (Dolobid)
Etodolac (Lodine)
Ibuprofen (Motrin, Advil)
Indomethacin (Indocin)
Ketoprofen (Orudis)
Ketorolac (Toradol)
Nabumetone (Relafen)
Naproxen (Aleve, Naprosyn)
Oxaprozin (Daypro)
Piroxicam (Feldene)
Sulindac (Clinoril)
Tolmetin (Tolectin)
Meloxicam (Mobic)

All of these drugs have similar action and similar side effects. They can be helpful in treating the symptoms of an arthritic hip if you are not yet ready for surgery.