Dear Alice,

In light of the current situation with Vioxx, what is your feeling on Celebrex? My 90-year-old father experiences a lot of pain in his back due to many age-related issues, i.e., spinal stenosis, arthritis, etc. His doctor suggested recently that Celebrex could help him, but after hearing about Vioxx, he is reluctant to take it.

Dear Reader,

Your father's reluctance to take Celebrex (generic name, celecoxib capsules) to help treat his arthritis is understandable in the wake of the recent negative press Vioxx (generic name, rofecoxib) and now Celebrex have received. Recent research have shown that there may be a correlation between taking these pain medications, which are COX-2 inhibitors, and an increase in the incidence of heart attack or stroke in people taking them over the long-term (for Vioxx) or at high doses (for Celebrex). These findings were unexpected considering the studies were conducted to find if those taking either of these medications for arthritis therapy were protected from or at a higher risk of developing precancerous growths. Merck & Co., the manufacturer of Vioxx, has recalled the drug voluntarily. Pfizer, Inc., the manufacturer of Celebrex, has pulled all advertising voluntarily, but will continue to offer the drug on the market unless its safety is more conclusively confirmed to be in doubt.

While your father may not want or choose to take Celebrex, alternative means of treatment for alleviating pain are available and may be more amenable to him:

Other pain relievers
As the field of medical science is always in flux, talking with a medical provider about other pain medication options as alternatives to COX-2 only inhibitors would be worthwhile.

Research has shown that massage decreases depression and stress hormones, eases muscle spasms and aches, and facilitates the production of the body's natural pain-killing endorphins, increasing sleep and the ability to accomplish daily activities.

Eating plans
What a person eats affects his/her overall health and performance. A diet high in saturated fats or vegetable oils increases inflammation, thus increasing tissue and joint pain. It's healthier to eat more fresh fruits and veggies and whole grains, and keep saturated fat consumption low.

Acupuncture and Acupressure
These ancient Chinese pain relief treatments are gaining popularity throughout the United States. In targeting key points in the body, these practitioners induce the release of endorphins, facilitating anti-inflammatory responses. If your father chooses to go this route, make certain that the practitioner is certified and licensed. Check their background by having them show their credentials and by contacting the accredited organization with which they are affiliated.

Herbs and Supplements
Herbs and supplements are available that could help ease or manage the pain in those who have arthritis. Your father needs to consult his physician before using any and discontinue use at any time if he experiences any adverse effects. The U.S. Food and Drug Administration (FDA) does not regulate dietary and herbal supplements, so there's no guarantee of their quality, quantity, and safety. Only buy these products from large stores or chains because they are more likely to adhere to higher standards as they have their reputations to protect. However, choosing products with a USP marking on the label indicates that they meet the purity and dissolution standards established by the U.S. Pharmacopoeia.

In addition, some major hospitals or medical teaching institutions now have pain management or palliative care units. It might make sense to look into these programs as options. Your father's physician may be able either to refer your family to a similar program, or to work with the professionals at that program to get your dad the pain relief he needs and deserves.

Whether or not your father decides to take Celebrex, utilize an alternative therapy, or use both in conjunction with one another, talk this decision over first with his physician. Hopefully, your father can find a way to lessen his pain so that he can get back to his everyday lifestyle.

The following web sites may be useful in garnering further information:

Vioxx Questions and Answers on the FDA web site
Celebrex Patient Information Sheet on the FDA web site

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