In current allopathic medicine the goal of musculoskeletal treatment is to address the patient’s injury or disorder by alleviating pain with the use of drugs, preventing further injury and returning the patient to his/her previous status and activities.The most commonly employed interventions are: 1) rest and watchful waiting 2) non-steroidal anti-inflammatory drugs NSAIDs and cyclooxygenase-2-inhibitors (Cox-2 inhibitors) and 3) surgery.
The more-action oriented approaches used my many chiropractor, naturopathic and osteopathic physicians differs from allopathic medicine because although avoidance of and rest from damaging activities is reasonable and valuable, too much rest without an emphasis on active preventive rehabilitation 1) encourages patient passivity 2) encourages the assumption of the sick role 3) fails to actively promote tissue healing and 4) fails to address the underlying proprioceptive deficits that are common in patients with chronic musculoskeletal pain and recurrent injuries.
NSAIDs are considered first line therapy for musculoskeletal disorders by allopathic doctors despite the data showing that there is no evidence that widely used NSAIDs have any long term benefit on osteoarthritis. Worse NSAIDS worsen joint disease. NSAIDs are known to inhibit cartilage formation and to promote bone necrosis and joint degradation with long-term use and NSAIDs are responsible for more than 16000 gastrohemorrhagic deaths and 100000 hospitalizations each year. The Cox-2 Inhibitors are supposed to provide anti-inflammatory benefits with an enhanced safety profile but gastrocentric focus of the drug developers failed to appreciate that Cox-2 is necessary for the formation of prostacyclin a prostaglandin that plays a role in vasodilatation and antithrombosis, not surprisingly therefore use of Cox-2 inhibitors drugs has consistently been associated increased risk of adverse cardiovascular effects including myocardial infarction, unstable angina, cardiac thrombus, resuscitated cardiac arrest, sudden or unexplained death, ischemic stroke, and transient ischemic attacks. Moreover Cox2 Inhibitors cause build up of leukotrienes a group of inflammatory mediators known to promote atherogenesis. Additionally surgery to treat musculoskeletal pain do not consistently show evidence of safety, efficacity and cost-effectiveness.
Integrative and natural medicine is a key. The goal and means of musculoskeletal treatment is to address the patient’s injury or disorder by simultaneously alleviating pain with the use of natural, non invasive, low cost and low risk interventions while improving the patient’s overall health, preventing future health problems and upgrading the patient overall paradigm of health maintenance and disease prevention from one that is passive and reactive to one that is empowered and proactive.
Commonly employed therapeutics include spinal manipulation, exercise and the use of nutritional supplements and botanical medicines which have been demonstrated in peer-reviewed clinical trials to be safe and effective for the alleviations of musculoskeletal pain. Supplements such as niacinamide, glucosamine, chondroitin sulfates, vitamin D, Vitamin B-12, anti-inflammatory diets, balanced and complete fatty acids therapy, proteolytic/pancreatic enzymes and botanical medicines such as boswellia, harpagophytum, uncaria and willow-bark are effective. Lifestyles change is key to management. Any treatment plan that allows the patient to resume his/her previous lifestyle is by definition doomed to fail as this will result in reoccurrence and perpetuation of the illness or disorder.