NSAID’s…doing more to help or harm?

Believe it or not the pain, swelling, and bruising that accompanies an injury is all a normal process immediately following an injury. This process, called the Inflammatory Process, is intended to facilitate repair and in return get the tissues on track to functioning normal again. Often times though this process is quite bothersome in both the intensity and duration.  This is where the help of a certified athletic trainer comes in to help treat and reduce the negative impact of the inflammation process that your body enduring. Without going into too much physiology and fancy terminology, inflammation is caused by numerous chemical mediators, activated cells, and plasma protein systems. There are considerable interactions among these mediators, cell types, and plasma protein systems, which are all intended to regulate the rate and extent of the inflammatory process. In other words, some of these interactions stimulate the progress of the inflammatory response whereas other interactions prevent the process from spreading beyond certain limits. Despite what may be publicized in the press about the harmful effects of inflammation, the fact remains that without this process, our bodies could not survive. Inflammation represents a protective response designed to heal the body of the initial cause of cell injury and the consequences of that injury. However the body often overdoes this process and the need to control it comes into play.

                There are 3 phases to the Inflammatory Process. The first is the Inflammatory Response Phase and this occurs immediately following tissue injury. In this phase you have the redness, swelling, tenderness, increased temperature, and loss of function to the injured area. This phase is the most critical to the entire healing process. The second phase is the Fibroblastic Repair Phase. During this phase of healing, regenerative activity leading to scar formations and repair of the injured tissue is taking place. The last and final phase called the Maturation-Remodeling Phase is a long-term process. During this process, the tissue gradually assumes a normal appearance and function and Type I collagen fibers are laid down increasing the strength of the tissue. This last phase, depending on the extent of the injury, can take months to years to completely heal.

                It is easy for anyone to reach into the medicine cabinet and grab the bottle of Ibuprofen, or Naproxen which both fall into the category of NSAIDs or Nonsteroidal Antiinflammatory Drugs. Brand names that fall into the NSAIDs category include Advil (Ibuprofen) and Aleve (naproxen). NSAIDs are strong inhibitors of pain, stiffness, and swelling especially in chronic-long term injuries like arthritis. However since NSAIDs are so easily accessible because they are an OTC (over-the counter medication) many individuals are actually causing more harm than benefit to their bodies. NSAIDs have many adverse reactions when over-taken, especially with everyday use. Over 16,000 people die each year and >100,000 are hospitalized as a result of adverse effects of chronic NSAID use. The most common adverse effects are gastrointestinal irritation, heartburn, nausea, upper gastrointestinal bleeding, and ulcers. Taking NSAID’s with food or milk may help diminish gastric problems. As with any other medication, taking NSAIDs chronically and daily can cause liver and kidney damage over time so the dosage and frequency that you are taking should be monitored. You should always follow the directions on the medication and not over-take or mix other medications together. As stated earlier the inflammatory process is vital to the healing process of the body. Your body has natural chemicals and cell responses to heal and deal with injuries. If you are chronically abusing and taking NSAIDs this can in turn take away from your body’s natural ability to cope with injury and inflammation. Your body will no longer see a need to produce natural chemical mediators at controlling inflammation and could delay healing within your body. The first phase to the healing phase of an injury is the Inflammatory Phase. This phase, as stated, is the most critical. It is the foundation of healing. Many studies are coming out with new research showing the effects of taking NSAIDs immediately following injury is actually detrimental to the inflammatory phase. The bottom-line here is, you need inflammation to heal. If you immediately start taking ibuprofen right after an injury, you are taking away the inflammation your body needs to start healing!

                NSAIDs are not all bad for you if taken properly. You should always talk to your doctor regarding the medications you are taking and they can make the proper recommendations for your specific needs. A suitable therapy response for the use of NSAIDs for an injury is typically up to 2 weeks after beginning therapy. Ingesting NSAIDs like candy, day after day, is not the way to go and you could really be doing more harm than good to your body. For more information on NSAID uses and other related topics, please see below.

  • ·         orthoinfo.aaos.org/topic.cfm?topic=a00284 (American Academy of Orthopedic Surgeons,”What are NSAIDs?”)





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