Aleve Instead of Ibuprofen for Arthritis Pain?

Summary: Naproxen is better at treating pain at night from arthritis, but appears to cause just as many side effects as Ibuprofen. Try to take the lowest possible effective dose of both drugs. You may also want to consider eliminating certain inflammatory foods and using supplements like a quality fish oil.

Dear Curtis: I take Ibuprofen for my arthritis knee pain. I’ll take anywhere from three to four doses a day of the little Ibuprofen tablets. But I know Ibuprofen can be tough on your stomach. I was thinking about switching to Aleve because some friends said it works well for them. What do you think?

Both Ibuprofen and Naproxen are in the same class of drugs called NSAID’s (Non-Steroidal Anti-Inflammatory Drugs). So, at first glance, you might assume that there really isn’t any difference between the two. In as far as how they act in your body, that’s true. But, as your friends have hinted at, there is evidence that naproxen is a little more effective in treating arthritis pain.(1)

Naproxen vs. Ibuprofen for Arthritis Pain

What researchers found in this study was that both Ibuprofen and Naproxen did a good job of relieving arthritis pain (which was measured by overall pain control, difficulty walking up a flight of stairs, difficulty in bending, stooping, etc.). Both Ibuprofen and Naproxen lowered the participants pain by at least 30%. However, Naproxen was the only drug to improve pain at rest and pain during the night.

This, in my experience, is one of the biggest things going for Naproxen as a lot of arthritis patients experience pain at night which keeps them from getting a good nights sleep.

What you need to know, though, is that the study didn’t really show any difference between Ibuprofen and Naproxen as far as side effects.

As you said, one of your concerns is that you are taking a fairly high, fairly regular dose of Ibuprofen each day to control your pain. Over time that can cause stomach side effects, especially ulceration. But Naproxen isn’t immune from these side effects either.

In short, switching to ibuprofen doesn’t appear to be much safer.

If it were me, here’s some things I would consider:

  1. Drop down to the absolute lowest effective dose you can find. For example, you said you are dosing three times a day. If you are taking over-the-counter Ibuprofen each of those tablets are 200mg. Most people take more than one tablet at each dose. But, let’s just say you are taking three tablets with each dose. Could you drop it down to two with each dose. Or, two with most doses but take three with the dose that precedes when the pain is the worst (like in the evening).
  2. If you find that the pain is really worse at night, then a switch to Naproxen makes a lot of sense as it’s been proven to help more then.
  3. How about your diet? I know, I know. Nobody likes to hear that they have to switch how they eat. But I almost always find that folks who have arthritis eat a very pro-inflammatory diet. Foods like grains and dairy’s can really aggravate your condition. Try to switch to ‘natural foods’: lean meats, lots of vegetables, some fruits and nuts. Check out my healthy eating section for more guidance.
  4. Maybe consider trying some of the supplements available on the market to help your arthritis. Some that come to  mind: a good quality fish oil which has helped a number of arthritis sufferers, glucosamine-chondroitin or Trigosamine (glucosamine and chondroitin but also contains hyaluronic acid which is a component of synovial fluid). Of course, supplements aren’t necessarily the answer but I honestly hate to see folks on high doses of NSAIDS like ibuprofen or naproxen as, with a high enough dose and enough time, the chance of getting stomach side effects becomes fairly high.

Sources:

1. Schiff M and Minic M.  Comparison of the analgesic efficacy and safety of nonprescription doses of naproxen sodium and Ibuprofen in the treatment of osteoarthritis of the knee. J Rheumatol. 2004; 31:1373-83

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Trackbacks

  1. [...] many to lower – or even totally eliminate – their NSAID use. Don’t get me wrong, NSAIDs work for arthritis pain, but the side effect profile (as you are well aware of) if not something I like to see people [...]

  2. [...] Ibuprofen is certainly known for it’s side effects, namely upper gastrointestinal bleeding. However, despite it’s nasty reputation for bleeding ulcers in the stomach clinical studies and patient feedback has not shown ibuprofen to be a big cause of general bleeds like nosebleeds. [...]

  3. [...] written before about patients switching between ibuprofen and naproxen when they can’t tolerate the side effects. Sometimes this switch is very helpful. Other times, an intolerance to one NSAID just pops up again [...]

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