July 1, 2016

OTC Painkillers: Conflicting and Confusing Advice

More than 29 million Americans regularly use over-the-counter painkillers. The most common are:
  • NSAIDs (non-steroidal anti-inflammatory drugs).​ These drugs use ibuprofen and/or naproxen. The common brand names are Advil, Motrin and Aleve.
  • Acetaminophen. Tylenol is the leading brand name.

Conflicting Warnings
So which is safer and more effective?​ As usual, there are pros and cons for both choices. Here are two recent examples:
  • Studies reviewed by an FDA advisory panel last year found mounting evidence that NSAIDs increase the risk of heart attack, stroke, and heart failure in people with or without heart disease. Increased risk can occur as early as the first weeks of taking the drug, and the risk rises with higher doses and extended usage.​ See http://1.usa.gov/29cuFEM.
  • In light of this FDA report, it might seem that using Tylenol would be a wiser choice. But a 2015 review in the British Medical Journal concluded that the drug simply doesn't help with back pain. In fact, Tylenol may hurt more than it helps. Patients taking acetaminophen were almost four times more likely to have abnormal results in liver function tests than those taking a placebo. This report suggests patients consider NSAIDs, which appear to be more effective for back pain because they also ease inflammation.

​​Pill-​Free Option Is My Choice
I've been using OTC pills for back pain off and on for years. Until a month ago, I was taking Advil twice a day. But I've been making more of an effort to use physical therapy for my Parkinson's, and I have also incorporated some core strength exercises that have considerably eased the back pain.  Given the risks that come with any of the OTC pain pills, I've decided I can tolerate the low level of pain that continues.

I'll discuss my exercises and physical therapy in future posts.

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