NSAIDs are a large group of drugs that have pain- relieving (analgesic) and fever-reducing (antipyretic) effects, as well as the effect of reducing inflammation when used over time. The anti- inflammatory effects may take anywhere from a few days to three weeks to take effect.

Allan Metzger, MD, responds: It's important to find the best NSAID that works for you. It may be necessary to go through three or four different drugs before you find the best one. If you are feeling better, then the dose can be gradually lowered, but it is important not to stop taking the medication abruptly because this could result in a severe flare. I really believe you will need fewer drugs if you commit to a regular exercise program.

Non-Steroidal Anti-Inflammatory Drugs (called NSAIDs) such as Ibuprofen, naproxen, etc … interfere with bone fusion. If your surgery involves a bone fusion, you must not use those drugs for a good 6 months following surgery. Discuss this with the surgeon.

Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation of the stomach, small intestine or large intestine, can occur at any time, with or without warning symptoms, in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs). Minor upper gastrointestinal problems, such as dyspepsia, are common and may also occur at any time during NSAID therapy.

NSAIDs are not specifically contraindicated, but the Lovenox labeling includes a warning about the use of concomitant treatment with platelet inhibitors, such as aspirin. All NSAIDs inhibit platelet function and, as a result, may affect primary hemostasis. Aspirin is a particularly important NSAID in this regard since it irreversibly inhibits platelet function.

Robin K. Dore, MD, responds: Tylenol (acetaminophen) provides analgesic properties (pain relief), but it cannot do anything to prevent inflammation. Inflammation causes the calcification along the spinal ligaments; therefore, you would want to have something that is anti-inflammatory. Question: I was diagnosed with AS in 1982 and also have fibromyalgia, diabetes, irritable bowel syndrome, etc. Since that time, I have been under the care of my internist, a rheumatologist and an endocrinologist.

NSAIDs work by keeping your body from making Circulating Immune Complex (CICs) however SOME CICs are VITAL to LIFE; they keep your kidneys functioning & maintain your intestinal lining. Aspirin, Advil, Celebrex, other NSAIDs & Tylenol are highly toxic to the LIVER. Every year 20,000 Americans DIE from over-the-counter drug side effects, another 100,000 are HOSPITALIZED with BLEEDING INTESTINES, LIVER or KIDNEY DAMAGE.

Opinions vary. Many doctors feel that Cox-2 inhibitors have never been shown to be more effective than traditional NSAIDs like ibuprofen and naproxen. If gastrointestinal safety is an issue, patients are prescribed protective drugs like proton-pump inhibitors to lower their risk even more. Cox-2 inhibitors have bigger and more exorbitantly expensive marketing campaigns. Cox-2 inhibitors also cost much more than traditional NSAIDs.

NSAIDs may potentially have several well-known detrimental effects in your system such as gastric irritation and liver damage while acupuncture has virtually no side effects. In terms of the action on your muscle and joint pain, acupuncture works in a completely different manner than medication does. Most pain-relief and anti-inflammatory medications provide excellent short-term pain-relief by blocking the production of pain-causing substances called prostaglandins.

No one can promise that participation in a residential drug rehab will induce sobriety, but no other drug treatment program offers as great a probability of successful recovery. Between 40% and 60% of participants in drug rehab leave the program to lead better lives of complete sobriety; some others may eventually relapse and need some degree of additional therapy; and some recovering addicts may need to undergo a residential program more than once.