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What can I take instead of anti-inflammatory tablets?

Q) I'm 55 and suffer from arthritis in my knees and fingers. Unfortunately I'm not allowed to take anti-inflammatory tablets as I’m taking aspirin. I've tried all manner of natural remedies but nothing works. I'm a piano teacher and as you can imagine it's no fun having pain and stiffness in my joints in my hands. Is there anything that you could advise for my situation?
Diana, Kent (Summer 2010

A) There's no absolute reason not to use low-dose aspirin and anti-inflammatory tablets together, but doctors don’t like the combination because of the risks to the stomach. Some doctors might argue that the anti-inflammatory drug naproxen could be used as a substitute for aspirin. On the whole there has been a trend for GPs to avoid non-steroidal anti-inflammatory drugs (NSAIDs) altogether as they may cause stomach ulcers and raise the chance of a heart attack. As with any drug the pros and cons have to be balanced.

What alternative treatments could you take? Paracetamol at a decent dose (up to eight tablets daily) may also control your symptoms well. The evidence for glucosamine isn't strong and the same applies to fish oil, but you could try these for a trial period. It's also important to keep the muscles around the joints strong so don’t neglect those exercises, particularly for the knees.

This answer was provided by Dr Philip Helliwell for the Summer 2010 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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