NSAIDs
Ross Hauser, M.D.

NSAIDs are non-steroidal anti-inflammatory drugs . These are drugs that are not steroids but whose main function is to reduce inflammation (just like steroids). The first NSAIDs used were of the chemical name salicylates of which aspirin was the most common. It was phenomenal in reducing inflammation, however, it would commonly bore a hole through the stomach. Upwards of 30 percent of patients could not tolerate it for that reason. Hence, the advent of all of these new NSAIDs.
 

Are NSAIDs Safe? No!
A study done in 1998, published in The Journal of the American Medical Association, found that adverse drug reactions (ADRs) account for over 100,000 deaths of Americans every year. This study is describing both the medicines prescribed by doctors and the ones available over the counter. The authors wrote, "We deduced that ADRs may rank from the fourth to sixth leading cause of death (in U.S.)." Only heart disease, cancer, and lung disease kill more people than prescription drugs. Guess which drug class has the most frequent side effects and kills the most people? You guessed it, NSAIDs. NSAIDs are the most common reason for adverse drug event reporting to the Food and Drug Administration in the United States. Painkillers, including NSAIDs, topped the list as causing the most deaths.
 

You may ask, "How does this happen? How can the Food and Drug Administration approve medicines that kill upwards of 100,000 people each year?" The answer is easy. They forget the facts. Drugs suppress normal, healthy bodily processes and mechanisms so the only end result has to be harm to the person. They may have a short-term benefit, such as pain relief, but there are many more long-term problems. Let's just take one FDA-approved NSAID: Duract (bromfenac). It was launched in July of 1997 as the strongest NSAID ever to come on the market. In just 11 months after hitting the market, over 2.5 million prescriptions were written. It wasn't too long before all the adverse drug reactions started piling up. The FDA was flooded with cases of adverse drug reactions, including liver failure and deaths. The company was then forced to voluntarily withdraw the drug from the market in June of 1998.
 

Besides death, NSAIDs cause a myriad of other well-known side effects. Compare this to the side effects of Prolotherapy. It should be noted that the Physicians' Desk Reference, the main reference book on drugs, lists over one hundred side effects for each of the NSAIDs. Typically the side effect lists for the NSAIDs take up over 50 percent of the space for each drug in the book. Due to the frequent side effects of NSAIDs, a new class of anti-inflammatories is invading the market called COX-2 inhibitors. These apparently inhibit the cyclooxygenase enzyme that causes pain and inflammation, but do not inhibit the COX-1 enzyme that protects the stomach. Athletes, do not be fooled! Anti-inflammatory is anti-inflammatory! Cyclooxygenase is the key enzyme, which starts the healing cascade. Any medication that blocks that process will hamper your chances of healing.
 

Besides the above reasons not to use NSAIDs, there is the effect these drugs have on the pocket book. Many of them cost over $100 per month to use, including Piroxicam, Diflunisal, Ketoprofen, and Fenoprofen. For just about the same price, athletes can Prolo their sports injuries away instead of anti-inflaming them to stay.
 

What is a Corticosteroid Anyway?

The small glands that sit atop the kidneys, called the adrenal glands, are the glands that are responsible for secreting hormone that regulate the vital functions of the body that are needed to live in an ever-changing environment. These hormones are responsible for maintaining homeostasis (balance) so we can handle different stressors from the environment. The main hormones secreted by the adrenal gland are the corticosteroids.

 The typical corticosteroid is cortisol, also referred to as hydrocortisone. The effects of corticosteroids are numerous and widespread. They influence carbohydrate, protein, and lipid metabolism; electrolyte and water balance; and the functions of the cardiovascular system, the kidney, skeletal muscle, the nervous system, and the other organs and tissues. Furthermore, the corticosteroids endow the person with the capacity to resist many types of noxious stimuli and environmental changes.
 

For instance, if a person eats an allergenic food, it is cortisol that keeps this allergic reaction from not killing the person. Cortisol also helps keep blood sugar up when a person has not eaten for a long time, like during a marathon race. Naturally-occurring corticosteroids, like cortisol, are necessary for proper bodily functioning, especially under stressful conditions.

Cortisol is the naturally-occurring adrenal hormone. There are many synthetic analogues including cortisone (prednisone), Triamcinolone, Celestone, Dexamethasone, and many others. These synthetic analogues are many times stronger than natural cortisol and are often injected into the athletes' joints, ligaments, and tendons because of their potent anti-inflammatory effects.
 

Using the main pharmacology text from many medical schools, Goodman and Gilman's The Pharmacological Basis of Therapeutics, Seventh Edition, you will see why it is our opinion that cortisone shots have essentially no role in the treatment of athletic injuries. "Cortisol and the synthetic analogs of cortisol have the capacity to prevent or suppress the development of the local heat, redness, swelling, and tenderness by which inflammation is recognized. At the microscopic level, they inhibit not only the early phenomena of the inflammatory process, edema, fibrin deposition, capillary dilatation, migration of leukocytes into the inflamed area, and phagocytic activity, but also the later manifestations of capillary proliferation, Fibroblast proliferation, deposition of collagen, and still later cicatrization (healing by scar formation)."

What modern medicine forgets is that steroid therapy is, at best, just palliative therapy—it reduces inflammation and reduces symptoms, but the underlying cause of the disease remains. This is why natural medicine physicians and Prolotherapists use very little cortisone in their practices. Cortisone, Prednisone, Celestone, and the rest of the synthetic analogues do nothing to repair the damaged tissue. They, in fact, damage the tissues themselves by making them weaker.
 

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NSAIDS (nonsteroidal anti-inflammatory drugs)