Remember the furor that was caused when the conventional painkiller rofecoxib (Vioxx) one of the main COX-2 inhibitors was taken off the market in 2004 because it was causing an increase in deaths from heart attacks. The

additional news with this and a myriad of other "pain relief" products has been all bad ever since.

More recent studies have shed damaging light on the safety, and efficacy, of all NSAIDs (nonsteroidal anti-inflammatory drugs) like Ibuprofen for example.

This news is probably devastating if you have chronic pain and rely on NSAID types of medications to get you through your day. But the good news is that there are a number of natural ingredient herbal alternatives that are

effective for short and long-term pain relief that will not tear up your stomach nor increase your risk of a heart

attack or stroke.

Numerous Studies now reveal that you should avoid NSAIDs, period.

NASIDs act by inhibiting an enzyme called cyclooxygenase (COX), which produces prostaglandins. It is prostaglandins that are responsible for causing swelling and pain in painful conditions like arthritis. Because this

activity of inhibiting COX often damages the lining of the stomach and increases bleeding, a more selective class of COX inhibitors was developed.

These selective inhibitors work on only one form of COX, namely COX-2. Since COX-2 is responsible for inflammation, the aim was that they would only relieve inflammation and not impair the beneficial effects of COX-1, which protects the lining of the stomach. But COX-2 inhibitors have failed in a big way, leaving some drug companies with the proverbial egg on their face and massive lawsuits to deal with to keep them occupied.

The news continues to get worse. Recent studies have emerged that raise serious concerns regarding the long-term safety of all NSAIDs in terms of heart health not just the selective COX-2 inhibitors.

According to a study published last year in the prestigious British Medical Journal, some of the more commonly used NSAIDs are EVEN MORE LIKELY to cause heart attacks than the COX-2 inhibitor rofecoxib. The study

looked at more than 9,000 people between 25 and 100 years old who had recently suffered their first heart attack. After adjusting for all the confounding variables, the researchers observed a significantly increased risk of heart attacks in people using diclofenac (a 55 percent increase), ibuprofen (a 24 percent increase), rofecoxib (a 32 percent increase), and naproxen (a 27 percent increase), as compared to those not using these over the counter drugs.

Worse yet, a recent review of 23 clinical trials involving more than 10,000 patients found that NSAIDS as a whole (including selective COX-2 inhibitors) were NOT EFFECTIVE for long-term pain relief in for example, osteoarthritis of the knee.

The researchers concluded that while short-term use of NSAIDs can reduce pain in osteoarthritis of the knee only slightly better than a placebo, the current evidence does not support the long-term use of NSAIDs for this condition, particularly in view of the adverse effects associated with their continual use.

So what can you buy that really works?

The evidence is abundantly clear that NSAIDs should not be your primary treatment for joint and muscle pain. But this does not mean you have to live with it, either, especially when there are proven herbal alternatives that can bring much needed relief from pain.

So what can you buy that works? Let's take a look at a few all natural herbal solutions:

1. The first herb is Willow Bark. Numerous studies have revealed how effective it is for alleviating pain. More promising still, a recent large-scale study has proven that willow bark is safer and more effective than any NSAID

on the market today.

The study involved 922 doctors and 4,731 patients in Germany. Over a six to eight week period, patients with arthritis or back pain took various doses of willow bark extract, averaging three tablets per day, and rated their pain intensity from 1 to 10 (with 10 representing pain of the highest intensity). Most of the patients had previously been

taking NSAIDs but had stopped using them either because they were not effective or because of their side effects.

During the observation period, average pain intensity was reduced from 6.4 to 3.7 points in the first four weeks of treatment and fell even further to 2.7 after eight weeks. Overall, 97 percent of the patients reported a significant

reduction in pain, and 18 percent reported complete pain relief. Minor side effects occurred in only 1.3 percent of patients such as abdominal pain and allergic skin rash.

The Willow Bark extract used in this study contained 60mg of salicin per tablet. Its important to take a tablet of this strength or slightly greater in order to obtain the best results.

2. The next herb is Boswellia, an impressive anti-inflammatory herb from India. In a recent random, double-blind, placebo-controlled, crossover study of 30 patients who had osteoarthritis of the knee, half received Boswellia and the other half received a placebo for eight weeks.

ALL of the patients who took Boswellia reported decreased knee pain, decreased swelling in the knee joint, increased knee flexibility, and increased walking distance. The dose used was 1,000mg of Boswellia extract per day containing 400mg of boswellic acids. A few of the subjects experienced minor gastrointestinal adverse reactions.

3. The next herb is devils claw (Harpagophytum procumbens), which comes from the dry areas of southern Africa. A recent randomised, double-blind pilot study compared the effects of aqueous devils claw extract and the conventional drug Vioxx on acute back pain.

During a six week trail, 88 patients received either devils claw extract (containing 60mg harpagoside) or Vioxx (12.5mg). Twenty-three percent of the patients taking devils claw reported no pain for at least five days of the final week of treatment. Only 13.8 percent of the drug patients reported the same result. There were no significant differences between the two treatments, so the study concluded that devils claw extract worked just as well as the COX-2 inhibitor.

4. In addition to the above, all natural ingredient products with several herbs in their formulas that act together to synergistically reduce pain. Menastil, CorProfen, and EZ Pain Relief are tried and proven non-addictive,

non-narcotic solutions that work as well as if not better than the herbs above to help you reduce and manage your pain.

So how do you know which of these remedies to use? Once again, each person on this earth is anatomically different as to what works and what doesn't when it comes to applied pain relief of a topical, oral, or hypodermic applied nature. It depends on the individual response to the product. One of these herbs will work better for one person than another for each particular person.

The main word of the day is avoid NASIDS, and experiment with the all natural ingredient over the counter product solutions as above to manage and control your pain.