I'm too young for this shit

February 28, 2012 9:57 AM

Lifelong asthmatic, and at age 36 I now have osteoarthritis in the knee due to sports injuries (meniscus is frakked). Realizing now that NSAIDs aggravate my asthma...what other options do I have for relieving the pain & inflammation with minimal side-effects?

I will, of course, go see my doctor about this. But I am very busy and can't make time to see him for another month or so.

I am not into any homeopathic, naturopathic, woo-woo stuff. Science/evidence-based remedies only, please.

posted by wutangclan to health & fitness (24 answers total)

Oh and I guess Tylenol relieves pain, but it doesn't do much to relieve the inflammation (especially the fluid swelling).
posted by wutangclan at 10:01 AM on February 28, 2012

Do all NSAIDs affect your asthma equally? I know some people who find they have very different responses to the different types of NSAIDs.

Here's an article about doctors' takes on anti-inflammatory food plans. It's something that works for some people and not for others, as discussed in the article.

I am seeing a rheumatologist who recommends this supplement based on its chemical properties. Don't know if that's too "naturopathic" for you, but I find it helps.
posted by Sidhedevil at 10:04 AM on February 28, 2012

No ideas for OTC things, but at the very least you should be elevating that knee and icing it regularly. I had two meniscus repairs last year.
posted by noxetlux at 10:06 AM on February 28, 2012

Your pharmacist should be able to help.
posted by uans at 10:15 AM on February 28, 2012 [1 favorite]

IANAD. An internet search indicates that extra-virgin olive oil contains oleocanthal, which acts similarly to ibuprofen as an anti-inflammatory. The recommended dose is ~3 tbsp per day.

According to this natural remedies website:The effects of many diseases associated with inflammation such as asthma’s inflammation of the lungs are reduced with regular consumption of olencanthal. So, it shouldn't interfere with your asthma.

Remembering that not all olive oils are equal (some are falsely marketed as extra-virgin), the sources recommend finding one with a naturally peppery flavor and makes the back of your throat tingle a bit, which indicates high olecanthal content.

I haven't cited all the references I found, I just looked for one that said something about asthma. Do a search for yourself, and you'll see the scientific studies conducted.
posted by lizbunny at 10:19 AM on February 28, 2012

Not a doctor, but an arthritis sufferer....

Are you asking for only OTC options or do you just want to prepared for what the options are?

If Advil and Alleve are out for you, ice is about the only OTC remedy that will actually have any effect on the OA. Tylenol is somewhat effective for the pain but I don't think it will do much for disease modification.

Neither of these options are something you can do/get on your own. There are topical NSAIDs (Voltaren gel has diclofenac, taken in oral format as well) --topical use will result in a lot less systemic NSAIDs in the blood. You could also get hyarulonic acid injections or steroidal injections to the joint. I don't think the injections are treatments that can be used forever though, and you are young.

THe topical NSAIDs probably won't work as well as systemic ones and the injections are not a firstline treatment to try....so yeah, you're going to need to see a doctor in any case.
posted by Tandem Affinity at 10:37 AM on February 28, 2012

Ask your doc if a steroid injection is indicated for you. Some docs will only give you one or two, ever, others don't mind doing it more often (once a year or so, I'd guess).

I have asthma and osteo/degenerative-(as well as inflammatory) arthritis, but naproxen never bothered my asthma. I had mixed success with cortisone injections (hip one was good, knee one not so great). Glucosamine and chondroitin (I'm not a homeopathy gal, either, but it was recommended so often I decided to try it) didn't help me at all and made me sick to my stomach.

When I was having a lot of pain (and using Rx strength naproxen, getting the inflammatory stuff under control) I would ice for 20 minutes every morning before running. And after. And before bed. It really did help.
posted by Pax at 10:49 AM on February 28, 2012

Also, my doc has drained my knee, too. NOT fun, but provided some relief.
posted by Pax at 10:50 AM on February 28, 2012

Do all NSAIDs affect your asthma equally?

This. There are a great many different choices which have different (side) effects.
I'm sure you already know about icing and physical therapy exercises to strengthen muscles in the vicinity. There are also various braces (none of which ever worked for me, but others report differently.) There are no accepted ways to repair menisci (though various remedies appear on the scene from time to time and one may eventually work).
posted by Obscure Reference at 11:00 AM on February 28, 2012

Thanks to all for the info so far...will read properly tonight after work.

Are you asking for only OTC options or do you just want to prepared for what the options are?

A bit of both -- looking for immediate OTC relief and also want to know what the right questions are to ask when I see my doc next month.
posted by wutangclan at 11:02 AM on February 28, 2012

Do all NSAIDs affect your asthma equally?

Perhaps I should get a referral to an allergist?
posted by wutangclan at 11:09 AM on February 28, 2012

My mom's doctor just recommended turmeric extract for her arthritis.
posted by elsietheeel at 11:21 AM on February 28, 2012

I know it's complicated to find time to see lots of specialists, but I think seeing an allergist about their recommendations for prescription and OTC arthritis and anti-inflammatory meds that won't exacerbate your asthma would probably be wise, since it doesn't sound like either of the conditions is going away anytime soon :( .

I was in a different situation from yours--the NSAIDs were forbidden me by a gastroenterologist, not because of asthma--and I used to take a half-tablet of ibuprofen with two tablets of Tylenol, just to get a little anti-inflammatory boost in with Tylenol's analgesic-only mechanism. (At one point I Sharpied scare quotes around "pain relief" on the Tylenol bottle!)

It just sucks to be in the midst of the medical Jenga game where the meds that help with one issue make another issue worse. Hoping your doctors will find some good answers for you!
posted by Sidhedevil at 11:30 AM on February 28, 2012

Oh, also ice. I know that the research on ice is somewhat inconclusive, but I find it helps me immensely. These wraps are comfortable and well-made, and the ice packs are sturdy like whoa. They're not cheap, but the quality is excellent.
posted by Sidhedevil at 11:32 AM on February 28, 2012

Have you looked into meniscal replacement?
posted by fshgrl at 12:07 PM on February 28, 2012

There's quite a bit of reasonably good science behind turmeric as an anti-inflammatory, as suggested by elsietheeel above. It's also one of the ingredients in the Zyflamend supplement recommended by Sidhedevil. As with anything that might actually have a noticeable effect in your body, it's not for everyone, particularly people with gallstones. It looks like it's probably about as effective as NSAIDS for inflammation, and likely safer for many people.

Some people get relief from topical NSAIDS, which might (?) be more tolerable with your asthsma.
posted by Corvid at 12:10 PM on February 28, 2012

Omega-3 supplementation might help.


It has some similar bleeding risk as NSAID if you take higher doses, so read and/or talk to your dr.
posted by mercredi at 12:31 PM on February 28, 2012

My link got lost.
http://www.painjournalonline.com/article/S0304-3959(07)00041-3/abstract
posted by mercredi at 12:32 PM on February 28, 2012

You could try out a topical that is very good for knees, called Pennsaid. Www.pennsaid.ca has information. You might tolerate it OK.
posted by PickeringPete at 3:01 PM on February 28, 2012

Thanks all.

In the short term, I'll try icing. I've never liked icing before (I hate cold), but I guess I gotta bite the bullet.

Looks like long term I should look into seeing an allergist, and perhaps trying topical NSAIDs.
posted by wutangclan at 7:31 PM on February 28, 2012

My mom has had trouble with this for a long time. Glucosamine (helps rebuild the cartilage) along with Bengay (vanishing scent is so important)/Blue Goo kinds of creams have seemed to help the most.
posted by stray thoughts at 9:02 PM on February 28, 2012

I've never liked icing before (I hate cold), but I guess I gotta bite the bullet.

It would probably be expensive, but after knee surgery I had this continuous-flow "icing" machine (oddly, I can only find it on Google for horses...) that has a wrap for your [knee] connected to a tube, connected to a cooler that keeps water flowing through the wrap. The idea is that it's not so cold that you "burn" your skin (why the trainer makes you do it only do 20 minutes on and off). It's really not unpleasant at all.
posted by Pax at 5:17 AM on February 29, 2012

I had this continuous-flow "icing" machine

Cryo-cuff. Yes, I am borrowing one from a friend.
posted by wutangclan at 9:17 AM on February 29, 2012

Late follow-up, but for those that are interested, I am now using Voltaren (topical formulation of diclofenac) that is sold without prescription in Canada. It works well!
posted by wutangclan at 8:37 PM on March 20, 2012