By Dr. Mercola
Chronic pain is a significant challenge in the U.S., affecting more people than diabetes, heart disease and cancer combined.1 Up to 80 percent of the U.S. population will experience back pain at some point in their life.2 Overall, pain costs the U.S. between $560 billion and $635 billion each year.3
To control pain, many turn to ibuprofen, a non-steroidal anti-inflammatory drug (NSAID) often prescribed after an injury, to treat menstrual cramps and to calm a headache.
Sales of over-the-counter (OTC) analgesic medications, used to treat discomfort and pain, have continued to rise over the past decade. In the past three years alone, annual sales have jumped by $300,000.
Many of the available pain relief medications come with a long list of potential side effects. In recent research, scientists have linked the use of ibuprofen and acetaminophen, two popular OTC analgesics, with hearing loss.
Common Analgesics Linked to Hearing Loss
In this short news video Dr. Partha Nandi, chief health editor for WXYZ (ABC) News Detroit, discusses the results of the study and easy ways to protect your hearing.
According to an analysis at the National Institutes of Health (NIH), a little over 11 percent of Americans report having pain every day for the previous three months;5 23 million also experienced severe pain.
You might think that medication sold over-the-counter would be relatively safe when used as directed, but a growing body of evidence suggests that NSAIDs and acetaminophen (brand name Tylenol) may have more long lasting and negative side effects.
The most recent research reports that long-term regular use of NSAIDs and acetaminophen may be linked to a higher risk of hearing loss.6
Data from more than 55,000 women in the Nurses' Health Study found that those who reported regular use of NSAIDs or acetaminophen for more than six years had a 9 percent to 10 percent greater risk of hearing loss more than a decade later.7 Lead author Dr. Gary Curhan, a professor at Brigham and Women's Hospital, commented:8
"I worry that people think NSAIDs and acetaminophen are completely safe, and that they don't need to think about their potential [side effects]. But particularly for people who are taking them for chronic pain, I try to encourage them to look at why they are having the pain, not what they can take to try to treat the pain."
A 2012 study by the same author demonstrated the use of ibuprofen or acetaminophen two or more times per week was also connected with an increased risk of hearing loss.9
Although the studies did not prove cause and effect, and the magnitude of loss was low, the authors caution that prevalence of use is high and may have large public health implications.10
Hearing loss is a result of ototoxicity triggering damage to the cochlea. The first symptom is often tinnitus, or ringing in the ears.11 This may be followed by hearing loss or loss of balance. You may not notice a hearing loss until you have difficulty understanding conversational speech.
NSAIDs Trigger More Negative Health Conditions
Hearing loss in men as a result of regular use of NSAIDs or acetaminophen has been well-documented and has a greater impact in younger individuals.12 This recent study has confirmed the same implications for chronic use of NSAIDs in women. However, long-term use of NSAIDs also have other implications that may affect your health.
In 2015, the U.S. Food and Drug Administration (FDA) strengthened warnings on NSAIDs, including ibuprofen, to reflect the risk of an increased chance of experiencing a heart attack or stroke within weeks of taking the OTC analgesic.13
The risk appears to increase with longer use and higher doses, and increases risk of heart attack and stroke whether you have a prior history of heart disease or not.14
Pregnant women who use NSAIDs also had an 80 percent higher risk of miscarriage.15 This association was greater when the NSAID was taken for more than a week or was taken during the week of conception.
Gastrointestinal (GI) disorders have been associated with NSAID use. Risk factors for related complications include a previous GI event, high dose NSAID therapy or other chronic disorders, such as cardiovascular disease.16
Upper GI bleeding is a common result of long-term NSAID use. Up to 15 percent of all upper GI bleeds in North Jutland County, Denmark, were explained by NSAIDs.17
NSAIDs are also associated with lower GI bleeding and perforation.18 Overall mortality from complications related to lower GI bleeding have decreased but in-hospital fatalities for upper and lower GI complication events has been constant, despite new treatment strategies.
NSAIDs also cause skin reactions, although it is difficult to estimate the frequency of these reactions as only the most challenging present at a hospital and are recorded.19
In one prospective study of nearly 20,000 inpatients, 0.3 percent developed a generalized skin reaction, while another meta-analysis of clinical trials found 1 percent to 2 percent of patients using NSAIDs developed a reaction.
Prevention Is the Best Medicine
As with most health conditions, prevention is the best medicine. In order to limit use of NSAIDs for pain control, find the pain trigger to treat the cause, not just the symptom. Chronic pain is one of the leading causes of disability in Americans, and the numbers who suffer only continue to rise.
It is important to recognize that pain is your body's way of communicating that something is wrong. Pain is not the disease, but rather powerful feedback that some activity or lifestyle choice is triggering your discomfort.
Of course, this is not the case for injury and traumas, but those causes constitute a relatively minor percentage of chronic pain.
Physical pain may be the result of an underlying lifestyle choice, overuse injury or emotional trauma that you may have discounted. When searching for the underlying cause of your pain, consider the following potential sources, and take steps to address them:
✓ Emotional Trauma
Very few people want to be told that their pain is psychological or emotional in origin, but there is quite a bit of evidence to back this up. One theory is that emotional trauma (as well as physical injury or environmental toxins) may stimulate molecules in your central nervous system called microglia.
These molecules release inflammatory chemicals when stressed, resulting in chronic pain and psychological disorders like anxiety and depression.20 Emotional and physical pain appear to activate similar areas of your brain.21
Before his retirement, Dr. John Sarno used mind-body techniques to treat patients with severe low back pain and has authored a number of books on this topic.22
His specialty was those who had already had surgery for low back pain and did not get any relief. He had a greater than 80 percent success rate using techniques like the Emotional Freedom Techniques (EFT).
✓ Poor Sleep
Poor sleep can actually impact virtually every aspect of your health. Since sleep is important to your circadian rhythm (sleep-wake cycle), it actually "drives" the rhythms of biological activity at the cellular level.
Your body needs deep sleep for tissue growth and repair, which is crucial for pain relief. According to recent research from Great Britain, poor or insufficient sleep was actually the strongest predictor for pain in adults over 50.23
✓ Magnesium Deficiency
Among magnesium's many roles is blocking your brain's receptors of glutamate, a neurotransmitter that may cause your neurons to become hypersensitive to pain.24 Deficiency in magnesium may also lead to an increased number of debilitating migraine headaches.25
This is especially important because an estimated 80 percent of Americans are deficient in magnesium. Two major lifestyle factors that further deplete your body of magnesium are stress and prescription drugs, putting chronic pain patients at particular risk of deficiency.
✓ Leaky Gut
Dietary changes are crucial for managing pain, in part due to the way foods influence your gut health. Substances in grains may increase intestinal permeability (i.e. leaky gut syndrome), allowing undigested food particles, bacteria and other toxins to "leak" into your bloodstream.
Leaky gut can cause digestive symptoms such as bloating, gas and abdominal cramps, as well as cause or contribute to many others symptoms, including inflammation and chronic pain.
✓ Lyme Disease
Some of the initial symptoms of Lyme disease may include a flu-like condition with fever, chills, headache, stiff neck, achiness and fatigue. However, it often becomes chronic, causing muscle and joint pain.
Because Lyme and all of its co-infections cause so many constant symptoms, it easily mimics disorders such as multiple sclerosis (MS), arthritis, Parkinson's, chronic fatigue syndrome, fibromyalgia and others.
If you're suffering from chronic pain and don't know why, it's worth considering Lyme disease, even if you don't think you've been bitten by a tick (its primary transmitter).
Fewer than half of Lyme patients recall ever getting a tick bite. Many Lyme patients don't remember such an event because the tick numbs your skin before biting so it is never felt.
✓ Postural Control
Upper and lower back pain are two of the more common reasons for chronic pain disability.
Fortunately, much of the time it is the result of poor posture and inappropriate use of your back muscles. Rounding your shoulders forward while sitting for hours at a computer may result in stretched back muscles and tight chest muscles.
Poor sitting posture and sitting for hours without a break can increase the stress on your lower back and increase the risk of back pain. Learning to stand and sit straight, getting up frequently and practicing the proper way to stand, walk and lift will reduce your risk for back pain.
Additionally improving muscle strength and flexibility will help reduce your current pain levels.
✓ Pain Medications
Ironically, the very drugs that most physicians prescribe to treat pain may end up making your pain worse after just a few months of use. Dr. Sanjay Gupta, associate chief of neurosurgery at Grady Memorial Hospital and CNN's chief medical correspondent, reports:26
"…[A]fter just a few months of taking the pills, something starts to change in the body. The effectiveness wears off, and patients typically report getting only about 30 percent pain relief, compared with when they started.
Even more concerning, a subgroup of these patients develop a condition known as hyperalgesia, an increased sensitivity to pain."
Sedentary Lifestyle Increases Risk of Pain
Leading a sedentary lifestyle may also increase your risk of developing a chronic pain condition, as your body was designed to move consistently throughout the day. Researchers have demonstrated that sitting for eight hours increases your risk of cardiovascular disease, even if you exercise for 30 to 60 minutes during the day. Sitting for more than six hours a day is linked with heart disease, diabetes and premature death from all causes.27,28
A study from Finland found a link between children who had a sedentary lifestyle and those who experienced a higher amount of chronic pain as they grew older.29 Another study found adults who got up more frequently throughout the day also suffered less pain.30
We know that emotional trauma and depression changes your perception of pain.31 A recent study demonstrates that remaining sedentary increases your risk of anxiety and worsens mental health.32 Megan Teychenne, Ph.D., lead researcher and lecturer at Deakin University's Centre for Physical Activity and Nutrition Research (C-PAN) in Australia, said:33
"Anecdotally — we are seeing an increase in anxiety symptoms in our modern society, which seems to parallel the increase in sedentary behavior. Thus, we were interested to see whether these two factors were in fact linked. Also, since research has shown positive associations between sedentary behavior and depressive symptoms, this was another foundation for further investigating the link between sedentary behavior and anxiety symptoms."
Natural Options to Reduce Your Pain
You have many choices to manage chronic pain, but the first is to discover the reason for your pain so you aren't throwing medication or treatments at a symptom rather than addressing the root cause.
Less than 4 percent of medical schools had a required course in pain in one review, and many offered no dedicated courses at all.34 When physicians don't know how to effectively treat chronic pain, they resort to the only treatment they know: prescription drugs, which will do nothing to solve the underlying reasons for your pain. There are also non-drug options available to treat your pain while you rebalance using proper lifestyle strategies.
One of the most common reasons people visit their conventional physician is for back pain, second only to upper respiratory infections. Superficial pain medications are the most common treatment offered, followed by steroid injections and then surgery. Unfortunately, without addressing the cause for the problem, these solutions rarely lead to a full recovery.
There are several safe, non-drug options, which may help you as you determine the cause of the pain and develop a treatment plan for a full recovery. You can read more about them in my previous articles, "6 Surprising Chronic Pain Triggers" and "15 Natural Remedies for Back Pain."