Popping That Motrin or Other NSAID Drugs May Hurt Your Knees! - Regenexx®

Popping That Motrin or Other NSAID Drugs May Hurt Your Knees!

can NSAID drugs make arthritis worse
We’ve never liked NSAID drugs much, given their propensity to dramatically increase heart attack risk. I’ve often suspected that because of the way they work, they may actually hurt the joint rather than help it, but until now I’ve never seen a study where a large group of people were followed for long time to see if taking the meds did any harm. Now a new study using the data from a government-sponsored study suggests that taking certain types of pain meds for your arthritis may cause more arthritis.

What Are NSAIDs?

NSAID is an abbreviation that stands for nonsteroidal anti-inflammatory drug. It’s a big drug class that includes a bunch of nonprescription drugs like Motrin, ibuprofen, Advil, Aleve, and Naprosyn and the prescription drugs Mobic, Celebrex, Voltaren, and others. They are the single most common medication taken for pain relief, with many traditional medical guidelines telling patients to take them. But do they do more harm than good? Could NSAIDS make arthritis worse?

NSAID Side Effects

The side effects of these drugs are nasty and include cardiac issues, like sudden-death heart attack, stroke, and stomach bleeding. The heart attack issue is a big one, prompting the American Heart Association to come out with a warning to patients and physicians to stop taking the drugs or to limit their use.

The Long-Term Effects of Popping Pills for Your Arthritis Pain

The new study was performed using data from the Osteoarthritis Initiative (OAI), a government-funded study that provides open source data on knee arthritis to researchers. There are thousands of people, both with and without arthritis, who are being tracked, each with detailed histories and serial X-ray and MRI imaging over time.

The researchers that tracked medication use sought to determine if there was either a good or bad long-term effect of taking these meds. As a result, they looked at MRI changes over many years in patients who were taking medications for pain (the vast majority of them were taking NSAIDs) or patients with arthritis who took nothing. Even after adjusting for all the things that could make these two groups of patients different (like arthritis severity), the patients taking meds had more arthritis progression over the eight years. How much more? About twice as much!

How Could NSAIDS Make Arthritis Worse?

The first thing I did was to pull the full paper to see what these patients were taking. Sure enough, about two-thirds of them were taking NSAID drugs. Hence if there was a single medication culprit, it was most likely to be those drugs. NSAIDs block inflammation and can also hurt new bone formation, so one possibility is that the patients taking these drugs for years have less of a normal repair and maintenance response to wear and tear, leading to more joint breakdown.

The upshot? NSAIDs are bad news due to their heart attack effects. It’s regrettable that pharma has done a good job hiding these cardiac effects from most physicians and patients, because few really understand that Motrin could be the most dangerous over-the-counter drug money can buy. Now we have a new potential issue—the very arthritis that these drugs are supposed to help may be made worse by the drugs! You gotta love American medicine! We know, based on multiple high-level studies, that certain supplements will help arthritis pain and likely protect against worsening, but the pills doctors have been taught to push like giving a kid M&Ms is the drug that causes heart attacks, and truth being stranger than fiction, it also appears likely that NSAIDS make arthritis worse!

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Read 14 Comments
  1. Did the study also include the activity level of the patients they were tracking ?
    I am wondering if less pain due to the NSAID use caused patients to be more activie Therefore causing more joint damage?
    Those that didn’t take NSAIDs may have been less active due to the level of pain they were experiencing .

    1. Kathy,
      They did their best to match physical activity, age, BMI, etc to isolate the effect of the medication.

  2. Thank you. Very helpful. I will stop taking nsaids for my arthritic knees.
    And will pass the info on.

  3. I had regenexx stem cell therapy on my knee and my doctor recommend prescription NSAID after 5 weeks. This article makes me confused about what to do?

    1. Duane,
      Each case is different, as each person’s medical history and both the issue and it’s underlying causes differ. You’re treating doctor is the expert in your individual case! But if f you’d like me to inquire for you, I’d be glad to. Just need to know who treated you, what was your knee treated for, and when were you treated?

  4. I quit taking NSAIDS and my arthritis pain is actually more tolerable. I am also seeing a chiropractor to keep spine in line which has definitely helped my knee arthritis. Things are more “level” and doesnt put as much pressure on the medial side which is bone on bone.
    I have also lost sixteen pounds- the sodium in the Naprosyn was causing water retention. Also has helped with pressure on the knee. Dont have any xrays or MRIs to compare, but feel better.

  5. I assume the study did not consider Acetaminophen in their results since they were not mentioned. I use Acetaminophen for my hip arthritis now since I read about the effects of NSAIDs. I did notice more heart palpitations on NSAIDs, which led me to understand they do affect the heart. Thanks for adding to this info.

    1. Linda,
      That’s a good move! The study included many different medications for pain. What was significant about the findings were that there was a very significant overlap between the people who were taking NSAIDS like Motrin, Celebrex, etc, and the progression of Arthritis. Tylenol works really well for pain, however the concern would be that taking it regularly can result in liver issues. Many people have found good alternatives in Curcumin and Fish Oil, or the Advanced Stem Cell Support Formula is a supplement we put a year’s worth of research into to create a supplement to support stem cells and chondrogenesis.:http://www.regenexx.com/regenexx-advanced-stem-cell-support-formula/ and http://www.regenexx.com/curcumin-for-knee-arthritis/

  6. Hello Regennex Team and Dr. Cento:

    First off, thanks for the article on how NSAID’s are damaging to the knees or other joints.

    I actually emailed you folks months ago and was looking at coming down to Oregon to get a 2nd opinion of my knee MRI which says I have moderate to severe chondrosis of the femoral condyle and tibia plateau (also have a Baker’s cyst and patellar tendonosis). I have had PRP on my right knee up at UW in Seattle, with about 50 percent improvement and have heard good stories with retired military guys like me with DJD or OA that PRP and Stem Cell injection therapy could be beneficial, but nothing conclusive that I can come across.

    Right now, I have researched that folks with DJD or OA, after trying MSM and Glucosamine, without any improvement, according to the Arthritis Foundation, that it most likely will never work, which was me. Over the past few months startd taken Omega 3/6/9, Vitamin D, C, and cut my motrin to 600mg twice a day, after reading some journals that keeping it 1200mg a day and under is less risky.

    I have tried going cold turkey with no motrin, but then my bilateral wrists, shoulders, knees, back, etc… all feel like that deep aching joint feeling. Which happened the past couple days, which I’m trying to come off for good.

    I realize after studying Prolotherapy, PRP and some of Stem Cell, that proliferation type injections, need the body to naturally heal it and with any tears or “osis” of the tendon/ligaments, all that NSAID’s do is slow down or ruin any natural healing process the body is trying to do. Like the saying goes “Time heals all wounds”. I have done dry needling, acupuncture, TENS machines, etc.. and soft tissue modalities like Graston and ART, without much of anything.

    With tendonosis, the only things that seem to work are TIME, ISOMETRICS, and MASSAGE work to break up adhesions and elongate the muscle fibers once again. All along, taking it slowly before getting back to training or working out that injured the area in the first place.

    So, after my lengthy thesis above (LOL), what type of supplements other than your aforementioned that you recommend for a beat up military guy with multiple DJD/DDD issues?

    What are your thoughts about “wet heat” to combat his patellar tendonititis / osis. I’m thinking about introducing that back into my home therapy again.

    Also, would like to know your opinion about the cold chamber or Cryotherapy that they are doing now for 3-min treatments on a guy like me with multiple joint issues, is it counterproductive to healing? Would infared sauna or warm pool therapies, like those salt water immersion tanks I have seen?

    I am looking at all forms of therapies these days to just have what you doctors call a “better quality of life” and “move better”.

    I had my left knee MRI looked at and they believe my LCL, MCL, and ACL are all in take, I have mild patellar tendonosis of my proximal tendon and possibly some plica of sorts, but the articular cartilage was mild, not sever in my doctors opinion, thus the reason I was looking at coming to Oregon for a 2nd opinion of what you may or may not think is wrong with my knee.

    In the meantime, just improving my walking, without my knee giving way. Working on isometric exercises to improve my VMO, and ITB, Quad, and Hamstring flexibility. It was recommended I start bicycling for my cardio and as therapy to help build up strength.

    I also am trying to lose weight like all of us when we get up in age.

    Thanks for your article and would love any feedback your team can give me since I’ve been all over the place with various therapies, treatments, or advice and just want to live without pain and stay moving. I will look at your formula above to see what it can do for me.

    Thanks,

    Tom

    1. Tom,

      Based on our experience and research, the supplements outlined in the blog have shown the most positive benefit. Generally speaking, exercise to tolerance is beneficial. Keeping both weight and sugar down is also very important. Given that knee issues are often caused by the misfiring of low back nerves, the missing link would seem to be a comprehensive Orthopedics 2.O type exam. But to give more specific advice, we’d need to see your images, medical history, etc. If you’d like us to weigh in, please submit the Candidate form here: http://www.regenexx.com

  7. I had both knees replaced in 2001.. Left was always good till recently with a sore, burning feeling in front of the knee.my right kneewas never good and without pain and swolleness even after 2TKR and 1 revision. I told the DR I will come back when I really can’t walk cause I am tired of dealing with pain and don’t like to take meds. I also was told my LK is troubling me cause it is time for another replacement and the life of a replacement is 15 to 20 years.
    My question is I always thought after a replacement one could get an MRI. Is this true? Thanks

    1. Marie,
      Really sorry to hear of your ongoing pain and issues. Unfortunately, we hear and see these complications of and issues with knee replacement regularly. It depends on the MRI equipment. Although some older MRI’s may not be compatible with a TKR prosthesis, the majority of MRI equipment today is safe and compatible with knee replacement parts. But it would obviously be very important to check with the Imaging Location on this important point!

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