Aleve or Advil (or Tylenol)

[skywalkerbeth]

Hello

I am a new owner (well, not exactly new, but it's flaring again recently) of sacro-iliac pain.

My regular doc said take Aleve and take it easy for at least a week. Heat at night, ice after exercise for 15 minutes, and do exercises for my back.

I was never an Aleve taker but ONE capsule (one) made me feel nauseous the rest of the day and maybe even a little the next day. Just a bad feeling in my tummy. A few times I thought I was going to throw up.

I used to pop Advil like it was candy (not strictly back issues, way back when I had undiagnosed Lyme disease for years and would have joint swelling and pain), until we figured it out and "cured" me.

What do you use? He said Aleve was good for this kind of pain. He didn't mention Advil or Motrin.

[alexis_the_tiny]

Beth, from what I know, Advil and Aleve are both NSAIDs. The difference, at least according to the friendly pharmacist, is that Aleve is really strong while Advil/Neurofen is a lower dose. He also suggested taking Aleve with antacids and on a full stomach because it can cause irritation to the stomach lining.

[indysteel]

Beth, from what I know, Advil and Aleve are both NSAIDs. The difference, at least according to the friendly pharmacist, is that Aleve is really strong while Advil/Neurofen is a lower dose. He also suggested taking Aleve with antacids and on a full stomach because it can cause irritation to the stomach lining.

Friendly or not, I'm not sure your pharmacist is correct. While both NSAIDs, Aleve and Advil use two different active ingredients--naproxin and ibuprofen, respectively. My understanding is that a standard OTC dose of Aleve controls pain longer than a standard OTC dose of Advil--at least according to Aleve's marketing. Each can irritate your stomach, as can aspirin, another NSAID. One should also be aware that NSAIDs can impact your kidneys. Especially if you're using it during exercise, it's important to up your fluid intake. Tylenol uses yet another active ingredient. In my experience, Tylenol makes a great fever reducer but is less effective when it comes to pain relief. In fact, I'm not even sure it's classified as an NSAID. If it's the only thing your stomach can tolerate, however, I suppose it's an option. Do not, however, use it with alcohol.

I've had a variety of aches and pains--including SI joint irritation over the last year. I have become FAR more relunctant to use NSAIDs to control the pain. The tendency with OTC drugs is to treat that as wholly benign. Unfortunately, they're not benign. I reach for the ice instead and religiously do the exercises my physical therapist gave me. I'm not saying you shouldn't use them, but use them as spraringly if you can. Take them with food if necessary, drink lots of water, and avoid alcohol.

[Dogmama]

I'd see a specialist & get some good exercises. NSAIDs are not without risks. I've taken meloxicam for 15 years (a prescribed NSAID) because I have arthritis in my hands, spine, etc. Now I have a constant ringing in my ears when things are very quiet. That's just one of the side effects that "they" don't tell you about.

[jessmarimba]

I use...nothing, usually. For the last year Tylenol has been the "recommended" pain reliever b/c the others can inhibit bone growth. Unfortunately, it doesn't really do much for pain. I take Excedrin for migraines when absolutely necessary and will occasionally take tylenol PM if I'm in too much pain to sleep, but there isn't a pill that really has helped my back pain (not even percocet).

For me, laying over a pilates ball on my stomach and then my back is the best thing I can do to let it relax and decompress. Once that feels good, I have a little while before it starts to bother me again. Obviously I'm having different issues than you are but I wonder if there is something similar that might help you, even temporarily.

[grey]

I'd see a good physical therapist. I used to have SI pain - couldn't even put a leg down sometimes. One visit to a good PT, he saw the problem, taught me some stretches & exercises, and no more SI pain :D May you be just as lucky.

BTW, Aleve is banned in Canada because it causes heart problems. My Dad was taking Aleve every day for his back pain. He started having heart issues he thought were unrelated - forgot to pack Aleve when they went to Nova Scotia, and was surprised not to find it on the shelves there, and a pharmacist explained why - it causes heart attacks. After some research online, they discovered this was true. His heart issues disappeared, we think forgetting to pack that bottle maybe saved his life.

[ny biker]

Tylenol/acetaminophen is not an NSAID. It does not reduce inflamation.

If the Aleve is making you sick, call your doctor and talk to him about it. There are other NSAIDs out there. He might say Ibuprofin is fine, or he might say something else is better.

All NSAIDs bother my stomach. I always have to take them with food.

There's also lots of information online about whatever drugs you might be taking. Drugs.com can be useful:

http://www.drugs.com/sfx/aleve-side-effects.html

And the NIH has all kinds of good information about drugs, vitamins, all kinds of stuff:

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a681029.html

[indysteel]

Physical therapists--good ones--are life savers. I went a year with some significant back and hip pain. I popped Advil when it got really bad with no real lasting relief. I finally went to my doc and got a PT referral. After one visit, I felt better. After a couple months worth of treatment, almost all of the pain went away and the mobility of that hip had improved greatly. Thanks to the exercises, I haven't had any problems for almost a year.

[surgtech1956]

I like Aleve, because I can take it in the morning and seems to last alot longer for me. I broke my ankle in December and still experience alot of swelling and the Aleve works better as an anti-inflammatory drug than Advil, at least for me.

[NbyNW]

I don't really think to reach for painkillers when my SI is acting up. I save the ibuprofen for when I have really bad PMS.

I find ice/heat to be plenty potent for reducing inflammation and improving blood flow. Stretching, ongoing core strengthening/maintenance, massage all help. Also being aware of any alignment problems and correcting them during exercise or regular activities, like walking (this is where a PT can really help). General good posture, especially when sitting.

There are also some good self-massage techniques for lower back/glutes, you can use anything from a cheapo inflated rubber toy ball to specialized balls by Yamuna or Franklin, or if you want to really target specific trigger points, a tennis ball or lacross ball.

I also went to an osteopath for about two years, following a major injury. Things would go out of whack pretty easily, and he would gently move them back in place. Started going every 3 weeks or so and gradually tapered off as I got stronger, and one day he said he thought I was doing well enough that I didn't need to go back in on a regular basis, and he was right!

At various stages with my injury recovery, I've found muscle relaxants can help. Some have awful side effects, so it may take a bit of trial and error to find out which would work for you and still enable you to function. If my pain is really severe, I take Tizanidine, which my Dr. originally prescribed for my TMJ pain, but hey, it works all over.

In a pinch, red wine does the trick, too. In moderation, of course.

[badger]

I get frequent headaches and hated taking OTC for them. I wanted to take "natural" remedies as much as possible, so I found white willow bark and a combination of guarana and feverfew to be quite effective in alleviating most of the headaches.

Just because they're herbal doesn't mean they're harmless, but they have not given me any side effects, even on an empty stomach. They do take longer to take all the pain away, but I've been very happy with the results.

Advil makes my GI hurt, even with food, and they don't do anything for my headaches.

[Dogmama]

I just read a research article that said 3 grams of fish oil daily decreased inflammation. It was in the Journal of Sport Science (I think) September edition.

[badger]

I just read a research article that said 3 grams of fish oil daily decreased inflammation. It was in the Journal of Sport Science (I think) September edition.

I started taking fish oil last month, and had a noticeably easier PMS last cycle. Maybe a coincidence, I'll find out in a couple of weeks if it has indeed made a difference.

[skywalkerbeth]

Hi everyone

Thank you everyone for the information. I have tried to keep it to a minimum this week but I am heating my back morning and night. Right now, as a matter of fact. I filled a tube sock with rice and nuked it. That works pretty well actually!

I can't find the paper with the exercises the doc gave me though, darn it.

Fish oil, huh? I wonder if that can be in a capsule to avoid the fishy flavor.

NbyNW, what happened? How did you get injured?

I don't think I'm going to use Aleve again, I really felt like crap. Advil didn't do that to me ever, and I was popping two every four hours years ago.

Jess, how big is a pilates ball? I need to get to the gym, maybe someone there can help me out.

[Dogmama]

Hi everyone

Thank you everyone for the information. I have tried to keep it to a minimum this week but I am heating my back morning and night. Right now, as a matter of fact. I filled a tube sock with rice and nuked it. That works pretty well actually!

I can't find the paper with the exercises the doc gave me though, darn it.

Fish oil, huh? I wonder if that can be in a capsule to avoid the fishy flavor.

NbyNW, what happened? How did you get injured?

I don't think I'm going to use Aleve again, I really felt like crap. Advil didn't do that to me ever, and I was popping two every four hours years ago.

Jess, how big is a pilates ball? I need to get to the gym, maybe someone there can help me out.

You should be icing, not heating. Ice will quell the inflammation.

Yes, fish oil is in a capsule.

[nscrbug]

I have chronic back pain...not really SI-related, though. I have spondylolisthesis (slipped vertebra) at my L5/S1. I wake up every morning with back pain. For the most part, stretching and using my inversion table first thing out of bed, gets me to the point where I can at least stand up straight and be mobile. Then by the time I get to the gym, my back has loosened up enough where I'm good to go...until I sit down again for a long period of time (like at my desk at work). I have found OTC NSAIDS to not be very helpful for my particular situation...and Lord knows, I've tried 'em all at some point. I will occasionally pop an Aleve or Advil after a particularly long and grueling ride, but I have to be honest and say that I don't notice much (if any) pain relief from it. What did work for me, was taking Celebrex (which is a prescription NSAID marketed for arthritis). It was prescribed to me by my foot doctor last year when she thought I might have arthritis in my some of my toes. She wrote the script for a 1-month suppy and told me to give it a try and see if my toe pain improved. I took 1 Celebrex pill per day...it didn't do much for my toe pain, but my lower back felt wonderful...so that was an unexpected bonus. :D Of course, since I was only taking it on a "trial" basis, she didn't specify refills, so once I finished the bottle....no more Celebrex. I suppose I could always ask my primary doc to write me a script for it, but I manage okay without it...for now. ;)

[jessmarimba]

I'm not sure if I have a 55cm or 65cm ball. The medium sized one. When I lay on my stomach I kinda of roll over it, and if something hurts a LOT I back up bit and relax there until I can keep going.

My back pain is from breaking it, but I don't know if it's muscle or bone or nerve pain or what. I know the upper back muscles tense up and the ball helps those relax, but I think the lower back pain is from an increased arch in the upper back caused by the angle the break healed at. It sort of relieves the pressure on those vertebra when I can lay over the ball. Similar to an inversion table, without the head rush :) (I can't afford one of those, anyway).

I have found that pilates helps me a lot, but I am working individually and in small classes with a specific teacher who knows how to deal with injuries. I have one "spot" that I can't seem to fix and on days it's acting up she helps me to modify things to benefit without aggravating it.

The other thing that has helped me is that I pretty much don't wear shoes with any heel. Not running shoes, not dress shoes, not sandals, not boots - pretty much nothing. Even normal-soled running shoes can aggravate the pressure in your back if it is already sensitive.

[skywalkerbeth]

Jess, my God, I'm sorry. Breaking your back!! You are a trouper.

ncr, is Celebrex safe? For some reason I thought I heard there were issues with it.

This morning (post re-fitting last night) I went out. 18 miles, no meds whatsoever before I left.

I don't feel too bad actually. There is some soreness, but better than it was and now I am icing per doctor's orders.

Maybe the fitting made a difference...

[NbyNW]

...
Fish oil, huh? I wonder if that can be in a capsule to avoid the fishy flavor.

NbyNW, what happened? How did you get injured?
...
Jess, how big is a pilates ball? I need to get to the gym, maybe someone there can help me out.

If you can find Nordic Naturals, it doesn't taste terribly fishy. I'm especially fond of the peach flavor.

My injury: construction site accident in a developing country, related to my graduate studies. I was struck on the hip by a falling gate and the impact fractured my sacrum through the nerve exits on the rights side at S1-S2. Luckily it was not displaced so I didn't need surgery. Just lots of bedrest and PT. And Pilates, which I had been doing prior to the injury. (Jess, sounds like you found a really good instructor. Hooray!) I went to the osteopath at the recommendation of my TMJ specialist, and it turned out to be a good move. I still get massages, and lately my MT has been helping me focus on trying to relax the muscles around the injured area that are still guarding.

Exercise balls come in several different sizes. I'm 5'1" and use a 55cm ball. I can use a 65cm ball if it's a bit deflated. If you do a search for exercise balls, swiss balls or pilates balls they'll usually tell you what size they recommend for your height.

[nscrbug]

Jess, my God, I'm sorry. Breaking your back!! You are a trouper.

ncr, is Celebrex safe? For some reason I thought I heard there were issues with it.

This morning (post re-fitting last night) I went out. 18 miles, no meds whatsoever before I left.

I don't feel too bad actually. There is some soreness, but better than it was and now I am icing per doctor's orders.

Maybe the fitting made a difference...

There are issues with ALL NSAIDS...and Celebrex is no different. They all have warnings placed on the packaging. From my research though, it is supposed to be a tad bit gentler on the stomach. I'd say the best thing would be to ask your doctor about it.

[Dogmama]

There were problems with Vioxx (sigh, I loved Vioxx...) but Celebrex seems OK for now. However, if you're allergic to sulfa drugs (like me) they don't want you taking Celebrex.

But, there are no "safe" NSAIDs. Short term is probably OK but long term can cause problems.

[NbyNW]

Hi everyone

I can't find the paper with the exercises the doc gave me though, darn it.



You might be able to call your doctor's office and ask if they have a copy of the prescribed exercises in your file. My PT always made copies of my "homework" as I got stronger.

The exercises are probably boring, possibly uncomfortable. But you should do them and see how your body responds.

[Selkie]

I like Aleve, because I can take it in the morning and seems to last alot longer for me. I broke my ankle in December and still experience alot of swelling and the Aleve works better as an anti-inflammatory drug than Advil, at least for me.

Same deal with me. During my recent ankle tendonitis, prescription-strength Advil (600 mg) did little to cut the pain/inflammation. Podiatrist gave me prescription-strength Aleve (500mg) and it damped the pain/decreased the inflammation to a reasonable level.

[grey]

mportant information about Aleve

Aleve can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use Aleve. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance. http://www.drugs.com/aleve.html

Also see: Why is Aleve illegal in Canada? http://answers.yahoo.com/question/index?qid=20071105152755AA0hKKk (it's not illegal, it's just considered a prescription-only drug)

This drug was on its way to killing my dad. Just a public service announcement, since most NSAIDs are just bad for your stomach/intestines. Carry on.

[skywalkerbeth]

WHOA! That sounds awful! I am so sorry.

My back isn't too bad after 61 miles this wkd. Not fantastic/superb, but not bad. In fact the weird thing was that what pain I was getting on the ride was in a different spot/different kind of back pain. Not bad, just uncomfortable.

I'm not taking Aleve again. That was a really funky experience.



If you can find Nordic Naturals, it doesn't taste terribly fishy. I'm especially fond of the peach flavor.

My injury: construction site accident in a developing country, related to my graduate studies. I was struck on the hip by a falling gate and the impact fractured my sacrum through the nerve exits on the rights side at S1-S2. Luckily it was not displaced so I didn't need surgery. Just lots of bedrest and PT. And Pilates, which I had been doing prior to the injury. (Jess, sounds like you found a really good instructor. Hooray!) I went to the osteopath at the recommendation of my TMJ specialist, and it turned out to be a good move. I still get massages, and lately my MT has been helping me focus on trying to relax the muscles around the injured area that are still guarding.

Exercise balls come in several different sizes. I'm 5'1" and use a 55cm ball. I can use a 65cm ball if it's a bit deflated. If you do a search for exercise balls, swiss balls or pilates balls they'll usually tell you what size they recommend for your height.

[NbyNW]

WHOA! That sounds awful! I am so sorry.

My back isn't too bad after 61 miles this wkd. Not fantastic/superb, but not bad. In fact the weird thing was that what pain I was getting on the ride was in a different spot/different kind of back pain. Not bad, just uncomfortable.

I'm not taking Aleve again. That was a really funky experience.

Meh. It was years ago, and I rarely think about it anymore except for the regular maintenance my body needs. I even forgot my injury "anniversary" this year, for the first time, realized it later that week.

There are many other regulars on this board who have been through far worse, and live to ride another day! If you dig around you will find some amazing stories of recovery, healing, and adapting.

I'm glad the fitting seems to have helped. Take care --