When Painkillers are GOOD for You

photo of NSAID tablets

“When there is pain, there are no words.” ~ Toni Morrison

Speaking Out

When I see versions of the paleo autoimmune protocol forbid NSAIDs, my blood pressure spikes. When I read yet another article on how NSAIDs will kill you, I get angry. Why? Because I have experienced excruciating pain, when NSAIDs didn’t feel like a choice, so much as a means to survive.

Then, I take a deep breath, calm myself down and remember that I also love these bloggers. Like me, they offer their blogs to the public for free, with a heartfelt desire to help people. Mainstream Americans often take medication without thinking, believing that if something is sold over-the-counter, it’s harmless. Healthy living websites simply want to educate people about the risks.

My concern stems from the fact that people with autoimmune disease aren’t mainstream America. Their lives are much more challenging, and the medical decisions they make aren’t lighthearted at all. Telling them to give up their pain medication increases the burden on someone who is already overwhelmed.

This article is a call for compassion: If you want to help people in pain, you need to understand their experience. The pain needs to go away before the pain killers do.

A Few Facts:

  1. Although some people with autoimmune disease don’t have pain, many live with a level of pain impossible to imagine, unless you’ve experienced it yourself. Doctors even prescribe anti-depressants, because the pain can lead to suicidal thoughts.
  2. NSAID stands for nonsteroidal anti-inflammatory drug. They were created as an alternative to steroids, which have a dizzying array of side effects. NSAIDs are also an alternative to narcotics, which in addition to serious side effects, carry the risk of addiction and overdose. This isn’t to say NSAIDs don’t carry risks as well, but it’s important to remember that people take them as an alternative to more debilitating medication.
  3. Although there are anti-inflammatory supplements available that can be very helpful (and I will detail them later in this article), they aren’t as strong as NSAID medication and for people with chronic pain, they often aren’t enough.
  4. Usually, people who tell others to go off NSAIDs cold-turkey either haven’t experienced excruciating pain, or their pain went away immediately after making dietary changes, or trying one of the herbal alternatives. If you are one of those people, that is awesome and cause for celebration. However, most people aren’t that lucky. Autoimmune disease involves immune and inflammatory processes that are chronic and complex. Toning them down is a long-term endeavor. It can be done! But if your disease involves inflammatory pain, it’s natural to need NSAIDs during that transition.
  5. The autoimmune protocol was originally designed to be a food elimination diet, done for 30 days, after which foods would be reintroduced while the body is monitored for symptoms. It’s an old and very effective technique for identifying food intolerances. Medication isn’t food and should never be added to an elimination protocol. Rather, as food intolerances are identified and removed from the diet, pain decreases, and people are able to reduce their dosage naturally.
  6. While NSAIDs have been linked to leaky gut, which is a contributor to autoimmune disease, STRESS is also linked to leaky gut. And there is literally nothing more stressful than pain. (I’ll go into the science of this below.)
  7. If people are in pain, they can’t sleep, and poor sleep is linked to increased inflammation and the development of autoimmunity. Since the autoimmune protocol stresses the importance of reducing stress and getting enough sleep, the advice to stop NSAIDs cold-turkey is contradictory.

The Pain Effect

When we experience pain, the brain releases a number of neurotransmitters and hormones in response. One of those is cortisol – the fight or flight hormone. When it’s released, our heart beats faster, our blood pressure goes up, the immune system is suppressed, organs slow down, and blood is redirected to skeletal muscles. This response is designed to protect us, by giving us the energy we need to react in a dangerous situation. However, it’s also meant to be temporary, with full function of our organs and immune systems restored once the danger has passed. With chronic pain, cortisol keeps getting released over and over, and these effects which are meant to be brief, become chronic as well. Needless to say, this damages our bodies over time. We aren’t meant to live in pain. Studies even show that people with chronic pain have shorter life spans.

In addition, the stress of living with pain creates a vicious cycle that causes more pain.
Drawing provided by Krames Patient Education:

drawing which shows how pain affects sleep, mood, activity and energy
A Balanced Approach

When I was researching alternatives to conventional rheumatoid arthritis treatment, I fell in love with Dr. Mercola for this sentence:

“Pain relief is obviously very important, and if this is not achieved, you can go into a depressive cycle that can clearly worsen your immune system and cause the RA to flare. So the goal is to be as comfortable and pain free as possible with the least amount of drugs.” – Dr. Joseph Mercola

Having treated over 3,000 people with RA and seen the pain experience up close, he expressed an empathy which I desperately needed to hear. Note the last sentence in his quote – he doesn’t tell people to go off their medication. Instead, his treatment protocol offers advice on alternatives, helping people lower their dose. For those who need to continue some level of NSAID use, he offers advice for doing this safely. This is the balanced approach I would love to see more of in the paleo and real food community.

How to Reduce Your Pain Medication Safely

  1. Go on a healing diet such as GAPS, Wahls or Paleo, and as your symptoms improve, your dose can reduce naturally. Don’t put the cart before the horse and spike your inflammation by removing medication first. If you would like to try the autoimmune protocol, stick to the food eliminations; identifying food intolerance and removing those foods often leads to dramatic pain relief
  2. Here is a list of natural supplements with pain-relieving and anti-inflammatory properties. They are absolutely worth trying, and I take some myself. Even if they don’t eliminate the need for NSAIDs completely, they may help you lower your dose. Work with your healthcare team to discern which is best for you: curcumin, cat’s claw, fish oil, krill oil, black currant oil, boswellia, willow bark, and tart cherry.
  3. Don’t “bear the pain” thinking that is a healthier choice. (See the pain cycle information above.) If you need to take NSAIDs, simply do it mindfully, and make every effort to live healthfully and reduce your need for them. Dr. Mercola’s advice is to take them with a full meal, and once per year to have your liver and kidneys tested for full function (good advice for anyone on any medication long-term.)

Guilt-Free Zone

Healing from rheumatoid arthritis, I struggled with feelings of guilt and shame about relieving my pain, due to the anti-medication message of the alternative health and paleo communities. Now that I write this blog, I receive emails from people having similar struggles. Some people say they feel like a failure if they still need pain relief. Others fear the diet won’t help them at all if they aren’t willing to go off their medication first. Guess what? Taking painkillers hasn’t stopped my healing process. In fact, I would say it’s been integral to my healing process, because it has kept my stress at a manageable level and allowed me to sleep at night. Prior to starting a healing diet, I was taking very high doses of ibuprofen and naproxen, to survive the daily flares. Once I started GAPS, the flares started to diminish, and so did the dose of my medication. I then added anti-inflammatory supplements, which allowed me to reduce my dose even more. Currently I’m doing the core autoimmune protocol (food only), and my inflammation is continuing to drop. I am fast approaching the day when I won’t need any painkillers at all, but right now I still take 1 aleve tablet twice daily. Why? Because when I stop taking it altogether, the inflammation in my body ramps up, bringing pain back to my daily life and making sleep almost impossible. With this small dose, I’m comfortable both day and night. That is a feeling that promotes healing. Pain is not.

I’m not an anomaly when it comes to healing through diet while still taking painkillers. Dr. Terry Wahls still takes some on a daily basis, although like me, her dose has reduced dramatically. As a woman who understands excruciating pain, Terry has never advocated going off pain medication if you are still experiencing pain. Ann Wendel is another person who shared her story on Robb Wolf’s website; she healed Hashimoto’s through the Paleo diet, but it took 9 months before she could start to reduce her anti-inflammatory medication. It didn’t stop her healing. And I guarantee you there are others, but you won’t find a lot of evidence on the internet, because people tend to keep that information secret, out of fear of judgment. All I ask is that we stop judging and start understanding. I’m not pro-NSAID; the goal is definitely to reduce and ideally eliminate the need for this medication.  I’m just saying that can take time, and while we heal, NSAIDs can help.

Disclaimer

This website has a disclaimer link on the sidebar that is always in effect, but since I’m talking about medication here, it seems prudent to end the article with this reminder: I’m neither a doctor nor a dietitian. This blog is designed to chronicle my own health journey, share what I learn in the process, and connect with others on a similar path. Everything I write here is simply my opinion and not a replacement for medical advice. May we all be well!

Update 2/2/14

After writing this article, a new book was published dedicated to the autoimmune protocol: The Paleo Approach by Sarah Ballantyne, Ph.D. The book includes a section on medications that can exacerbate leaky gut. These include NSAIDs, Steroids, DMARDs, Oral Contraceptives, Hormone Replacement Therapy, Antibiotics, Acid Reflux Medication, Laxatives and Anti-Diarrheals. However, the author is very clear that people shouldn’t go off their medication cold-turkey. The information is given, so we can be aware of their effects on our bodies and set the goal to find alternatives and/or taper off these medications as we heal. Here’s a quote from the book:

“Changing, tapering, or discontinuing your medication – especially if you are taking prescription drugs, but also any daily over-the-counter medication that your doctor may have recommended – should, without exception, be done under the supervision of a health care professional. I must also emphasize that changing your medication is not, in most cases, something to tackle when you initially adopt the Paleo Approach. By improving your diet and addressing lifestyle factors first, you will be able to heal your body as much as you can while you are still taking these drugs, which will significantly help you adjust to discontinuing them.”

That’s the balanced advice I’ve been looking for in the paleo community.

AIP Series

I’ve written a series of articles to guide you through the autoimmune protocol, step by step. It includes FAQ, mistakes to avoid, book reviews, and more. Click here to see the whole list.

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This post is linked to the following blog carnivals:
Fresh Bites Friday, Sunday School, Natural Living Monday, Healthy Tuesday, Family Table Tuesday, Scratch Cookin’ Tuesday, Fat Tuesday, Traditional Tuesdays, Tuned In Tuesday, Waste Not Want Not Wednesday, Well Fed Wednesday, Wildcrafting Wednesday, Whole Foods Wednesday, Allergy Free Wednesday, Real Food Wednesday, Party Wave Wednesday, Tasty Traditions, Thank Your Body Thursday, Simple Lives Thursday, Paleo Rodeo,

43 thoughts on “When Painkillers are GOOD for You

  1. Thanks for all of your great information, Eileen! I know how much time is spent in trying to heal, and also in maintaining this (very helpful) blog. It is inspiring and encouraging!

  2. Something interesting is happening in response to this article. Usually people comment publicly when they like one of my posts. Instead, I’m getting lots of private emails from people thanking me for writing it. I think that demonstrates again how taboo this subject is. I’m respecting people’s privacy by not posting the emails here, but know that this article has touched a lot of hearts, souls and hurting bodies.

    • Hi Eileen-

      Thank you for all of your great advice! I sincerely appreciate reading it. You mentioned all of the alternative medications to try, like tart cherry and cat’s crill, etc. do you recommend taking ALL of those? or just some? I would like to take a list to my co-op to get started on them. I currently am on the AIP without any supplements. Thank you!

      • Hi Kate. First, I have to say that I’m not a medical professional, so consider this recommendation “advice from a friend” and definitely run it by your own healthcare team before you make your decision. (1) Only try one supplement at a time. You want to take as few pills as possible, and there’s no sense taking one where you don’t notice a difference. Also, what works for one person may not work for another; we’re all unique. (2) Whatever you choose, be sure to read the label and make sure it’s allergen-free (no wheat, corn, soy or dairy). (3) I don’t necessarily recommend one supplement over another, but I can give you some advice for choosing quality within each category. Curcumin is a great anti-inflammatory, but it’s very difficult for the body to absorb. There’s one brand that is formulated to be more bio-available: Life Extension Super Bio-Curcumin. Cat’s Claw is similar, in that there’s a substance within it that’s beneficial called POA, and formulas which focus on that ingredient seem to be more effective: one such brand is Saventaro. As for fish and krill oil, there’s a wide range of quality. Chris Kresser wrote a detailed article with recommendations. Dr. Mercola recommends krill oil over fish oil. Boswellia & willow bark are recommended by Dr. Cowan, and since they need no special formulation to be effective, they’re easy on the budget. Tart cherry, in contrast, can be quite expensive. Ginger is something that’s easy to try as a food. You can buy the root at the grocery store and make ginger honey tea. So, that’s some of my research shared. Health food stores often have experts on staff as well, so see what they have to say. But again, choose just one to start with. Over time, you can add others, but it’s best to start slow and see how your body responds.

  3. Thank you! I do not have an auto-immune disorder but have suffered from frequent migraines for years. I may never be rid of them, but 3 years ago I decided to do everything I could to have fewer migraines, and I’ve reduced them about 80%. One of the things I had to do was get myself to take medicine at the first sign of trouble! For me, NSAID taken with caffeine is more effective than the prescription migraine drugs, but for either option, it is important to take it at the first sign of migraine rather than waiting until the pain becomes unbearable. The idea that “healthy, natural” people shouldn’t swallow pills was one of several bad ideas blocking me from doing that.

    • Reducing your migraines by 80% is awesome, Becca, and I’m so glad you have a pain relief system that works for the few that remain. Thanks for sharing your story!

  4. I agree with you. I’ve had two terrible car accidents that have caused me horrible migraines and back pain. I wasn’t pleased with the free manner in which my doctor wanted to prescribe painkillers and anti-inflammatories, but I did take them to get me through some of the worst of it, and to help me sleep at night. I took them only as a temporary measure, and once the negative side effects (grogginess, upset stomach, etc) got more annoying than the other pain, I stopped, but I don’t feel guilty about it. Excruciating pain that prevents me from living my life is not an alternative. Over the years I’ve worked with physios, personal trainers, acupuncturists and massage therapists. Now I do yoga and exercises regularly to strengthen my back to avoid taking meds again, but I would never judge someone who did take them when things are bad.

    Thanks for sharing this well-written defence on Waste Not Want Not Wednesday :)

    • Thanks for sharing your story, Danielle. It shows exactly the kind of balanced approach that makes sense. I think when you’ve experienced that level of pain, you get it in a way that others may not. I’m so glad that both the pain (and the need for pain meds) are behind you. Hugs.

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  6. Well said! I couldn’t explain it better myself and my doc would agree! I hate pain killers and I take some strong ones. My husband hates the thought of any drugs and has always been anti drugs. Mannn when I am in pain he is begging me to let him help me with some pain relief. Massage, heat packs, TENS unit, patches, distraction and yes pain killers. As he puts it, I have to sleep some time. There has been times I have not slept for over 24 hours due to pain. Am I going to be ashamed for taking a pain killer? HELL NO! Am I going to be stoic and deal with the pain? OK maybe yeah… but when the cranks get real bad … HELL NO!

    Thanks for writing this. Pain killers can help with healing if they allow you to sleep. If they allow you to swim and get joints moving.

    They can also break the cycle of pain. I notice my muscles start tensing when I am in bad pain which makes the pain worse. With pain relief, my muscles relax which lessens the pain beyond the pill. Add in some distracting relaxation and who knows? Maybe Sandman will come knocking…..

  7. Thank you. I found this at exactly the right time. I am new to the autoimmune paleo community (I have Ankylosing Spondylitis) and have been panicking and crying and beating myself up about NSAIDs. I felt like a failure and felt like I was sabotaging all my hard work. I also felt so weak when I had to “give in” to the pain and take some Naproxen.

    • I’m so glad you found this article, Amy. You are NOT a failure. Just do the food portion of the AIP, and as your symptoms decrease, you can slowly decrease your NSAIDs. There’s no such thing as “giving in” to excruciating pain. It’s a matter of survival and self-love. You have every right to relief. Hugs!

  8. Thanks for your post — YOU motivated me to get some Napoxone compounded without additives. It’s sitting in front of me waiting for me to take the plunge — I’m nervous because of drug reactions, but I think I’ll take a little at a time STARTING TOMORROW, since seeing this post reappear after I thought it lost seemed like a little sign — a little nudge. I’m in horrible pain 24/7 in my lower body (burning, bone chilling, aching, stiffness, etc.) — various neuros say it is ms — one nuero said it absolutely isn’t ms — and now from research I suspect protracted w/d to pain killers as the culprit as I took pain killers before this pain started, so I have been tapering. I have been on GAPS for about 1.5 years, though since I can’t tolerate ferments, or anything beyond chicken, duck, pheasant, and a lot a veggies (soups and stews and broths and a little chicken liver) and a lot of duck fat, I’d say I’m really on a paleo/ketogenic diet, though I’d love to be ON GAPS! Even be on paleo and eat all that yummy food. I started going into shock from food intolerances and my doctor recommended GAPS. My paelo/ketogenic diet prevents shock when I eat – it has stabilized the food intolerances — I believe that is a form of healing? When I eat too many peas or too much squash (sugars I guess) the pain dials up and and I back off these a while. I do feel I crave the move starchy/sugary veggies.. When I get a good amount of fat, the pain dials down. I don’t know exactly what’s happening with my body but it’s totally knows what it needs and doesn’t. Now to reduce the pain… thanks!!!

    • Hi Laurie. You absolutely deserve pain relief, and I’m glad you’re working with your doctor to find a medication that works with your sensitive system. If your food intolerances are stabilizing, you are definitely healing. Sometimes medication and a healing diet work better together, than either one does alone. At least for a while. Gentle hugs to you.

      • Thank you Eileen! I get discouraged because I’m not “progressing” on GAPS, and get anxious because I feel stuck — like “can’t get out of it” even if I wanted to without going into shock and dying. Do paleo people ever get “stuck” like this? Not going into shock by eating this limited (but I might add delicious soups and stews) diet IS life saving, so I need to keep remembering it’s keeping me alive. I’m glad you think that I am healing too. Oddly, I’m never fatigued and am very productive in spite of the pain. Another pay off to a paleo/ketogenic diet I’m guessing! The pain has worsened over time, and it seems pain begets pain, so I’m looking forward to Napoxine dialing it down! Thanks again!

        • When you plateau and feel “stuck”, it’s a good time to work with your healthcare team to add something new to your protocol. It can be addressing sleep patterns, or adding daily meditation, doing emotional freedom technique, looking into supplements, or trying an elimination diet like the paleo autoimmune protocol. We are all unique and complex, and there are many ways to tweak our healing process in the right direction. Each time I plateau, this is what I do.

          • Feeling so stuck right now, and stress of losing my job or needing to quit (massage therapist with RA) is causing more stress and pain. What a vicious cycle! I agree wholly with not beating yourself up about relieving pain. Thank you. It is so helpful not to feel so alone.

          • It’s especially hard when it affects your career, and I can relate, because I’m a massage therapist as well. When RA first hit, I took extra painkillers to continue working, but I got to the point where (1) the flares got so bad I couldn’t work through them any more and (2) I accepted that I couldn’t keep that up long-term. I needed to make a change. Even though I’ve healed a ton and no longer flare at all, I still have low level inflammation in my joints, which limits my strength and flexibility. I don’t notice it in daily life, but I would notice it if I tried to return to deep massage as a career. Thankfully, our career has other options. I’m still working as a bodyworker, but I now specialize in lymph drainage and craniosacral therapies. They’re light touch modalities that are easy on my hands, yet very effective for my clients. I know it’s hard to be forced to make a change, but sometimes it sends us in a positive direction long-term. Most massage therapists I know WITHOUT RA eventually shift to modalities that are easier on their bodies, if they stay in the career long enough. I just want you to know I’ve been where you are and come out the other side, and I’m doing great, both personally and professionally. I have the same hope for you. Gentle hugs, Emily.

  9. Thanks very much for your blog, and for this post in particular, as well as your experience with the Autoimmune Protocol! I’m 35 and beginning to suspect that I have Ankylosing Spondylitis, which runs on both sides of my family. I’m not in anywhere near the excruciating and debilitating pain that you and others have dealt with, but I’m always uncomfortable and wakeful while sleeping and stiff/sore in the mornings. I have periods of very limited motion and tingly/numb sensations that come and go. I have not been diagnosed, but at this point I’m not even sure what good a diagnosis would do me, since I would first want to try a natural and nutritional avenue to feeling better and controlling the disease, with the help of over-the-counter NSAIDs too (thank you for affirming something I was strongly questioning in the AIP!) This is such a drastically different way of eating than I or my family is used to that it really scares the crap out of me. I don’t like to cook, but I LOVE food. I feel like I have an emotional attachment to food. I actually cried when I was reading the AIP guidelines. I guess I’m not yet quite at the point where the pain is enough motivation. But I’m glad to know that this works for people! Your story (and Paleo Mom’s, whose blog I came upon yesterday in researching this online) is so amazingly inspiring! Thanks for sharing it!

    • Hi Ann Marie. Have you seen my interview with Charles, who has successfully treated his AS through diet? For him, starch was the key, which I hear is true for many with AS. Don’t feel like you have to jump right into the AIP. Try full paleo first, then maybe remove starch as a test. If that doesn’t work, try the AIP. It’s absolutely OK to approach all of this in stages. I love food, too! The good news is that you can find really delicious replacements for the foods you’ve come to love. A healing diet can still reward the tastebuds (and the heart). It’s really a change of mindset, more than anything else. Thanks for reaching out.

  10. Ty so much for this post!! I googled paleo and inflammation and found you! I’ve been paleo for 2 years and it significantly reduces my arthritic inflammation. However, almost 2 weeks I got immunized (a whole other topic!) for an upcoming Cuba trip and am in the middle of a massive flare up. Feeling horrible that I’m about to ruin any progress I’ve made, I need to take a stronger anti inflammatory. I’ve been religiously taking turmeric and ginger and it is has not made a difference AT ALL in the amount of inflammation! And I’m getting more worried as this flare up is highly unusual since going paleo. I’m taking ibuprofen today to just settle this crazy inflammation. Ty for easing my guilt and concern over doing so.

    • Marni, you are so clearly someone who would never abuse painkillers. I’m so glad you found this article; they definitely have their time and place. May your flare pass quickly!

      • I’m just so thankful for your post as it eased all guilt. And ibuprofen has made a huge difference in cutting down the flare up, for which I’m also thankful. :)

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  12. I am struggling with CFS and have been taking ibuprophen for pain. I also have IBS so have been feeling conflicted about medicating pain if it is detrimental to long-term healing. But the protocol for optimal health is so overwhelming between diet restrictions, herbs, suppliments etc. living “clean” seems nearly impossible! I’ve been taking my diet one step at a time, trying to appreciate the progress without beating myself up for not getting it all right immediately. I found the advice here very helpful in applying the same perspective to meds. Thank you!

    • You’re welcome. One step at a time still gets you there. Getting off medication is a worthwhile goal, but that doesn’t mean it’s achievable overnight, and guilt is not a healing state!

  13. Eileen,
    This post is such a breath of fresh air! I am a physical therapist who had to stop working (among other things such as strenuous exercise) due to rheumatoid arthritis. Even though I have counseled my own patients over the years on how to surrender and take things day by day, it is still hard not to feel guilty for taking the necessary medications or not always sticking to the restrictive diets that may or may not help my condition. At times, it is hard to have hope at times and it is hard not beat myself up.
    Your blog and it’s contributors have given me some hope and softness that I needed today.
    Thank you.

  14. Eileen,
    Thanks so much for bringing this post to my attention. I started taking MTX and 15mg meloxicam (NSAID) in Jan 2012. My MTX increased to the max dose over the next several months, with my RA symptoms only worsening. I started Humira in Aug 2012, and it felt like things were finally starting to get better. I was able to start reducing my MTX in Dec 2012. I started a GF diet in Jan 2013, that quickly evolved to a paleo/primal/perfect health diet. I was able to completely remove my NSAIDs in Feb 2013. I continued to reduce my MTX until I was down to 5 mg (2 tabs) in Sept 2013. Stress, lack of sleep, disrupted exercise routine and a retired rheumy all contirbuted to a re-activation of my RA symptoms. I increased my MTX back to 4 tabs in Nov 2013, got a new prescription for my NSAID in Jan 2014, and my new rheumy doubled up my MTX to 8 tabs in early Feb. I am now trying to get things back under control with the AIP. My symptoms have not improved, 3 weeks in, so I ditched my NSAID on Tuesday. My symptoms worsened tremendously over the past few days, but I thought I should tough it out. Your article has helped me to realize that it’s better to get my pain under control first. I will continue to follow the AIP, but with stick with my NSAIDs until I feel better! Hugs, Karen

    • Thanks for sharing your story, Karen. It’s empowering to remember how you healed once, so you know that you can do it again, and tapering meds as you heal is the safest way to go. You also gained some hard-earned wisdom about the role stress and sleep play in our autoimmune disease. Sarah Ballantyne says that’s tougher to manage than diet sometimes, and I totally agree. But it’s so worth it. I believe in you! Gentle hugs to you, as well.

  15. Thank you for providing so much helpful information. My doctor has finally ordered some additional tests because I haven’t been healing as quickly as I used to, and there is a strong history of autoimmune disorders in my family. I have been taking diclofenac for my chronic low back pain, and it also manages the pain in my hands and joints. I had the stomach bug 3 weeks ago, and there was a concern I had a perforation in my stomach from long-term NSAID use, so I discontinued for nearly a week. My pain came screaming back. I’m grateful I have a doctor that understands how active I am, and how health-conscious I am. She completely supports my adoption of the W30 for management of chronic inflammation. I was cleared to go back on diclofenac and my pain dropped back down almost immediately. I have felt a bit like a traitor since my inflammation isn’t responding completely to the dietary changes. I’m now trying the AIP, but that is much harder for me, because I love peppers! La, la, love peppers. The spicier, the better. However they might be very troublesome for me. I haven’t been able to stay compliant for more than 24 hours at this point, but I keep trying. I am very grateful that you have posted your journey so people like me can benefit from your experience.

    • Hi Lori. Thanks for sharing your story. Nightshades might very well be the problem. They are my biggest inflammation trigger. I know, they seem impossible to give up at first, but when you feel so much better, they’re not even tempting. I also recommend you check out some of the supplements mentioned in the article. They really helped me reduce my NSAID use, and some people find they’re so effective that they can go off NSAIDs altogether.

  16. Just finished reading this and I literally want to cry (tears of joy!!). Just recently, I self-diagnosed myself with HS. I’m assuming at least one culprit is my heavy use of ibuprofen to alleviate horrendous monthly menstrual cramps. I have been taking, for as long as I can remember (15 ish years) 600 iu ibu every 4 hours for the usual 2 days/month that I experience the otherwise unbearable pain. I’ve been at the AI Protocol diet as best I can for the last 2 months or so, with no ability to even decrease NSAID use just yet. Frustrating, & I feel like I’m wasting my time by not doing the 100% by the book protocol. Your article gives me such a huge sigh of relief, knowing that there are others out there still needing to rely on the old NSAID standby…for now at least. Just want to say thank you.

    • Oh Emily, I’m so glad you found this article. You aren’t wasting your time at all. The food & lifestyle portion of the AIP are the primary healing components. Two tips that might help you with the pain in the meantime: (1) Have you ever heard of Chasteberry? It’s an inexpensive herb that is known for regulating hormone imbalances and the associated pain. The dosage is 400mg twice daily, not just during your period. It’s an ongoing daily supplement that takes about a month before you notice the effects. I’ve taken it myself and noticed a huge difference Here’s a link to more information: http://www.wholehealthchicago.com/464/chasteberry/ . (2) For immediate pain relief during your period, Mickey Trescott from the blog Autoimmune Paleo found willow bark to be really effective. So, those are some things you can try while your body heals. Disclaimer: since I’m not a medical professional, simply consider this advice from a friend, and check with your healthcare team, to be sure there are no contraindications for you. Gentle hugs coming your way!

  17. Hi Eileen,

    Thank you for writing this. I am a 26 year old dancer who has had excruciating joint pain and just recently got diagnosed with rheumatoid issues. I changed my diet to the Autoimmune protocol, and have immensely decreased my pain (it is wonderful), but am still in pain and need to dance until the end of my season at the end of may. I felt guilty for taking NSAIDs occasionally because I was scared they were interrupting my ability to heal from my gut. This post made me feel so much better. Your blog is so inspirational to me, I have not found anyone writing about RA and doing the autoimmune protocol and so I just wanted to thank you.
    -Rosalia

  18. Eileen, I am on my way right now to get a bottle of Aleve. I have been one of the those people “white knuckling” our way through RA pain and I’ve been in that vicious cycle you mention above: pain, no sleep, cortisol, more pain, no sleep. I’ve been loathe to take painkillers these years on paleo, especially an NSAID, but reading that it hasn’t slowed your gut healing or that of others, I’m going for it. A small dose, but one that hopefully will promote more internal ease which will surely promote less stress and more healing. One other question, have you written about some of the studies about RA and personality traits? I know there have always been studies about that, but some of the work that Dr. Gabor Mate has done more recently has resurrected some of those ideas about an RA “personality type” and I’m wondering what you think? Thanks as always for everything you do.

    • Yes, pain isn’t healthy either, and I’m glad you are seeking relief. As for Dr. Gabor Mate, I read some of his essays. I believe in the mindbody connection, and I think looking into repressed emotions, and unmet personal needs is wise for anyone to do, RA or not, but I don’t believe in a “personality type” for autoimmune disease. I think we human beings are more complex than that, and I hesitate to step into the boxes people sometimes draw for us. That said, he seems to be a gentle and caring man, and undoubtedly, there is some wisdom to find in his books. There are lots of avenues to healing, and I wouldn’t close the door on any of them.

  19. Thanks so much for this post, I too have avoided NSAIDS while implementing the AIP for Hashimotos, but the chronic joint and muscle pain I feel keeps me impaired, and somewhat depressed. Thanks for the balanced perspective, and the encouragement to find what works.

  20. So grateful to have landed here. My RA was manageable up until about two months ago. I have dealt with it naturally but have been on pain meds every day, in a lot of pain, still not sleeping much and feeling guilty about everything. This gives me hope for healing and sticking with natural methods. I have a great doctor who continually encourages me but I don’t know anyone personally who deals with this. Thank you so much.

    • Hi Kathy. Never feel guilty for relieving your pain. However, if you’re taking a lot of pain meds and are still in a lot of pain, I recommend trying something new. There are two paths to take: one is to go on immunosuppressants temporarily, to get the RA under control so the natural methods have a chance to work. Healing is complex and takes time, and sometimes meds + diet/lifestyle are the answer. Here’s a good article by someone who recently made that choice. If you don’t want to do that, I highly recommend working with a functional medicine practitioner who has experience with quickly getting autoimmune symptoms under control through a combination of the autoimmune protocol, anti-inflammatory supplements (some of which are mentioned above), and functional tests to find other inflammation triggers. I recommend Anne Angelone from The Paleo Mom Consulting. She has Ankylosing Spondylitis herself, which is similar to RA, and she understands pain. Wishing you full healing, Kathy, and help in the meantime. Gentle hugs.

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