NSAID: Facts for sportsmen and women

NSAID: Facts for sportsmen and women

Our in-house osteopath Carol Plumridge here shares some interesting information on NSAIDs (non-steroidal anti-inflammatory drugs) that you may want to consider. As with any drug treatment, speak to a professional first – either a pharmacist, GP or practice nurse.

Here are a few interesting statistics: 

  • 2002/6: in the Football World Cup 50% of players took them during the tournament and 10% took them before every game
  • 2008: 60% of athletes in the Brazil Ironman trials took NSAIDs
  • 19% of young football players take NSAIDs, showing a tendency to copy senior players

Why do athletes take them?

  • Athlete’s perception
  • Pain prevention
  • Soreness prevention during and post event
  • Lack of confidence in self-recovery
  • Psychological addition
  • Seen as harmless
  • Peer pressure
  • Self-medication encouraged

Why not?

Dr. Stuart Warden et al, in the British Journal of Sports Medicine 2009, stated that prophylactic use of NSAIDs (i.e. taking them ‘just in case’) is not safe. There is no indication or rationale for their prophylactic use in sport; they should only be used when pain and inflammation are present.

Use of NSAIDs in soft tissue injury

The benefits of using NSAIDs over alternatives are minimal and the risks are not fully known.

What’s interesting is that the mild effects on symptom relief are counterbalanced by their harmful effects on tissue repair. They may impair tissue regeneration if administered in early stages.

In cases of tendinopathy, NSAIDs hinder tendon healing and, apart from Ibuprofen, they can reduce tendon strength. There’s no evidence that they help tendon treatment at all.

NSAIDs have negative effects on bone and ligament healing and repair, mostly demonstrated in prolonged usage. There is also evidence that NSAIDs contribute to delayed degradation of scar tissue and are not recommended for treatment of fractures.

All things considered, the use of NSAIDs to treat muscle, ligament and tendon injuries should be reassessed.
Paracetamol has a similar efficiency to NSAIDs in soft tissue injury, is cheaper and has fewer side effects (provided the recommended dosage is strictly adhered to). Paracetamol is the painkiller of choice for most soft tissue injuries.

When should you take NSAIDs?

Soft tissue injuries associated with inflammatory conditions such as bursitis and synovitis and with nerve impingement do warrant short-term treatment with NSAIDs.

Any side effects or contraindications?

It’s worth noting that NSAIDs can:

  • Interact adversely with many common medications due to effects on the kidneys.
  • Involve G.I. risks including nausea, vomiting, diarrhea and abdominal pain
  • Increase the risk of heart attacks in those with pre-existing heart disease
  • Cause bronchospasm with asthmatics
  • Lead to decreased fertility in women

NSAIDs contribute to around 2,000 deaths per year, so should not be taken lightly. Always consult a health professional before taking any medication. If they are necessary, take the minimum dose for shortest possible time; responses to NSAIDs vary, so try another only if the first is not effective.

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