After one popular pain-killing drug, Merck's Vioxx, was pulled from the market and two others, Pfizer's Bextra and Celebrex, had their safety severely questioned, many Americans are opting to leave their anti-inflammatory drugs on the shelf -- and understandably so.These drugs are in a class of painkillers known as cox-2 inhibitors, which are part of a larger class known as nonsteroidal anti-inflammatory drugs (NSAIDS), and are often used to treat arthritis and other pain. Let's take a quick look at these drugs' disturbing past:

• · Vioxx was pulled from the market in September 2004 after a study showed that patients taking the drug faced twice the risk of heart attack
• · Bextra was found to double the risk for heart attack and stroke
• · The National Institutes of Health announced, also in December 2004, that over-the-counter pain reliever Aleve has been linked to an increased risk of heart attack and stroke.

In light of all of these significant warning signs, increasing numbers of patients, particularly those with arthritis, are seeking pain relief through alternative methods -- and they're in luck. Probably the most important way is to reduce inflammation is to eliminate sugar from your diet and for most of us that also includes all grains. Just this simple strategy may provide amazing relief.

If eliminating sugar and grains doesn't provide you with the relief you seen then the following herbal solutions provide the benefits of painkilling drugs without raising your risk of serious health problems like heart attacks and stroke.

You should work with your own knowledgeable health care professional, someone who understands natural medicine, to develop the best combination of herbal alternatives for you.

Ginger: This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice. Powder capsules are also available, but I recommend using the fresh root.

Boswellia: Also known as boswellin or "Indian frankincense," this herb contains specific active anti-inflammatory ingredients, referred to as boswellic acids that animal studies have shown significantly reduce inflammation. This is one of my personal favorites as I have seen it work well with many of my rheumatoid arthritis patientsAnd in another study of 175 patients with rheumatic disorders such as rheumatoid arthritis, 122 participants had reduced stiffness and inflammation just two to four weeks after starting on boswellia.

Fish Oils: The omega-3 fats EPA and DHA found in fish oil have been found, by many animal and clinical studies, to have anti-inflammatory properties that reduce joint inflammation and promote joint lubrication.

Animal based omega-3 fats are absolutely essential for any comprehensive anti-inflammatory program. They form the precursors to the molecules that actually produce or inhibit inflammation in your body (prostaglandins). That is why it is essential to make sure you are getting enough. It is also vital to understand that you need to reduce omega-6 fats like vegetable oils seeds and nuts, as it is actually the ratio of omega 6:3 fats that determines how much inflammation is present. You could theoretically consume enough omega-3 fish oils to work but then ruin the effect by consuming too many omega-6 fats.

Those of you who read the newsletter regularly know that I'm a fan of Carlson's brand fish oil and cod liver oil as I have seen clear and often substantial improvements in my patients who use it. It has shown particularly positive benefits in those with rheumatoid arthritis.

You can find the Carlson's fish oil/cod liver oil in the Recommended Products section of my website; your local health food store may also carry Carlson's, and usually they are very helpful in recommending any other trustworthy brands.

Bromelain: This enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful.

Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. The delicious raw butter we carry from organic pastures contains "Wulzen anti-stiffness factor." This factor has been found to be highly effective in reversing arthritis and protects against calcification of joints. I have also used this for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. I used a topical preparation for this.

In one study of 106 people with various types of arthritis who did not respond to NSAIDs, 63.5 percent of those who took CMO orally and applied the cream topically (it's available both in oral supplement and cream forms) improved, compared to only 14.5 percent of those taking a placebo.

Evening Primrose, Black Currant and Borage Oils: These contain the essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain. These are the exception to omega-6 fats that are necessary to have in your diet. It is reasonable for many to take these as a supplement, particularly if you struggle with dry skin in the winter, as this is a strong indicator that you are deficient in these fats

In one study of 37 rheumatoid arthritis patients, those who received 1.4 grams of GLA per day reduced the number of tender joints by 36 percent, the tenderness of the joints by 45 percent, the number of swollen joints by 28 percent, and the degree of joint swelling by 41 percent. The placebo group showed no significant improvements.

I personally prefer the use of GLA supplements from evening primrose oil but borage oil contains a higher concentration of GLA, which means you need fewer capsules, and it tends to be less expensive.

Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmits pain signals to the brain.