What are the methods to reduce pain from systemic inflammation?

From the Guidelines

To reduce pain from inflammation throughout your body, start with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) at 200-400mg every 6-8 hours or naproxen sodium (Aleve) at 220-440mg every 12 hours, not exceeding the maximum daily doses (1200mg for ibuprofen, 660mg for naproxen). This recommendation is based on the most recent and highest quality study available, which suggests that NSAIDs are effective in reducing pain and inflammation 1.

Key Recommendations

• Apply ice to inflamed areas for 15-20 minutes several times daily to reduce swelling and pain
• Use heat therapy through warm baths, heating pads, or warm compresses for 15-20 minutes to relax muscles and increase blood flow
• Stay hydrated with 8-10 glasses of water daily and adopt an anti-inflammatory diet rich in omega-3 fatty acids, colorful fruits and vegetables, while limiting processed foods, sugar, and alcohol
• Engage in regular, gentle exercise like walking, swimming, or yoga to reduce inflammation by improving circulation and releasing endorphins
• Prioritize adequate sleep (7-9 hours nightly) and stress management techniques such as meditation or deep breathing exercises, as stress hormones can worsen inflammation

Additional Considerations

• For moderate pain associated with signs of inflammation, consider escalating analgesia and using higher doses of NSAIDs as needed, and if inadequately controlled, initiate prednisone or prednisolone 10–20 mg/d or equivalent for 4–6 weeks 1
• Cognitive behavioral therapy (CBT), yoga, physical and occupational therapy, and hypnosis may also be beneficial for chronic pain management 1
• It is essential to weigh the benefits and risks of NSAIDs, including cardiovascular, gastrointestinal, and renal risks, when prescribing them for pain and inflammation 1

From the FDA Drug Label

NSAIDs are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as different types of arthritis, menstrual cramps, and other types of short-term pain. To reduce pain from inflammation in all body parts, NSAIDs such as ibuprofen 2 or naproxen 3 may be used.

• Follow the prescribed dosage and take the medication at the lowest dose possible for your treatment.
• Use for the shortest time needed to minimize the risk of serious side effects.
• Consult your healthcare provider before taking NSAIDs, especially if you have any medical conditions or take other medications.

From the Research

Reducing Pain from Inflammation

To reduce pain from inflammation in all body parts, the following options can be considered:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and diclofenac can be effective in reducing pain and inflammation 4, 5, 6, 7, 8
• NSAIDs work by inhibiting prostaglandin synthesis, which helps to alleviate pain, fever, and inflammation 5
• However, NSAIDs can cause adverse effects such as gastrointestinal ulcers, cardiovascular events, hypertension, acute renal failure, and worsening of preexisting heart failure 5, 6
• To minimize the risk of adverse effects, it is recommended to use the lowest effective dose of NSAIDs for the shortest possible time and to perform individual risk assessments and treat patients accordingly 5
• Alternative options such as corticoids may also be considered, but the evidence on their effectiveness and safety is limited 7

NSAID Options

Some specific NSAID options that may be considered for reducing pain from inflammation include:

• Ibuprofen, which has a favorable safety profile and is effective for many acute and chronic pain conditions 4
• Naproxen, which has been shown to improve physical function, reduce pain, and reduce the number of painful joints compared to placebo 7
• Etoricoxib, which has been shown to reduce the number of painful joints compared to placebo 7
• Diclofenac, which has been shown to be effective in reducing pain and inflammation, but may have a higher risk of adverse effects compared to other NSAIDs 7

Precautions and Considerations

When using NSAIDs to reduce pain from inflammation, the following precautions and considerations should be taken into account:

• Patients with a history of gastrointestinal ulcers or cardiovascular disease should use NSAIDs with caution and under the guidance of a healthcare professional 5, 6
• Patients should be monitored for adverse effects and the impact of NSAID use should be understood to mitigate the risks 8
• NSAID discontinuation should be evidence-based and individualized to specific requirements 8