Pain caused by degenerative processes in the joints causes a person considerable discomfort. One of the mandatory prescriptions of an orthopedic doctor is non-steroidal anti-inflammatory drugs, which sometimes the patient begins to take at his own discretion in large quantities. What do you need to remember so as not to further harm your health?
Uncontrolled use of NSAIDs is a direct path to exacerbation of gastrointestinal diseases
What are NSAIDs
The purpose of non-hormonal anti-inflammatory drugs is to reduce and eliminate inflammation in the joints. The absence of hormones makes the effect of the medications quite mild and eliminates serious side effects. However, this is only true if the treatment of arthrosis or osteoarthritis is carried out under the supervision of a specialist.
What is the principle of action of non-steroidal anti-inflammatory drugs? How to take them correctly? Experienced doctor, chiropractor Anton Epifanov says:
Steroid hormonal anti-inflammatory drugs / glucocorticosteroids / GCS
Typical and frequently used representatives of this group of drugs: prednisolone and methylprednisolone (Solu-Medrol, Metipred, etc.), hydrocortisone, Kenalog, Diprospan, Dexamethasone. There are glucocorticosteroids for administration intravenously, intramuscularly, intraarticularly, orally, externally, in suppositories (suppositories).
The action of GCS and the principle of their operation
Steroid drugs (glucocorticosteroids, GCS) are the most powerful, hormonal, anti-inflammatory drugs. GCS have the following main effects:
- anti-inflammatory
- immunosuppressive (immunosuppressive)
- antiallergic
- anti-shock
What is inflammation? In response to the influence of any damaging factor (infection, injury, burn, introduction of a foreign protein, etc.), the body responds with a protective reaction, i.e. inflammation. In the damaged area of the body, special substances are synthesized - inflammatory mediators , which create conditions to combat the damage: blood flow increases, temperature rises, the nervous system is notified of what is happening through pain receptors. The immune system is activated, immune signaling proteins (cytokines), antibodies and white blood cells at the site of inflammation become more aggressive . Hence the characteristic symptoms of inflammation: pain, swelling and swelling, increased local and general temperature, redness.
GCS suppress the body's inflammatory response, blocking the synthesis of inflammatory mediators in the body and suppressing the aggressiveness of the immune system. Symptoms of inflammation quickly decrease, but the cause of the disease remains. If the symptoms of the disease are so destructive that hormonal anti-inflammatory treatment is required, we carry out research in search of more subtle and safe ways to influence the course of the disease . Even when the disease has genetic roots, in most cases this is successful.
Possible side effects. Security measures. Diet
Most often we encounter:
- Peptic ulcer of the duodenum or stomach
- Exacerbation of infections due to decreased immunity
- Increased blood pressure
- Increased glucose (sugar) in the blood
- Osteoporosis
Metabolic disorders with increased body weight are quite rare; In recent years, GCS preparations have become safer, and medicine has learned to use them delicately.
We will do everything possible to stop you from taking hormonal anti-inflammatory drugs. If taking GCS is a necessary measure, we will offer you a safe regimen and diet that prevents weight gain.
How to reduce the risk of side effects? First of all, this is the choice of drug . For example, methylprednisolone, which has greater therapeutic and fewer side effects compared to prednisolone, has recently become widespread. If necessary, anti-inflammatory drugs can be taken under the guise of an anti-ulcer drug . Long-term use should also include prevention of osteoporosis .
Secondly, the correct reception mode . Your doctor will tell you how to use the medicine correctly throughout the day. For long-term treatment, periodic dose changes and breaks are practiced.
Thirdly, you cannot rely only on the GCS. We must understand that this is a symptomatic treatment. We will look for and treat the causes and primary mechanisms of the disease.
Fourthly, you should remember about proper nutrition , and your weight will remain under control.
How to refuse GCS?
If you cannot refuse corticosteroids due to an increase in the symptoms of the disease, most likely, insufficient attention is paid to non-hormonal basic therapy .
Regularity of immunomodulatory treatment and infection control is also important. It is often possible to discontinue GCS after correcting the state of the immune system and treating chronic infections . Nervous stress, sleep disturbances, nervous exhaustion are also possible causes of your difficulties. To cancel long-term use of corticosteroids, a course of antidepressant treatment is sometimes sufficient.
What non-steroidal anti-inflammatory drugs are most often prescribed for arthrosis?
- Aspirin is indicated in the initial stages of treatment of arthrosis and osteoarthritis, however, patients with diseases of the heart, blood vessels and gastrointestinal tract require special caution.
- Diclofenac - in tablets or ointment form.
- Ibuprofen is one of the most common medications that is easier to tolerate by the body than others.
- Indomethacin - attractive at an affordable price, relieves pain well, but it has many contraindications.
- Ketoprofen - in the form of tablets, injections, ointments, aerosols, gels, suppositories and even a preparation for applications.
- Movalis is less toxic to the gastrointestinal tract than many others, but is contraindicated in patients with diseases of the cardiovascular system.
- Nimesulide – copes with pain and inflammation, and also helps stop the destruction of joints.
- Etoricoxib requires strict adherence to the dosage, otherwise complications from the heart and blood vessels are possible.
There are a lot of drugs in the NSAID group: they must be prescribed by a doctor
Indications for use
NSAIDs are used for inflammatory diseases of connective tissue, which are accompanied by damage to joints, cartilage, tendons, ligaments - arthritis, arthrosis, osteochondrosis, spondyloarthritis, tendovaginitis, bursitis.
NSAIDs are used for conditions that are accompanied by mild or moderate pain: headache, dental, menstrual, muscle, joint, as well as pain due to muscle injuries, joints, ligament damage, neuralgia.
Together with narcotic analgesics, NSAIDs are used for multiple injuries and pain after surgery.
In combination with antispasmodics, analgesics-antipyretics are used for pain associated with spasm of smooth muscles - hepatic, renal, intestinal colic.
In addition, certain NSAIDs are used for elevated body temperature (fever) against the background of infectious inflammatory diseases of the upper respiratory tract and ENT organs (tonsillitis, sinusitis, sinusitis, otitis), lower respiratory tract (bronchitis, pneumonia), influenza and colds.
What you need to remember when taking an NSAID drug
Medicines in this category have a fairly quick pain-relieving effect, so many patients do not deny themselves an “extra pill.” In fact, this approach is very dangerous, since an overdose is fraught with serious complications. Therefore, doctors strongly recommend:
- take such medications only as prescribed by a doctor and in the dosage indicated by him;
- do not combine the use of several drugs from this group at once;
- take medications only with water, since tea, coffee, juice or milk distort the effect of the drug;
- do not self-medicate.
Simultaneous use of non-steroidal drugs and alcohol is incompatible and life-threatening
Treatment with anti-inflammatory drugs alone is ineffective. This is only part of complex therapy for age-related or post-traumatic arthrosis. To restore joint mobility, it is necessary to undergo a course of intra-articular injections, for example, Noltrex, to eliminate the deficiency of synovial fluid in the joint capsule and stop painful friction of cartilage. In some cases, long-term use of chondroprotectors, physiotherapy and other therapeutic methods are indicated. Only an integrated approach will bring results.
Immunomodulators
Immunomodulators are medications to correct the functioning of the immune system. We resort to immunomodulators when it is necessary to increase, decrease or regulate the activity of a particular immune mechanism.
The immune system is our main defender. It saves us from pathogenic microbes, fungi, parasites and cancer cells. For medical purposes, it is customary to consider three parts of the immune system:
- Cellular immunity. It is determined by the presence and activity of different types of white blood cells (leukocytes).
- Humoral (immunoglobulin) immunity. Immunoglobulins are special proteins that can recognize harmful biological and chemical factors that have entered the body.
- Cytokines are special protein molecules that mainly provide communication and coordination between immune cells. The blood test mainly evaluates the content of interferons (a subtype of cytokines); they are especially important for fighting viral infections. In addition, cytokines play an important role in autoimmune inflammation (tumor necrosis factor, IL-6, etc.).
All parts of the immune system work in close relationship with each other.
The selection of immunomodulators is made according to immunological blood tests . Modern immunomodulators make it possible to selectively influence one or another deviation in the functioning of the immune system.
Interferon inducers (Cycloferon, Panavir, Neovir, Kagocel, Amiksin, etc.). They increase the production of interferons. We often use them for chronic viral infections, together with antiviral drugs.
Interferon preparations (Viferon, Human Interferon, Anaferon, etc.). They replace their own interferon and thereby improve the function of the immune system. We use them in cases of significant interferon deficiency.
Regulators of cellular immunity (Galavit, Polyoxidonium, Lykopid, etc.). They stimulate (regulate) the activity and production of white blood cells. The drug Polyoxidonium is approved for use in rheumatic pathology, because does not stimulate autoimmune reactions. The drug Galavit is interesting because it blocks the production of TNF (tumor necrosis factor), which is involved in joint inflammation in autoimmune arthritis.
Thymodepressin is a new promising drug for suppressing the excessive production of aggressive immune cells. One of the safest immunosuppressants. Has proven itself in the treatment of psoriatic arthritis. Promising in the treatment of rheumatoid arthritis, ankylosing spondylitis, and vasculitis.