Painkillers, Deafness and Arthritis

Not your usual sort of headline, but although most of us take painkillers occasionally, or regularly for chronic conditions, there are some well-established downsides such as gastric problems.

However, a new in the American Journal of Medicine alerted me to something I didn’t know, and that is that regular use of painkillers is linked to an increased risk of hearing loss. Even small amounts, such as for example taking paracetamol at least twice a week, can put you at risk of a massive 99 per cent increase in the chance of you having mild to severe deafness before the age of 50. If you regularly take ibuprofen or aspirin then that is not as high a risk, but is still a staggering 61 per cent increase over those who never take painkillers.

So that is something to think about, and particularly for those who take painkillers regularly for chronic conditions such as arthritis. If you suffer in this way you are more than likely to be prescribed non-steroidal-anti-inflammatory drugs (NSAIDs) by your doctor, and these include aspirin and ibuprofen.

If you have been taking such drugs in the belief that they will help with the pain, the evidence does not support it. One trial that looked at the long-term effects of NSAIDs versus placebo on pain showed “no significant effect of NSAIDs compared with placebo at one to four years” and over six years the British Medical Journal published a review of 23 studies that reinforced this view. They concluded that “NSAIDs can reduce short term pain in osteoarthritis of the knee slightly better than placebo, but the current analysis does not support long term use of NSAIDs for this condition. As serious adverse effects are associated with oral NSAIDs, only limited use can be recommended.”

All very well, but what can you do about the pain from arthritis? Natural alternatives such as white willow bark (the natural substance that aspirin was synthesised from) and many find acupuncture of great help in relieving long term and chronic pain. Personally I recommend you get hold of Patrick Holford’s excellent book ‘Say No To Arthritis’ for a thorough look at all the options from anti-inflammatory essential fats from oily fish to plant extracts such as boswellia, bromelain and ginger.

Natural help for pain

I have known Patrick Holford for many years, and his nutritional advice is always sound and on target. I thought you would be interested in his thoughts on treating pain naturally, particularly the importance of healing the gut, easily damaged by painkillers, with a combination of digestive enzymes, probiotics and glutamine, and identifying and eliminating food allergies.

His top six natural pain killers are these:

1. Turmeric

Curcumin, the active ingredient in turmeric, works as well as anti-inflammatory drugs, but without the side effects. Like NSAIDs, it blocks the formation of the pro-inflammatory prostaglandins (PGE2), as well as leukotrienes. It has been used for its medicinal properties in Ayurveda for hundreds of years and there is no evidence of any downsides, even in high doses of 8g a day.

2. Olives

Olive extract decreases levels of pro-inflammatory substances and reduces levels of two inflammatory messengers called TNF-alpha and interleukin-8. In one study with mice, the extract reduced TNF-alpha levels by 95% and some of the newest pain-killing drugs work by reducing TNF-alpha.

3. Extract of hops

An extract from hops, called isooxygene, is anti-inflammatory and one of the most effective natural painkillers of all. Not only is it almost as effective as ibuprofen, but it also doesn’t have the gut-related side effects of anti-inflammatory drugs. This is because ibuprofen also inhibits COX-1 (the so called ‘good’ COX, because it produces prostacyclin, which protects the gut lining), whereas the hop extract does not.

4. Quercitin

Many plant foods contain flavonoid compounds, which are known to inhibit inflammation. One of the most potent is quercitin and just one red onion, or a cup of berries, or three servings of greens provides about 10mg of quercitin. Other good sources include red wine, tea, grapefruit, broccoli, squash, red grapes, cranberries and citrus fruits. This is one reason why vegetarian diets have proven highly effective in reducing pain and inflammation. However, taking fifty times this amount, 500mg a day, quercitin becomes a potent anti-inflammatory inhibiting the production of the pro-inflammatory prostaglandins (type 2) and also inhibiting the release of histamine, which is involved in inflammatory reactions.

5. Glucosamine

Glucosamine is proven to slow progression of osteoarthritis of the knee and good quality evidence shows it works as well as ibuprofen but with less side-effects. Although there is evidence that chondroitin works, the research does not show that it works better than glucosamine. Most of the research has been done using glucosamine sulphate, but the most absorbable form is glucosamine hydrochloride. Promising results are reported for pain relief and relief from arthritis in people taking daily supplements supplying 1 to 3g of one of the most effective sources of sulphur, methylsulfonylmethane (MSM). A combination of both glucosamine and MSM is particularly effective.

6. Omega 3

There’s no question about the benefits of upping your intake of omega 3s. A meta-analysis of 17 randomized, controlled trials assessing the pain relieving effects of omega-3 PUFAs in patients with rheumatoid arthritis or joint pain found that supplementation with EPA rich Omega 3 fats for 3-4 months reduces patient reported joint pain intensity, minutes of morning stiffness, number of painful and/or tender joints and NSAID consumption.

Putting it all together

The real magic comes when you take all these together. In practical terms this means both eating more of all these foods on a daily basis and supplementing 2 EPA rich omega 3 fish oil capsules, aiming for 1,000mg of EPA a day and combination supplements of these other natural remedies.

You need at least 1 gram of glucosamine to make a difference and almost as much MSM. With the right combination formula containing most of the above you’ll probably need 2 a day to maintain freedom from pain, 4 a day if you are in pain and 6 a day for acute pain.

If you’d like to know more details about the exact doses, and the research, read the new edition of Patrick Holford’s book, Say No to Arthritis, which I have personally recommended to many sufferers for its effectiveness. For news of his talks, workshops and other books visit his website at www.patrickholford.com

Painkillers increase your risk of dementia

We all take painkillers occasionally, but the dangers of becoming dependent on them are well known. However now there is another cause for concern with over the counter drugs such as those containing ibuprofen that are commonly taken to help with a short term headache or a long term condition like arthritis.

Previous studies have indicated that taking painkillers to ward off dementia might be effective, but a new study done in Seattle on 2,700 people found that as many as 66 percent were actually MORE likely to develop dementia if they took heavy, regular doses of painkillers.

They also had a tendency to have more diabetes, arthritis, and signs of heart failure. High doses of painkillers can have serious side effects, including stomach problems leading to ulcers and small bleeds in the brain have also been reported.

Painkillers are strong drugs and very useful for their prescribed medical purpose. Self medicating with them is never a good idea and they are not designed to be a preventive but a palliative for pain.

Painful Hands?

If your hands are painful, do you know for sure whether what causes it? You could have arthritis or might it actually be Carpal tunnel syndrome, one of the most common forms of Repetitive Strain Injury? About three in 100 of people in the UK suffer from carpal tunnel syndrome and it is characterised by pain, tingling or numbness in the hand.

About half of all carpal tunnel cases are work-related, and it a ccounts for the highest number of days missed at work compared to all other work-related injuries or illnesses. The condition develops when the median nerve in the wrist becomes compressed as it passes through the carpal tunnel, the narrow passageway of bones and ligaments on the underside of the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. Symptoms include:

· difficulty holding objects
· difficulty performing repetitive movements without pain
· numbness, burning pain, tingling in hand or wrist that increases at night

Some professions are more vulnerable to this condition than others. Particularly at risk are musicians, particularly pianists and violinists, hairdressers, reflexologists and masseuse, manual labourers, computer operators, and even surgeons. If you already have arthritis or any rheumatic conditions then this again can increase the risk of developing carpal tunnel syndrome as can conditions such as obesity, pregnancy, hypothyroidism, and diabetes.

What can you do about it?

Well painkillers, cortisone injections, splints and surgery (usually the final option) are the conventional route to go. However, my personal experience of a small sample of people I know that have had it done is that it needs to be carefully considered before you go under the knife. It can be painful and success is certainly not guaranteed, even orthopaedic surgeons admit that although surgery can cure night symptoms and transient tingling, if the nerve has been damaged as a result of carpal tunnel syndrome it probably won’t fully recover and complications from surgery can include complex regional pain syndrome (CRPS),which will permanently affect hand function.

On the alternative front, there are several options available:

1 Acupuncture can relieve the pain as it releases natural pain-relieving chemicals into the body, promotes circulation and balances the nervous system. If you can’t abide needles, then Acupressure will do the same job but usually takes a little longer to be effective in my experience.

2 Vitamin B6 deficiency has been associated with carpal tunnel syndrome in several research studies. If your diet is low in food sources such as sweet potatoes, avocados, brown rice, sunflower seeds, chick peas, salmon, pork, chicken, turkey, potatoes, bananas, and mangoes then supplementing with 50 mg 2 to 3 times a day is the suggested dose. At particular risk of B6 deficiency, in addition to poor diet, are those using oral contraceptives or HRT. The maximum intake of B6 from all sources should be less than 200 mg a day, unless otherwise recommended by your doctor or nutritionist.

3 Vitamin B12 – a study looked at the effectiveness of vitamin B12 for people with carpal tunnel syndrome due to overuse of the nonparalyzed arm after a stroke. For two years, 67 people in the study received 1500 mcg of vitamin B12 a day, and the remaining 68 did not. After two years, there was significant improvement in the group taking vitamin B12 compared to the untreated group. B12 is normally found in organ meats, and vegetarians may find they need supplemental amounts via injection which is often available on the NHS.

4 Enzyme supplements such as bromelain, found naturally in the juice and stems of pineapples, which are believed to help with the digestion of protein and may help to reduce tissue swelling associated with carpal tunnel syndrome. It can take several weeks to notice results.

5 One of my favourite homoeopathic remedies is Arnica, and in a double blind random study by the Department of Plastic Surgery of Queen Victoria Hospital in West Sussex, they found that arnica can speed up the recovery of hand surgery compared to a placebo. They used a combination of tablets and arnica ointment and saw a significant reduction in pain after two weeks.