How to Use NSAIDs and Tylenol Wisely

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You might think I’m against using all over the counter pain medications. However, I do use them rarely. The is key is using them smartly. So let’s discuss that today.

The NSAID or Tylenol Addict

I see so many patients each week that I would call NSAID addicts. Meaning that at some point, they got into a regimen where they needed drugs like Motrin, Advil, Aleve, Celebrex or other NSAIDs just to function. At first, it began with a flare-up, so they took some pills to be able to be in less pain. Then it advanced to having to take these medications to be able to exercise. Finally, it progressed to taking them every day just to function.

These are some of the hardest patients for us to treat, as we often take them off these medications for their procedures. Hence, trying to get an apples to apples comparison of where they are before and after being taken off these medications is tough.

Using Pain Medications Wisely

Is there a way to flip this script on its head? How can you use over the counter pain medications wisely rather than poorly? Let me show you what I do.

I’m getting older and while in residency I fractured a few bones in my back. Hence, every few years it needs to be treated with orthobiologics. Most other people would have had a lumbar fusion long ago, but that’s not at all where I want to head.

To help low-level inflammation on a daily basis, I take:

  • High dose fish oil
  • Curcumin with Bioperine
  • Fisetin
  • Metformin (I also have genetic blood sugar control issues)

This week I injured my back. That pain was enough to poke through my usually supplement anti-inflammatory regimen. Hence, I needed some help to see patients. Given that I almost never take these medications like Motrin or Tylenol and I have a base plan to control daily inflammation in place, they are incredibly effective for me. Hence, the first day I took two regular strength Tylenol pills twice about 6 hours apart. That was enough to keep me going. The next day my goal was to reduce that, so I took one dose. Yesterday I took none. If things are still a bit flared up by Monday, I’ll get in for a platelet based injection, but today that seems unlikely.

Avoiding Addiction

So how do you stay away from medication addiction? The big issue is recognizing the difference between help and dependence. Meaning taking a few Tylenol to help you through some acute pain is getting a little help. However, needing Tylenol to function is dependence.

How can you avoid the latter? When a problem continues beyond what Tylenol can handle, get it treated. This could be with chiropractic or physical therapy or if that doesn’t help, then consider orthobiologic injections. All of that should happen before you become dependent on over the counter pain medications.

The upshot? You can use Tylenol and other over the counter pain medications as a quick supercharge on top of your daily anti-inflammatory regimen. However, use these medications wisely and judiciously.

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5 thoughts on “How to Use NSAIDs and Tylenol Wisely

  1. Susan Maass

    Realized I was Aleve dependent when I first saw you in 2012. Stopped nsaids completely, but Tylenol doesn’t quite take away the pain. And while I have tried curcumin with some results, last week I purchased a product Curamin, recommended by a friend, that is amazing. It includes Boswellia and more. Thanks for your emails.

  2. Michael

    What is the brand of Curcumin with Boswellia?

    1. Chris Centeno, MD Post author

      ??

  3. Kim Mielke

    Is bioperine the same as Boswellia?
    If so they are both in Terry Naturally brand curamin

    1. Chris Centeno, MD Post author

      No, Bioperine is a pepper extract that helps with curcumin extract.

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