Do you regularly push yourself to your limits when you exercise and then depend on an over-the-counter painkiller when your body protests? It’s fairly common for athletes to use non-steroidal anti-inflammatory drugs (NSAIDs) after strenuous workouts. But is this a sound strategy, considering the possible side effects?
That question is challenging, because not all pain from exercise is the same, says sports medicine specialist Carly Day, MD. Your pain may come from a degenerative joint process such as arthritis. Or your pain may come from a tissue injury that can heal.
“My recommendation for or against taking NSAIDs to allow someone to exercise would be on a case-to-case basis,” she says. You need to weigh the benefits of exercise against the risks of regular painkiller use.
She offers this hypothetical comparison: A healthy older man with mild knee osteoarthritis who takes ibuprofen occasionally before golfing is likely to reap physical and mental health benefits that would outweigh the risks. But a young runner with severe Achilles tendinitis may take ibuprofen three times a day to push through the pain. If she does not adopt a strengthening and stretching regimen to heal the tendon, she’s likely doing more harm than good, Dr. Day says.
Factoring in side effects
The key to using NSAIDs is to recognize the side effects of these medications and factor that into your decision, Dr. Day says.
NSAIDs are sometimes associated with kidney damage and other risks. She strongly cautions anyone with the following issues against using NSAIDs that you take by mouth:
- Kidney disease
- Prior stomach ulcers
- Taking blood thinners
“Often I find patients are not aware that NSAIDs can increase blood pressure,” she says. “This is a notable side effect.”
So you should avoid NSAIDs if you have hypertension. A topical anti-inflammatory, a cream or ointment applied on the skin, may help relieve pain. But the oral form would pose too many risks, Dr. Day says.
The good and the bad
In theory, NSAIDs can help and harm your body simultaneously.
On the helpful side, they can decrease swelling, inflammation and pain. In certain situations, using the medication can allow more functional motion, which can eventually help with healing.
However, Dr. Day warns that inflammation is often the body’s natural way to create healing. So blunting that response with drugs may actually cause harm.
“Newer treatments, like platelet-rich plasma injections, are pro-inflammatory with the goal to promote long-term healing,” she says.
Talk to a physician
It’s important to stay active. So if you are having pain, it doesn’t mean you have to rest completely, Dr. Day says.
Keeping yourself healthy will involve diet and exercise. You can modify exercise in the short term to allow healing, for which a physical therapist can provide guidance through that process, she says.
“In certain situations, NSAIDs are helpful to allow you to stay active and decrease your risk of cardiovascular disease,” she says. But you should not take their use lightly.
If you are in pain after exercise, Dr. Day suggests working with a sports medicine physician to figure out what’s causing your pain.
If it relates to biomechanical factors such as poor form, underlying weakness or tightness, you can address those issues first.
“You can always try ice after activity, bracing and topical medications before resorting to oral NSAIDs,” she says. If that doesn’t help, then you should discuss the pros and cons of oral NSAIDs with your doctor.
By Bone, Muscle and Joint Team
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