Non-steroidal Anti-inflammatory Drugs: the Solution or the Problem? 

Non-steroidal anti-inflammatory drugs (NSAID’s) are among the most commonly prescribed medications, with over 30 BILLION doses taken by Americans each year. These medications are taken to reduce pain and inflammation associated with a variety of conditions, including osteoarthritis, muscle or tendon injuries, headaches, and spine pain.

NSAID’s are generally considered safe when taken as directed, however there are notable adverse effects that are well documented. Some of these effects are in fact quite serious. Among the most serious side effects are GI bleeding and acute kidney damage.

A recent article published in the journal Physical Therapy questions the common wisdom of taking NSAID’s, especially for acute muscle injury. We are learning more about the role of inflammation in healing, and it seems that inflammation is fundamental to the process of tissue regeneration following injury. Inflammation involves complex physiological events that eventually lead to the stimulation of new tissue growth. NSIAD’s, by interrupting this process, may inhibit healing.

There is some evidence to suggest that NSAID’s may even have a negative impact on Osteoarthritis as well. We need more research to investigate the long-term effects of NSAID’s on new bone growth in people diagnosed with Osteoarthritis.

The benefit of NSAID’s is likely due to their effect on controlling pain, and not the anti-inflammatory properties. However, other medications such as Acetaminophen (found in for example Tylenol) control pain without the unwanted inhibition of the inflammatory process. Of course, there are many other ways to decrease pain. See your physical therapist to learn about non-drug treatments for musculoskeletal pain.

Marcia Spoto PT, DC, OCS 

Duchesne E, Dufresne SS, Dumont NA. Impact of inflammation and anti-inflammatory modalities on skeletal muscle healing: from fundamental research to the clinic. Physical Therapy. 2017; 97 (8): 807-817.