I live on NSAIDs. I probably take 1,000 ibuprofen a year. Have done since a 2001 wreck that broke my back and neck. And I had to increase the dosage after being hit by a car last month. My breakfast is 2 or 3 ibuprofen and coffee, almost every morning since 2001.
Frankly I'd be better off with just two or three ibuprofen in the morning for inflammation and a single Tramadol or codeine a day when the pain is really bad. When the pain is bad enough a single Tramdol is good enough to get me moving with no side effects -- it's very mild. Ditto acetaminophen with codeine. For years a 30 day supply would last me 3-6 months. Then they cut it back to a 10 day supply, which lasted me a month because I took only one a day, at most -- sometimes only half. If I was gonna be an addict it would have happened long again. Never happened. I don't have the craving. It doesn't take much to relieve the pain.
But, thanks to junkies screwing it up for non-addicts with real chronic pain who aren't trying to get high, doctors are so paranoid now about being busted by the DEA they won't prescribe opiates for long term chronic pain. So now they tell me to take 800 mg of ibuprofen three or four times a day. They know it's B.S. and will eventually destroy my stomach, liver and kidneys. But they won't lose their licenses for that. I'll have to live and die with the complications.
Opiates aren't the problem. Junkies are the problem. They screw it up for everybody.
I've tried every alternative available, every topical salve, balm, ointment and voodoo rub. I was about to try CBD oil when a friend gave me some cannabis based balm in a mix of lotion with camphor and menthol, so it's not intended to be ingested, just rubbed on. Frankly, I can't tell that it makes any difference. Same with any balm. It's not the ingredients that matter, it's the massaging. The active ingredients can't penetrate enough to reach the deep aches in muscles and joints. Even the highly touted extra strength capsaicin doesn't really do what it claims. Any analgesic effect is limited to the skin surface and maybe a fraction of an inch of the subcutaneous tissue. It can't reach any deeper. But I can tell that after awhile I build up a resistance where it doesn't sting on the skin. That's just the effect on the skin-deep nerves.
Soaking in a hot bath with Epsom salts helps more than any muscle rub, balm or ointment. I don't know whether the Epsom salts actually help, but it seems to work better than just soaking in hot water. Often I'll get up in the middle of the night when the pain keeps me awake just to soak in the tub.
A week or so ago the "geriatric" clinic's nurse practitioner suggested referring me to the health network's "pain management center". I'm already familiar with that racket. For years, until recently, I was my mom's caregiver, and before her I took care of both grandparents. Now I'm old enough to be considered "geriatric".
Here's how the "pain management" clinic goes...
If you complain of chronic or severe pain at the urgent care clinic or routine office visit, they won't give you anything like codeine or Tramadol anymore. They'll tell you to overdose on ibuprofen while waiting three weeks for your intake appointment with "pain management". Meanwhile, try not to commit suicide from the constant pain.
On your first visit to "pain management" they'll keep you waiting an hour or two past your appointment. Then they'll "evaluate" you, which means halfway listening to the patient while dismissing his/her complaints. Then they'll reschedule you for a follow up appointment. They do no actual treatment or therapy on the first visit.
Four to six weeks later, you see another doctor at the "pain management" clinic, who suggests local injections of anti-inflammatories, or a nerve block if it's bad enough. The patient agrees, because he/she has been in pain for weeks without relief. But the doctor doesn't actually do anything that visit. Nope, they reschedule you for another 4-6 weeks later.
So from the time you're referred to "pain management" until you actually get any kind of treatment, 4-6 months have passed, with at least three office visits. Depending on your insurance. that's a copay of zero to $100 -- for nothing. Just a bunch of consultations.
And this is why some of my elderly neighbors prowl the hallways begging for just one effective pain pill, anything... just one oxycontin, Tramadol, codeine, anything. And they aren't junkies. They're in real pain.
That's also why many of my neighbors drink heavily. It's the one time tested pain reliever they can buy without jumping through hoops. And reportedly some high ABV beers with certain hops have some proven anti-inflammatory characteristics.