Kicking the Advil habit

September 28, 2010 2:20 PM

Trying to kick my ibuprofen habit. How can I ease my aches in the meantime?

I've had headaches, and body and joint aches & pains since I was a teenager. To cope with these aches, I've taken Advil on a weekly, and often daily basis, for the past 15 years. I haven't gone more than 3-4 days in that time period without taking Advil. I never take more than the suggested dosage (no more than 6 a day), but I'll often go through weeks where I take that dosage each day.

I want to go off Advil because I've had an ulcer in the past, and I also don't want to be so dependent on OTC meds to get through the day. However, I'm on Day 6 of no Advil, and I feel TERRIBLE - bad headaches, joint aches, stiff everything.

I'm working on trying to figure out WHY I have these aches. I've gone to doctors in the past, but didn't advocate for myself very well. I have an appointment lined up with my current GP. I'm not looking for the answer to why this is happening (though if your particular why is relevant to your remedy, please share!) -- I know getting to the bottom of the aches will be key, and I'm on the case.

I'm looking for in-the-meantime coping techniques for the aches. I'd like to feel better without going back on The Stuff.

What are your techniques and non-pill form remedies for muscle and body aches?

So far, I'm stretching in the mornings and evenings, being hyper-aware of my posture and how long I sit at my computer, and going for 1-2 mile walks broken up over the course of the day. (In my experiments over the years, the amount I exercise seems to have no bearing on the aches.) I'm sleeping and eating well and staying off caffeine and alcohol.

Thanks for your suggestions! I'm open to stretches, exercises, home remedies -- anything that's worked in the past for you.

Relevant info: 30-year-old female in the Twin Cities. Work from home 75% of the time, 25% at a casual office.

posted by Laura Macbeth to health & fitness (37 answers total)

Meant to add that I'm familiar with the rebound effect from Advil, and have hope that some of this achiness is related to that idea & will disappear once enough time has passed. I should also mention that the Advil takes away nearly all of my pain on good days, and about 50% of it on bad days.
posted by Laura Macbeth at 2:22 PM on September 28, 2010

You should definitely talk to your doctor about the long-term ramifications of taking ibuprofin over such an extended period of time. Ibuprofin can be terrible for your liver, especially if you ever drink any alcohol while taking it. On the other hand, other drugs like Aspirin have been proven to have a beneficial effect when taken at a low dose over a long period of time. There are reduced risks of colon and breast cancer, though Crohns disease is more likely to occur. Talk to your GP about your options.

If the aches don't seem to go away no matter what you do with your body, you might want to look into seeing a neurologist. ask your GP for a referral.
posted by custard heart at 2:26 PM on September 28, 2010 [1 favorite]

Hydration? I always have random aches and pains if I need liquids.

Alternatively, and really on the flip side of hydration, caffeine helps with my aches and pains at times.
posted by mikeh at 2:26 PM on September 28, 2010

Have you seen anyone about depression, fibromyalgia, chronic fatigue syndrom, allergies?

I don't have joint aches & pains, but I do have headaches. This runs in my family.

I have been keeping them away for the most part by using a sinus rinse and by drinking a lot of water.
I think my problem has always been that I have a hard time drinking fluids. I also have issues with my sinuses (blocked nasal passages). A

Since I'm now determined, I use a sinus rinse about 3-4 times a week and I make sure I drink a lot of water every day and my headaches are gone - except for an occasional one here and there.
posted by KogeLiz at 2:29 PM on September 28, 2010

Also, is this Day 6 of getting off cold turkey? Because in my never not a doctor opinion, this could be your body adjusting to not having it in your system after it's been there pretty constantly for 1/3 to 1/2 of your life.
posted by theichibun at 2:29 PM on September 28, 2010

nthing water - lots and lots of water. I can't take ibuprofen anymore but realized that most of what I always thought was a a headache/bodyache was really dehydration.

That said, there's probably a lot of other answers and I would love to hear them.
posted by MCMikeNamara at 2:31 PM on September 28, 2010

Definitely look into fibromyalgia or CFS, and don't hesitate to get a second opinion if your doctor doesn't seem to listen. Both of those diagnoses are controversial, with many doctors disbelieving in their existence.

http://en.wikipedia.org/wiki/Fibromyalgia#Controversies
posted by custard heart at 2:33 PM on September 28, 2010

Thanks for the answers so far! On the hydration front - I drink lots & lots of water throughout the day. It's actually all I drink and while I'm not overly obsessive about it, I do get enough during the day. (I enjoy the taste of water, so it's easy for me.)

And yes - Day 6 of Cold Turkey! I'm hoping I can wait it out long enough to find out what the actual aches are vs. what's the effects of taking ibuprofen for so long.
posted by Laura Macbeth at 2:35 PM on September 28, 2010

Oh, and I'm long-diagnosed with anxiety disorder/chronic depression (not currently taking meds), so I'll definitely bring that up with my new GP, along with the fibro, CFS, allergy options. Thanks again!
posted by Laura Macbeth at 2:37 PM on September 28, 2010

I recommend all the following: water, heat (heating pad, hot baths), yoga and acupuncture.
posted by bearwife at 2:39 PM on September 28, 2010

I've had back pain for about five years, hip pain for about three, and have very recently developed some strange knee pains. All of these are relieved by swimming for about an hour, once or twice a week. (the pain relief lasts about 4 days) I don't know if this will help you and I can't even explain why it's helped me, but it's been miraculous from the very first time in the pool. Maybe that could help a little while you sort things out?
posted by Eumachia L F at 2:40 PM on September 28, 2010

Thanks for asking! I noticed a couple years ago that I sleep A LOT better when I take ibuprofen, and also wondered if all these aches and pains are 'normal'. I'm very interested in other's responses and how your cold-turkey experiment turns out.
posted by MeiraV at 2:42 PM on September 28, 2010 [1 favorite]

BTW, it's acetaminophen that causes liver damage. Ibuprofen causes stomach damage. (Ever taste the liquid inside ibuprofen gelcaps before? It's *harsh*.)

If you see a doctor, though, there are ways of preventing much of the damage in advance. (One is prescribing a proton-pump inhibitor along with the NSAID. Technically, )

So anyway, my answer is boring... but see a doctor. No doctor is going to admonish you for wanting to kick a drug habit. And they can help make it easier for you. It will be easier for you if you have the help of a doctor, because then you won't have to worry as much about what's happening to your body or whatever.
posted by jrockway at 2:45 PM on September 28, 2010

(whoops, didn't finish my parenthetical remark. I was going to say that you could put yourself on this cocktail yourself, as everythint is OTC now. But I'm not a doctor.)
posted by jrockway at 2:45 PM on September 28, 2010

If you're drinking a lot of water maybe you're hypoatremic? Too much water can flush out the sodium and other electrolytes and put everything out of balance. It's not very common if you're not exercising, so you're probably fine, but I managed to do this to myself a year ago by drinking 1.5-2.5 litres of water a day and eating a low salt diet, and it definitely lead to cramps and aches. I was also exercising pretty regularly at the time, so I drank ~350 mL powerade an hour before exercise (I was already using sports gels during), and that fixed the problem within a couple of days.

Being hydrated isn't just about water, it's about keeping everything in balance. So consider replacing some of your water with an isotonic or hypotonic sports drink and see if that helps. Otherwise you seem to be doing everything you can, eating well, sleeping well, stretching, exercising, avoiding caffiene and alcohol (although if you went cold turkey on caffiene too that's going to make you feel worse for no benefit, so drink a moderate amount now if you were drinking it before). There are no quack remedies which will help, supplements, homeopathy, whatever, so don't bother.

Other than that, I find when my back is playing up it helps if I distract myself and try not to think about it (although I know this is hard!). Listening to music or immersing myself in work is the best option but often I end up snacking on tasty foods instead, something nice to take my attention away from how shitty I feel. Stopping to stretch can also help because it makes me slow down and think about my breathing and focus on what my body is doing besides being sore, so that's another distraction. I imagine meditation or similar might be helpful here too. Definitely the more you think about the aches, the worse they will feel (there is a lot of research to back this up). Ignoring the pain isn't a long term solution of course. But it might help get you through the next few days while the advil rebound wears off and until you can see the GP.

Also custard heart is totally wrong about ibuprofen and liver damage, probably got confused with acetaminophen, and the link to Crohn's Disease isn't well supported either. Seeing your doctor really is the best move here because internet health advice is generally worth what you paid for it (that includes mine of course!).
posted by shelleycat at 3:00 PM on September 28, 2010

I'm always achy. Sometimes the only thing that helps me is a HOT bath. I also like to throw some essential oils in there - eucalyptus, lavender, tea tree oil.
posted by Sassyfras at 3:01 PM on September 28, 2010 [1 favorite]

You might try some fish oil supplements. Fish oil helps inflammation. Works great for joint pain, in my experience, and in my father's.

There is little danger of developing ulcers while taking ibuprofen at the recommended dose, just for what it's worth. That's why the recommended dose maxes out at 1.2 g/day. You can actually take much higher doses for short periods of time to deal with acute pain. Many people with arthritis safely take ibuprofen for long-term management of their pain -- especially since the newer, more selective, NSAIDs were implicated in increased heart attack risk.

Furthermore, ibuprofen is not a narcotic and is not addictive, so you really have no "habit" to "kick."

On the one hand, it would be good to find out what the underlying problem is and address that, if possible, rather than merely dealing wiht your symptoms. On the other hand, general achiness can be hard to diagnose, and you may find that regular doses of ibuprofen are what works best anyway.
posted by kindall at 3:05 PM on September 28, 2010

I am not a physician, but have suffered a lot weird pains in my joints and in various parts of my body. I ended up figuring out that a lot of it had to do with stress and I had a job were I was sitting all day. After visiting a variety of professionals it basically came down to being stressed out caused me to tense muscles in my shoulder and neck, which could cause headaches. It also caused me to sit funny causing muscle imbalances. I also found out I had flat feet which caused a lot of lower body pain.
I haven't fixed all the pain, but exercising to fix postural problems, and focusing on stress relief have helped a lot. Massages, acupuncture, and rolfing are great because help relearn what it feels like to be normal, but they are not long term solutions and can be expensive. They also helped me realize when I was tensing up and I work on relaxing. For the flat feet I have been using a balance board to build up my arches have been wearing shoe inserts when I have to walk long distances.
posted by roguewraith at 3:09 PM on September 28, 2010

Oh, shelleycat's probably right. I usually avoid drinking when I'm taking any sort of painkillers just to be safe, but long-term use of ibuprofin can't be a terribly good thing for your system.

As for aspirin, if Crohn's link is only tentative, there are numerous other risks associated with taking it daily, such as internal bleeding. It can act as a blood-thinner, so if you suffer from low blood pressure it can be a dangerous thing. Chronic Ibuprofin risks include GI tract bleeding and ulcers, which I see you've already had some experience with.

and whatever you do, DON'T switch to regular Acetaminophen use. it can cause massive massive terrible headaches that will make you want to kill yourself. (I have personal experience with this). talk to your doctor before taking any medication long-term.
posted by custard heart at 3:10 PM on September 28, 2010

I weaned myself off of the vitamin I habit a few years back. Now I take it only for a severe headache or when engaging in activities that make the tendonitis flare up. One thing that helped was to pay attention to body mechanics. Most of my daily aches can be avoided or ameliorated by avoiding movements that irritate. Simple things like not crossing my legs, good posture, holding my stick shift sideways, etc. I use an extra pillow at night to elevate the knees or between the legs to keep them straight.

Not to harp on the water topic, but I find that staying extremely well hydrated makes a subjective difference. Not just drinking enough, but staying topped off to the point that any additional liquid is immediately voided.

Fish oil supplements, vitamin b, and glucosamine all have antiinflammatory properties but I've never been able to notice the difference.
posted by Manjusri at 3:13 PM on September 28, 2010

When you see your doctor, ask for a referral to a rheumatologist. They're the experts on most chronic autoimmune pain-causing illnesses (CFS, fibromyalgia, lupus and so on). These diseases can be sneaky so it might take several rounds of testing. But it is definitely something you want to have a doctor look at and NOT dismiss. A referral to a pain clinic might also be helpful. Even if it turns out to be chronic and you need painkillers to function, you should NOT just suck it up and live with it.
posted by Rosie M. Banks at 3:19 PM on September 28, 2010

RN here, although everybody knows I'm not your RN, of course. :-)

I have no idea if you have fibromyalgia or an autoimmune disease or any of the other conditions others have given. But short term, at least, I think I can tell you why you are having such a tough time after dropping ibuprofen completely.

The NSAIDs have a cumulative effect. Not a huge one, but it's there nonetheless. So when you stopped ingesting it suddenly, your body didn't like it. The reason NSAIDs work so well for musculoskeletal disorders is because they decrease prostaglandins. You are now feeling the effects of increased prostaglandin levels in your body.

You could try going back onto a reduced dose of ibuprofen from what you were taking, then decrease it slowly over a week or two. If you think you're over the big hurdle with the aches and pains, you can sort of tough it out for several more days. If you don't feel better after three or four weeks, go see your physician, but it's a little early to jump into specialist care.

Meanwhile, continue with your stretching, but gently. Try a warm bath or even a whirlpool, if you can access one. Massage may help you feel better - make sure it's not a sports massage and avoid deep tissue work. You could also decrease your running for a week or so, because exercise increases prostaglandin levels because muscles are working harder. I'm not suggesting that you completely stop running or stretching - just go wast temporarily until your aches are more tolerable.

Good luck! :-)
posted by lambchop1 at 3:53 PM on September 28, 2010 [2 favorites]

Oops - I said 'running' when I should have said 'walking'. My bad.
posted by lambchop1 at 3:54 PM on September 28, 2010

The only suspect in the cause of your pain that I haven't seen mentioned is Lyme Disease. Carried usually by forest ticks. Even if you are not an outdoor-sy type, if you have a pet that goes outdoors, that can be a vector for the tick.

I've not had it, but a couple friends caught it in Central Wisconsin. They reported chronic joint pain like arthritis, but X-rays showed nothing. One also had what she called "spider webs," an odd feeling in the skin like she had been draped in webs. She also told me about others in her treatment program that had pain in different parts of their body, or other unusual sensations caused by Lyme.

I am not your doctor, and it may take a couple referrals from your GP to various specialists before the cause is found. Keep being determined, and don't take "no" for an answer.
posted by IvanKalinin at 3:58 PM on September 28, 2010

Just ducked in to say what jrockway said about acetaminophen being the one that does a number on your liver.

Since he said that I will say that you should look into ibuprofen and make sure you're not doing the same thing to yourself as if you went off asprin therapy for the prevention of heart disease. I'm not sure the same positive effect and rebound is seen with Ibuprofin, but in your shoes, I'd check on that.

When you had your ulcer, did they test / treat for H. pylori or just take you off Ibuprofen? If you had H. pylori, I personally wouldn't worry too much about what the Ibuprofen was doing.

Also, nthing what has been said about hydration and electrolytes, plus the classic how is your matress / do your shoes fit properly thing.
posted by Kid Charlemagne at 4:01 PM on September 28, 2010

Seconding massage.

Also if it's possible, get someone from Occupational Health and Safety at your workplace to examine your desk and chair set-up, making sure they are optimal heights and distances from each other. (Or if that's not possible, do it yourself: google around for guidelines, and experiment with different heights/distances). I had regular headaches, sore back and neck until I raised my monitor up on two phone books.
posted by lollusc at 5:24 PM on September 28, 2010

Seconding Kid Charlemagne - Ibuprofen does not cause ulcers per se. Not a doctor, but worked in the category for a long time.
posted by digitalprimate at 6:05 PM on September 28, 2010

Take a look into the book Pain Free by Pete Egoscue.
posted by Pirate-Bartender-Zombie-Monkey at 6:21 PM on September 28, 2010

Massages, acupuncture, and rolfing are great because help relearn what it feels like to be normal, but they are not long term solutions

I disagree; massage and acupuncture can have long term effects depending on how you are utilizing them. Rolfing is specifically meant to effect changes in your body that are systemic; which is why they want you to sign up for a minimum of 10 sessions.
No personal experience with Rolfing.
If you're just running to the spa for a fluff massage when your back hurts, you'll probably not see long term benefits. But there are plenty of techniques and practitioners that can in fact provide long term relief for specific issues. However, I have no idea if those issues apply here or not. Something to look into.

You mentioned being vigilant about posture. Is this a new thing, or have you always been good about that? Obviously having good sitting posture is the best for your body as you rely on your skeletal structure and postural muscles to hold you upright, rather than peripheral muscles. However, it takes awhile to stop being sore when you're learning a better posture. You've got to train the body to stop using the muscles it used before and start using the better ones.
posted by purpletangerine at 7:11 PM on September 28, 2010

Two thoughts:

- Have you had your Vitamin D levels tested recently? In some people (and I'm one of them), low levels of vitamin D = achiness, also exhaustion. Easy fix, but might involve prescription doses of vitamin D rather than over the counter.

- Have you considered any body modality work? I've been getting a great deal out of regular Feldenkrais work, which is all about learning how to give your body choices about how you move, where you hold tension, etc.

I'm also in the Twin Cities, and would be glad to discuss further by email (my username here @gmail.com or mail me through the site.) and give you info on who I've been seeing if that's helpful.
posted by modernhypatia at 7:59 PM on September 28, 2010

Just a sidenote but, make sure you tell your doctor how much ibuprofen you have been using and for how long. Ibuprofen can cause other issues and long term use has even been linked with kidney cancer or other kidney problems.. At minimum your doctor should check your BUN and creatinine levels if not do an ultrasound on your kidneys.

Ibuprofen can also cause raised liver enzymes, although it is not as toxic to the liver as acetaminophen.
posted by SuzySmith at 11:39 PM on September 28, 2010

2nding having your Vitamin D checked. My wife went through this for a few months until they finally pinpointed Vitamin D as the issue. Vit D supplements made her feel 1000% better.
posted by COD at 5:53 AM on September 29, 2010

Diet may have something to do with your aches and pains. I recommend follosing the diet from Heal your headaches by Dr David Bucholdz and adding dairy to the list of foods to avoid. He believs that not only headaches, but alot of generalized pain is related, at aprtially to diet. It's worth a try.
posted by Lost at 6:01 AM on September 29, 2010

I don't have any advice for dealing with the aches and pains without Ibuprofen, but I dropped in to say this sounds a lot like my experience with celiac disease prior to diagnosis. I was taking advil in similar quantities on a regular basis, and trying other things like stretching (as you are). Please ask your doctor to check for this, even if you don't have the other symptoms. The initial blood tests are simple.
posted by purple_bird at 12:23 PM on September 29, 2010

All wonderful answers - thank you. I have an appointment with a new doctor this week. Crossing my fingers she'll be receptive to getting to the bottom of this. I'll bring up several of your suggestions. In the meantime, I'm going to try swimming, some yoga, hot baths and heat pads. Thanks again!
posted by Laura Macbeth at 12:52 PM on September 29, 2010

As a note: I was never a huge coffee drinker (maybe 1-2 cups per week), but I had a half cup yesterday and the same today. I had a couple of hours of lessened pain each time, so thank you for suggesting I add that back into my regimen. I never drank enough coffee for these aches to be related to a caffeine addiction, but there's definitely something in the caffeine that helps. Thanks!
posted by Laura Macbeth at 1:53 PM on September 29, 2010

IANAD. The following is based on family experience, and discussions with doctors, though. Long term ibuprofen use is not a good thing. My uncle took large doses (prescribed by doctors, though in excess of OTC amounts) of ibuprofen to deal with knee and ankle issues that, due to diabetes, he couldn't have operated on. The diabetes killed his kidneys, but the ibuprofen did a great amount of damage as well. My father was on similar doses, and his kidneys weren't that great, but long term ibuprofen can also damage the intestines, and while he died from things not caused by the ibuprofen, the ibuprofen did contribute to the damage.

Look up Sean Elliot and Alonzo Mouring, both NBA players that, due to the rigors of the long season, and frequent use (and over use) of ibuprofen (among other similar medicines) both required kidney transplants in their 30's.

I've had a couple back surgeries, and I'm struggling through achilles tendinitis at the moment, but given my background, and advice from a couple different doctors, I do my best to only take advil when I absolutely need some form of pain relief. Other than medication, I do a lot of stretching. I use ice (or heat) to soothe troublespots. A lot of times, for me, spending five to ten extra minutes with the shower pointed at my back is good enough to avoid taking ibuprofen. Take it when you absolutely need it, by all means, but try to figure out for yourself when that really is, and see how far you can stretch that before you need to take the ibuprofen.
posted by Ghidorah at 9:11 PM on September 29, 2010