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06/01/2009What can I take for PAIN?
Abida Zafar, MD
A common question among patients with CKD is "What can I take for pain?"
Definitely, we ask that CKD patients avoid all kinds of NSAIDs like Motrin, Advil, Alleve, Naprosyn as well as, COX-2 inhibitors like Celebrex. They seem to be left behind with not many choices. OTC Tylenol, Tylenol arthritis and prescription medicines like Tramadol (ultram) Darvocet and Vicodin are what we commonly recommend. Topical applications of NSAIDs may be beneficial in patients with localized inflammatory pain, and oral steroids are sometimes used in severe inflammatory arthritis. Although intra-articular injections would be ideal when possible. Traumeel is a homeopathic anti-inflammatory product that is available as topical, oral and parenteral preparations. When used under supervision, it alleviates inflammatory pain without major side effects.
There are a few more options which can be useful including some nutrients that are known to have anti-inflammatory properties. Examples include pharmaceutical brand fish oil 3000mg /day or 3-5 servings of cold water fish per week. Benefits are attributed to omega-3 fatty acids EPA and DHA. Turmeric and ginger, components of South Asian cooking also have anti-inflammatory properties. These can be purchased as capsules at various health supplement stores. Glucosamine and Genacol supplements have helped with degenerative arthritis.
Patients should have vitamin D levels checked and any underlying deficiency should be aggressively and adequately treated. Patients are advised to avoid pro-inflammatory type foods such as citrus, organ meat, refined sugar, flour, paprika and tobacco. Instead, diets should focus on natural, whole foods like fresh fruit, vegetables, whole grains, and healthy fats and oils.
We strongly advise patients to lose weight and perform non weight bearing exercises like water aerobics, swimming, stationary cycling and yoga. Thus, working together with our patients, we can try to help them with their most common complaint of pain.