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| NSAIDS - What You Should Know |
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NSAIDS - Non-Steroidal Anti-Inflammatory Drugs
Antipyretic - reducing or tending to reduce fever
Anti-inflammatory - preventing or reducing inflammation
Anticoagulant - a substance that prevents the clotting of blood
Analgesic - a medication that reduces or eliminates pain
Chronic - slow continuous onset of injury (i.e. Tendinitis, carpal tunnel, low back pain)
Acute - rapid onset of injury (i.e. Sprained ankle, bruised elbow)
Prostaglandins - chemicals produced by all cells in the body except red blood cells.
They signal inflammatory events such as blood vessel dilation, increase cell permeability, increase blood flow and increase temperature. Prostaglandins also increase the sensation of pain by ten to eighty times. (Hertal, Journal of Athletic Training)
NSAIDS
Non-steroidal anti-inflammatory drugs (NSAIDS) are often used by those with injuries. Just as the name implies NSAIDS have an anti- inflammatory effect. These drugs are taken to either control immediate inflammation after an injury or control chronic inflammation. There are many different types of NSAIDS. Some can be obtained by receiving a prescription from a physician and others by buying over the counter at your local drug store. Some common over the counter NSAIDS are aspirin, ibuprofen (Advil), and naproxen sodium (Aleve). Before you decide which NSAID to take you should know the differences between them. We will take a closer look at these drugs as well as acetaminophen (Tylenol). Although acetaminophen is not an anti- inflammatory, it is worth mentioning because of its popularity. It is also important to comprehend what happens to your body during injury in hopes that you can make the proper decision on which drug is most appropriate.
What Happens After Injury?
When you suffer from an injury your body reacts immediately. First, near the injury site, your blood vessels constrict (close). This constriction lasts for the first five to ten minutes after an injury occurs. After which your blood vessels dilate (open), causing an increased amount of blood flow to the injured area along with pain producing chemicals. These chemicals attract leukocytes, which are white blood cells that clean up damaged tissue. This action causes a burst in oxygen to the area. Prostaglandins are then developed. These play an important role in inflammation and are the only chemical that is inhibited by the use of NSAIDS. Prostaglandins increase blood flow and tissue permeability as well as increase the sensation of pain by ten to eighty times. (Hertal, Journal of Athletic Training) There are other chemicals that do the same things as prostaglandins. During inflammation these other chemicals are brought to the site by a different pathway than prostaglandins. This tells us that even though NSAIDS may stop the prostaglandins in the inflammatory process it does not stop the process all together; however, the question remains, do we need all that inflammation immediately after injury or surgery in order to help the healing process?
Stages of Healing
Inflammation is important to have during this first stage of injury. It collects appropriate cells needed to repair and clear away damaged tissue. This stage of injury, the "Acute Inflammation phase," usually lasts 24-36 hours and is then followed by the "Repairing phase." This will last anywhere from 7 -10 days. During this time your body removes the damaged tissue from the area and prepares that site for new tissue formation. Imagine a building being knocked over. Before you can build a new building you have to pick up the mess and clear the debris out of the way so that you can lay the foundation and then start the rebuilding. It is the same with your body when it is injured. The damaged tissue will rebuild during the end of the repairing phase into the .Maturation phase. which can last anywhere from a month to two years depending on the injury. The new collagen is produced and later new capillaries (blood vessels) are established. You can see that the initial inflammation does bring in cells and nutrients that are needed in order to .rebuild..
When Should I Take NSAIDS to Reduce Inflammation?
Each person will have a different amount of inflammation depending on their injury. Inflammation is needed to heal an injury, but inflammation that stays in the area for too long can be unhealthy. That is why NSAIDS are so controversial. There are two opinions. The first opinion is that NSAIDS should not be taken until 2-3 days after injury in order to allow the body time to have that natural immediate inflammation. The second opinion is that NSAIDS should be taken early in an injury in order to decrease the amount of immediate inflammation. They believe that the decrease in inflammation will decrease recovery time. NSAIDS will usually help with chronic inflammation; however it is the choice between you and your doctor or pharmacist to decide whether they are appropriate immediately after injury or surgery.
Here is some background information on each of the drugs to help you decide what may be best.
Aspirin
- Some brand names are Bayer, Ecotrin, St. Joseph.
- Has an analgesic, antipyretic, anti-inflammatory, and an anticoagulant effect. Commonly used for
- Headaches
- Toothaches
- Arthritis
- Aches and pains from colds or flu
- Menstrual discomfort
- Lowest costing
- Some brand names are Advil and Motrin.
- Has an analgesic, antipyretic, mild anti-inflammatory, and anticoagulant effect.
- The anticoagulant effect is less than that of Aspirin. Commonly used for
- Headache
- Muscular aches
- Minor pain from arthritis
- Toothache
- Backache
- Common cold
- Menstrual cramps
- Temporarily reducing fever
- Can purchase to your need, (i.e. Motrin for children)
- Brand name is Aleve.
- Has an analgesic, antipyretic, anti-inflammatory, and mild anticoagulant effect.
- Naproxen Sodium has a greater anti-inflammatory effect than Ibuprofen. Commonly used for
- Aches and pains from common cold
- Headache
- Toothache
- Muscle aches
- Minor arthritis pain
- Menstrual cramps
- Great for minor inflammation
- It is more potent than Ibuprofen and aspirin, so a smaller dosage is taken.
- Some brand names are Tylenol and Aspirin Free Anacin
- Is not an NSAID; so it does not have an anti-inflammatory effect.
- Has an antipyretic and analgesic effect.
Commonly used for
- Fever reducing
- Minor aches and pains
- Minor pain from arthritis
- Menstrual cramps
- Great for fever reducing.
- No anti-inflammatory effect, so it will not have any effect on the inflammation of an injury.
- Does not have anticoagulant effects.
- How long should you take the meds for?
Follow the instructions printed on the package label or follow your physician.s directions. As a general guideline, do not take any of these medications for more than 3 days for a fever and 10 days for pain. If you still have symptoms after those times periods then you need to go see your doctor. - What are the side effects?
The side effects for each medicine may be a little different. Always read the package information thoroughly. Some common side effects are nausea, abdominal cramps or pain, bloating and gas, diarrhea, headache, heartburn, indigestion, itching, loss of appetite, nausea, nervousness, rash, ringing in ears, stomach pain, vomiting, fluid retention, and dizziness. - Do I need to take the medication with anything? Again, read the packaging material thoroughly. You will need to take the Ibuprofen and aspirin with food. You should take the naproxen sodium and acetaminophen with a full glass of water.
- How much should I take?
Each medication is different. Follow the directions on the bottle. - Will these drugs interact with other medicines that I am taking?
Before you start to take any of these drugs you should check with your doctor or pharmacist to make sure it is appropriate for you. Each of the NSAIDS and the acetaminophen has food or drug interactions. For example, if you are on a blood thinner, like Coumadin, you do not want to take any NSAIDS. It is very important that you check with your doctor, therefore you will be positive on which over the counter medications are best for you.
www.nsaid.net
www.pdrhealth.com
www.fda.gov
Hertal, Jay. Journal of Athletic Training. The role of non steroidal anti-inflammatory drugs in the treatment of soft tissue injuries. Oct-Dec 1997. Vol 32 Iss 4 pg 350-359. Dallas, TX
Houglum, Joel. Journal of Athletic Training. Pharmacologic considerations in the treatment of injured athletes with non steroidal anti- inflammatory drugs. Jul-Sept 1998. Vol 33 Iss 3 pg 259-264. Dallas, TX
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Editor: Erik Nason NASA Official: David A. Tipton Last Updated: March 6, 2006 |
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