Participating in exercise and sport has many health benefits, ranging from improved heart health and good weight management to helping with mental health issues. But unfortunately, being active occasionally results in injuries. Treatment for injuries such as sprains and strains is varied, including the application of cold and hot packs, compression and massage, or medications. One of the more common types of medication used for sprains and strains are Non-Steroidal Anti-Inflammatories (NSAIDs). But, are they entirely safe for athletes to be using?
WHAT ARE THEY?
NSAIDs are a class of medications that provide anti-inflammatory effects, which do not have any relation to steroids. The mechanism by which NSAIDs work is by blocking the synthesis of prostaglandins, which are believed to be responsible for the body’s natural inflammatory response to an injury.
As their name suggests, NSAIDs reduce inflammation, but they also provide general pain relief. They are a good option for use when an injury has resulted in localised inflammation.
Quite a few different NSAIDs exist as an oral medication. Over the counter options are aspirin, diclofenac and ibuprofen……with diclofenac and ibuprofen also being available as topical rubs. Stronger NSAIDs also exist as prescription only medication….but of course, you would have to speak to your doctor for these.
WHEN SHOULD THEY BE USED?
There is some debate as to exactly when NSAIDs should be taken after an injury has occurred. Theoretically, if taken immediately, they can increase the risk of bleeding and bruising at the site of the injury; so it is generally recommended to take these types of medications 48 hours after an injury has occurred….but this, of course, depends on what type of injury you have sustained!
As a general rule, NSAIDs should be used when an injury results in localised inflammation or swelling. For injuries where there is no inflammation at all, NSAIDs may not provide much benefit. The general pain relieving properties may provide some assistance; but other medications, such as paracetamol, are probably a better choice.
SO WHAT ARE THE ISSUES?
Like all medications, NSAIDs have some side effects in addition to their desired effects. While these side effects are generally well tolerated, especially when the medication is only taken over a couple of days, there may be a few issues.
Stomach upset is a fairly common side effect of NSAIDs. Usually, taking these medications with some food will help to minimise this issue; but when taken over a long period of time, NSAIDs can cause some serious irritation to the stomach, often resulting in an ulcer!
Due to the way NSAIDs work in the body, they have also been linked to an increase in heart problems and stroke when taken over a long period of time. For any athletes out there who may be taking blood pressure medication, or have any other heart issues, NSAIDs may not be the best choice of pain relief….especially long term.
NSAIDs have an effect on the kidneys, which results in an increase of pressure being applied to the delicate blood vessels within the kidneys. Again, short term this isn’t too much of an issue; but for those who already have kidney problems, or are using the medication over a long period of time, it can potentially lead to kidney troubles.
Around 10% of asthmatics may have a sensitivity to NSAIDs; which can result in a worsening of asthma, sometimes causing an asthma attack. If you are affected by this, it is obviously best to avoid NSAIDs altogether. If you are unsure, you may be willing to try taking NSAIDs, but be aware that it may trigger an asthma attack…..so have your puffer handy, and realise that a trip to hospital may be the result!
ATHLETES AND NSAIDs
Many athletes take NSAIDs before training and competition on a regular basis in order to reduce any mild muscle tenderness; and to “prevent” the soreness that can result from long hours of exercise. But this is not a good idea!
Athletes often put their bodies under a lot of stress for a long period of time. The heart is working at an increased rate; and the kidneys are working overtime in order to process all of the toxins that are being produced by increased muscle use. In addition to this, athletes are often in a slightly dehydrated state, which adds even more stress to the heart and kidneys.
Considering the stress that the body is already under as a result of training and competing, and looking at the effects that NSAIDs can have on the body, combining the two is not a smart option. The additional stress that NSAIDs can put on the heart and kidneys, which are already under a lot of stress, can lead to further issues with these organs.
ARE NSAIDs SAFE TO USE OR NOT?????
As long as you are using NSAIDs for their desired purpose, over a short period of time, they are fairly safe to use…..just make sure you have them with a bit of food! Obviously they can have some undesirable side effects, but they are generally okay to use for otherwise healthy individuals.
For anybody with pre-existing medical conditions such as high blood pressure, heart problems, stomach issues, kidney troubles or asthma, NSAIDs are not the best choice. Of course, this depends on the individual and the severity of your condition. NSAIDs can be okay to use for a couple of days for some people with these types of health issues….but its always best to talk to your GP or pharmacist before trying anything.
For athletes who are in the habit of taking NSAIDs before training and competing, please stop! You are already putting your body under enough stress….the last thing you want to do is cause yourself health problems which will stop you doing the sport your love!
Over a short period of time, NSAIDs are a good option to help treat an injury which has resulted in some inflammation. They can help your body to recover from an injury a little bit faster than normal; and reduce any discomfort while your body is healing. Just remember not to take NSAIDs if you don’t need them…and if you need to take them over a long period of time, be sure to have regular checks with your GP or specialist!
The Sports Pharmacist 