December 11, 2020  | By

By: Dr. Tanuj Palvia, MD

There are times when NSAIDs (Non-steroidal anti-inflammatory drugs), such as Motrin, ibuprofen, Aleve, naproxen, Celebrex, Indocin, indomethacin, and aspirins, are appropriate, especially in the acute setting over a short course to reduce inflammation. However, for long-term use, there can be an increased risk of side effects with long-term use, including interference with the body’s natural ability to heal.

If you are undergoing a regenerative procedure at Physio Logic, then it is particularly important to stop the above drugs for two-to-four weeks before and six-to-eight weeks after procedures.

So what are alternatives to ibuprofen that can help with pain, but not impair healing mechanisms?

  • Acetaminophen (Tylenol) – should be taken at 500 mg, 1–2 tablets, every six hours as needed for pain. Take no more than 6 tablets or 3000 mg (3 grams) in a day. If you have a tramadol prescription, taking an extra-strength Tylenol at the same time can potentiate the effects of either drug alone.
  • Arnica – a homeopathic medication that can be taken orally or topically. Helps with acute traumas, bruises, soreness, and arthritis. Take 2 times daily for one week. If no improvement after one week, then stop.
  • Bromelain – a pineapple extract and a natural anti-inflammatory. As a tablet, take 500 mg 2–3 times daily. In capsule formulations, take 2,000 MCU per 1,000 mg or 1,200 GDU per 1,000 mg.
  • Capsaicin cream – made from hot peppers and decreases substance P, which leads to decreased pain. It helps with pain in superficial joints and muscles. Apply a moderate amount of 0.025% or 0.075% cream up to 3 times daily. I recommend using gloves or washing hands very thoroughly after use because the cream can burn. Do not touch eyes, nose, mouth, or genitals after use, as it can cause irritation and burning.
  • Fish oil – has anti-inflammatory properties, and can help with arthritis pain at high doses. Take 3–4 grams of a mix of EPA and DHA per day divided 2–3 times per day. Be sure you are getting a total of 3–4 grams of EPA and DHA. Don’t take it if it has a rancid odor. It’s best if taken with mixed isomers of vitamin E or a mixed antioxidant supplement to decrease the risk of oxidation.
  • Glucosamine – the building block for cartilage. It helps with mild to moderate arthritis. It is sometimes combined with chondroitin and MSM. Take 1,500 mg daily, divided into 2–3 doses per day, as it may cause stomach upset if taken at once. This is in the Regenexx supplement as well.
  • Turmeric  from the curcumin spice, has anti-inflammatory properties and helps with arthritis. Take 500 mg 2 times daily.  

Allow one to four weeks to notice a difference in pain for bromelain, fish oil, glucosamine, and turmeric. If you take any prescription medications or have any medical conditions, discuss with your physician before taking any of the above products. For turmeric and fish oil, discuss with your doctor if you take any blood thinners such as Plavix or Coumadin because it may increase the risk of bleeding. Stop turmeric and fish oil at least two weeks before any surgeries and at least three days before any other procedures or injections.

To learn more about healing alternatives and regenerative medicine at Physio Logic, or to schedule an appointment, give us a call or fill out the form below!


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