When you have to take NSAIDs

[cristiana]

Hello everyone

I wonder if anyone can help.

I've got a painful hip and sore leg brought on by heavy lifting. I've been told to take an anti-inflammatory to see if that helps resolve the issue, along with trying a few other things like keeping mobile, sitting correctly, compresses etc. 

I am hesitant to take anti-inflammatories as I am prone to gastritis at the best of times, but I've been advised I should be OK with the one that is being prescribed, if I take it in conjunction with a PPI to protect my stomach.  I've not picked it up yet but apparently it has a reputation of being one of the gentler ones.

Hopefully this won't be a long term thing, but I wondered if there was anyone else who has found themselves having to take NSAIDs, despite suffering from gastritis or a sore gut, and if there is anything else that can be done as well as taking a PPI to lessen their impact.

Thanks!
Cristiana

Edited January 12, 2022 by cristiana

[trents]

Are the hip and leg not getting any better over time? How long has this been going on? One option might be just to give it some time without taking the meds. What about cortizone injections to the affected parts?

[cristiana]

Hi trents

Thanks for these suggestions.

I have had a lot of pain over the years with a sacroiliac joint issue and I can normally deal with it with rest.  This time the pain, which seems to have spread from that area,  wakes me up at night, and seems to be worsening.  That's why, in a way, I'd like to deal with it before it gets worse. 

But your idea of waiting for a while is worth considering perhaps - it's only been about a week so it is early days.  I think with hip issues it's important to keep mobile but I possibly overdid it at the weekend because I went on a seven or eight mile walk and the pain went on the walk, but it came back with a vengeance at night.

I will keep the cortizone injection in mind - I expect that would be something I could get if I was referred to a consultant, but at the moment it wouldn't be the sort of thing that would be offered my family doctor.

Thanks again.

Cristiana

[trents]

Seven or eight mile walk? That's way beyond what is needed to remain mobile. You must be like me. If a little bit is good a whole lot must be much better! Seriously, I would see if the pain starts to subside on it's own and then begin some limited, gentle exercise. A physical therapy consult could be helpful in giving you some targeted exercises for the sacrum pain. Stretching and strengthening that is targeted can really be helpful. I do this daily (or almost daily) for lower back issues. The exercises strengthen and stretch lower back, hip, buttocks, quadriceps and hamstrings. All those muscle groups work together.

Another possibly helpful change would be to evaluate your sleeping posture with regard to your bed. My wife and I purchased articulating twin beds that allow us to raise the head and foot of the bed. They are motorized with remotes to allow you to change the configuration on the fly. Like you get in hospitals. This has helped with both GERD and lower back pain. Even putting a pillow under your knees takes stress off your lower back. As we have aged we find we can no longer sleep flat without getting lower back pain. And if you are a side sleeper, putting a pillow between your knees can alleviate strain on the hip muscles.

Edited January 12, 2022 by trents

[cristiana]

This is really great advice, thanks trents.  I shall try the sleeping position suggestion and have ordered a special pillow that they keep advertising on TV at the moment that's supposed to be good for backs and hips. 

I think I was so pleased the pain left me on the walk I thought exactly as you do, "a whole lot must be much better"!

[Wheatwacked]

My choice is Alka Selzer (aspirin, sodium hydrogen carbonate and citric acid) for any pain or upset stomach issues I have.   For serious pain that doesn't go away, prednisone or prednisolone. I had a black lab with congenital hip dysplasia. He was on 5 mg prednisone all his life, when he was x-rayed at 9 years old he had no arthritis, while all my other dogs did. 

Quote

From the Willow. It must have been salicylic acid that Hippocrates was dealing with when he recommended extracts of willow bark-for relieving pain and fever. American Indians gave willow-bark tea for rheumatism and fevers.   http://content.time.com/time/subscriber/article/0,33009,875752,00.html

 

https://www.netdoctor.co.uk/medicines/aches-pains/a8379/alka-seltzer-original/

 

https://my.clevelandclinic.org/health/drugs/11086-non-steroidal-anti-inflammatory-medicines-nsaids

Quote

Conclusions Nonsteroidal anti-inflammatory drug exposure was associated with higher risks of incident eGFR <60 ml/min per 1.73 m2 and eGFR decline ≥30%. Highest risk was observed in etoricoxib users, and lowest risk was with ibuprofen.   https://cjasn.asnjournals.org/content/16/6/898

 

[Cheley 69]

On 1/12/2022 at 9:35 AM, trents said:

Are the hip and leg not getting any better over time? How long has this been going on? One option might be just to give it some time without taking the meds. What about cortizone injections to the affected parts?

Have you thought about going to a chiropractor? My right hip and lower back have been killing me for years and so I tried a chiropractor, my poor posture always throws my aligmnent out and my right leg ends up a bit longer than the left. The chiropractor gets it back inline and I feel great.

[cristiana]

32 minutes ago, Cheley 69 said:

Have you thought about going to a chiropractor? My right hip and lower back have been killing me for years and so I tried a chiropractor, my poor posture always throws my aligmnent out and my right leg ends up a bit longer than the left. The chiropractor gets it back inline and I feel great.

Cheley, so funny you should mention this but I've booked to see one but have just postponed the visit because it has improved a fair bit over the past few days.   It is good to have this recommendation as I wasn't sure if I should be asking for physio instead.  Thank you for the tip.

[Cheley 69]

1 minute ago, cristiana said:

Cheley, so funny you should mention this but I've booked to see one but have just postponed the visit because it has improved a fair bit over the past few days.   It is good to have this recommendation as I wasn't sure if I should be asking for physio instead.  Thank you for the tip.

Lol, well I hope you stay on the mend. I know how painful it is and my stomach is trashed from all the NSAID I took trying to relieve the pain. I also looked up some excercises to do to help strengthen my pelvic area along with going to the chiropractor. 

[philastror]

On 1/12/2022 at 9:27 AM, cristiana said:

I am hesitant to take anti-inflammatories as I am prone to gastritis at the best of times, but I've been advised I should be OK with the one that is being prescribed, if I take it in conjunction with a PPI to protect my stomach.  I've not picked it up yet but apparently it has a reputation of being one of the gentler ones.

Hopefully this won't be a long term thing, but I wondered if there was anyone else who has found themselves having to take NSAIDs, despite suffering from gastritis or a sore gut, and if there is anything else that can be done as well as taking a PPI to lessen their impact.

Thanks!
Cristiana

I’ll admit I haven’t read every response so this might be redundant, but I’ve suffered with sciatica for years along with recent digestive problems and I would recommend patches. They have ones that are NSAID’s and ones that are lidocaine. You can ask your medical providers for recommendations and how to use appropriately, but it will bypass any stomach problems. Hope you get relief soon one way or another. 

[cristiana]

Thanks so much @philastror, a friend has recently suggested this to me.   I think perhaps I can get these on prescription in the UK.  It is something I'll bear in mind if the pain gets more severe.  At the moment it seems to be a little better, although TV ads for knee pillows, rise and recliner chairs and bath seats have suddenly taken on a new significance to me!

Edited January 16, 2022 by cristiana

[trents]

2 hours ago, philastror said:

I’ll admit I haven’t read every response so this might be redundant, but I’ve suffered with sciatica for years along with recent digestive problems and I would recommend patches. They have ones that are NSAID’s and ones that are lidocaine. You can ask your medical providers for recommendations and how to use appropriately, but it will bypass any stomach problems. Hope you get relief soon one way or another. 

NSAID Patches can have the same problem with stomach irritation as pills if used often for extended periods since they will also suppress the inflammatory process needed to rebuild the stomach lining. The COX inhibitors will still get into the blood stream to some extent. But they are great for short term, intermittent use. NSAID inflammatory creams and gels can be effective for close to the surface inflammatory pain.

[cristiana]

Thank you Trents, I wondered about that.  Would I be right in thinking lidocaine isn't a NSAID, @philastror?

[AlwaysLearning]

Every time I turn around, I hear of some other reason to avoid taking NSAIDs so I'm with you 100% on being hesitant.

I know this sounds a little out there, but before going to pharmaceutical route, I would investigate guided meditation for pain relief. From what I hear, it can be much more effective without any adverse side effects ... and there are plenty of free options on YouTube. I've heard of people doing some pretty incredible things with mind over matter, including speeding healing of the injury itself. For instance, just thinking about increasing circulation to an area of your body can increase circulation ... if you're in the right frame of mind, thus the guided meditation.

[trents]

6 hours ago, cristiana said:

Thank you Trents, I wondered about that.  Would I be right in thinking lidocaine isn't a NSAID, @philastror?

Lidocaine is a numbing medication that can be applied topically or injected. It is not an NSAID.

[RMJ]

On 1/12/2022 at 8:27 AM, cristiana said:

Hello everyone

I wonder if anyone can help.

I've got a painful hip and sore leg brought on by heavy lifting. I've been told to take an anti-inflammatory to see if that helps resolve the issue, along with trying a few other things like keeping mobile, sitting correctly, compresses etc. 

I am hesitant to take anti-inflammatories as I am prone to gastritis at the best of times, but I've been advised I should be OK with the one that is being prescribed, if I take it in conjunction with a PPI to protect my stomach.  I've not picked it up yet but apparently it has a reputation of being one of the gentler ones.

Hopefully this won't be a long term thing, but I wondered if there was anyone else who has found themselves having to take NSAIDs, despite suffering from gastritis or a sore gut, and if there is anything else that can be done as well as taking a PPI to lessen their impact.

Thanks!
Cristiana

If the NSAID is a COX-2 inhibitor it shouldn’t have the typical adverse effects on the gastrointestinal system that COX-1 inhibitors have.

Sucralfate is another drug that is sometimes taken to protect the gastrointestinal tract from NSAID effects.  It works by forming a protective layer.

[trents]

4 minutes ago, RMJ said:

If the NSAID is a COX-2 inhibitor it shouldn’t have the typical adverse effects on the gastrointestinal system that COX-1 inhibitors have.

Sucralfate is another drug that is sometimes taken to protect the gastrointestinal tract from NSAID effects.  It works by forming a protective layer.

COX-2 inhibitors have reduced GI impact but there are still plenty of people who develop peptic ulcers who take them daily over extended periods of time. There mechanism of action is they suppress only COX-2 instead of COX-1 and COX-2 like aspirin or Advil or Aleve do.

[ErinLu]

On 1/12/2022 at 10:27 AM, cristiana said:

Hello everyone

I wonder if anyone can help.

I've got a painful hip and sore leg brought on by heavy lifting. I've been told to take an anti-inflammatory to see if that helps resolve the issue, along with trying a few other things like keeping mobile, sitting correctly, compresses etc. 

I am hesitant to take anti-inflammatories as I am prone to gastritis at the best of times, but I've been advised I should be OK with the one that is being prescribed, if I take it in conjunction with a PPI to protect my stomach.  I've not picked it up yet but apparently it has a reputation of being one of the gentler ones.

Hopefully this won't be a long term thing, but I wondered if there was anyone else who has found themselves having to take NSAIDs, despite suffering from gastritis or a sore gut, and if there is anything else that can be done as well as taking a PPI to lessen their impact.

Thanks!
Cristiana

Hi. Before you stop the investigation on your hip issues - be sure to go to an orthopedic doctor that is familiar with (many hip doctors are not) labral tears-  this is diagnosed with a contrast CT with the contrast injected in the hip instead on vein in arm.  These are painful and can hurt more sometimes and less others. There are many degrees of a tear, but the damage might have to be repaired surgically. Labral tears often cause pain longterm. They hurt often not “where u put ur hand on ur hip” that’s the hip bone but more in the groin & internally (buttocks). It’s a pain that cannot be massaged away. 

[cristiana]

4 hours ago, ErinLu said:

Hi. Before you stop the investigation on your hip issues - be sure to go to an orthopedic doctor that is familiar with (many hip doctors are not) labral tears-  this is diagnosed with a contrast CT with the contrast injected in the hip instead on vein in arm.  These are painful and can hurt more sometimes and less others. There are many degrees of a tear, but the damage might have to be repaired surgically. Labral tears often cause pain longterm. They hurt often not “where u put ur hand on ur hip” that’s the hip bone but more in the groin & internally (buttocks). It’s a pain that cannot be massaged away. 

Thanks so much, ErinLu, that does sound like the pain I'm suffering.   I would very much like this level of investigation but I am not sure how easy it would be to pursue this within the NHS system in the UK.

However, I also have pain down the leg too but it's very difficult to pinpoint, it sort of moves around and doesn't appear to be following a particular nerve path.  Sometimes it's on the side of the knee, other times the front of the lower leg, other time the back. Other times it's in the outer thigh, other times its in the inside leg. The closest explanation I've found is that it is not "true sciatica" pain but, rather, referred muscular pain.  Does one get referred muscle pain with labral tears? 

https://backforever.com/sciatica-treatment/

[tessa25]

Pain in the hip and leg is quite common when the sacroiliac joint is out. A physical therapist can check if your hip is out and teach you how to put it back in yourself. It can take a month of exercises to get it to stay in on its own.

[cristiana]

Thank you Tessa, I did wonder if there was some sort of connection as the pain is quite close to the joint.  Yesterday I had to walk a couple of miles and that area felt tight, a new type of pain, sharp and a very tiny area was affected, but after the walk I had no more pain after that.  I will try to find a way that I can get a physio to look at this.