Is your pain reliever keeping you in pain?

Advil is one of the most frequently taken pain relievers and a favorite among athletes.

I did it for years, several times a day, almost every day.  Every time I had an ache or a pain I’d reach for it.  I kept giant 300 count bottles in my medicine cabinet.  Yes, that’s right, I said bottles…as in more than one at a time.  I’ve been an athlete my whole life and, like most athletes, no matter what the ache or pain Advil was the answer.

Advil belongs to a class of drugs called NSAIDs or Non-steroidal anti-inflammatory drugs that are often used as a treatment for the pain of an injury but they can also be used to reduce swelling caused by inflammation.  Examples of common over the counter NSAIDs include aspirin (Bayer), ibuprofen (Advil, Motrin), and naproxen (Aleve).

Injuries to our tissues cause the release of prostaglandins, chemical messengers that cause inflammation, pain, and increased blood flow via dilation of blood vessels.  NSAIDs work to reduce pain and swelling by blocking the production of prostaglandins.  Nobody wants inflammation, pain, and swelling when they are injured and this is what has caused NSAIDs to become such a popular drug.

But, as unpleasant the presence of prostaglandins may seem, they are a necessary component of the healing process.  Inflammation is your body’s way of bringing blood and nutrients to the area of the body that needs healing and pain is our body’s way of telling us when we’ve had enough and should rest.  Our bodies need prostaglandins to recruit the cells to remove cellular debris caused by the injury and build new tissue to heal the injury.  A common misconception is if we stop the inflammation in an injured tissue, the tissue will be healthy because healthy tissue is not inflamed.  However, NSAIDs block the function of prostaglandins and therefore delayed the healing process in all the soft tissues including muscles, ligaments, tendons, and cartilage.

Evan needed 3 pins to set the fracture in his finger.

But it doesn’t stop there.  Yesterday my husband had to have surgery to repair a broken finger.  As we were being discharged the doctor specifically told him to avoid taking NSAIDs like Advil or Aleve.  When I asked the

doctor why, I was not surprised by his answer.  It turns out the same mechanisms your body uses to heal soft tissue injuries also apply to the regeneration of new bone.

The process of bone fracture healing can be divided into four phases: immediate, early, regenerative, and remodeling. The immediate phase alerts your body to the injury. The early phase, characterized by inflammation, creates the pain and swelling associated with the fracture and is critical to successful fracture healing. The prostaglandins produced by the body in the early phase are essential in sustaining the healing process until the bone is completely healed.  The regenerative phase occurs when the fracture is bridged with new bone, and the remodeling phase is when the newly generated bone is replaced with mature bone to restore strength and integrity.

When NSAIDs are taken after a break or a fracture bone healing is inhibited because the activity of bone-building cells, called osteoblasts, is not supported by the presence of prostaglandins. Without prostaglandins, osteoblasts can still make new bone, “but not as robustly,’’ said Dr. Thomas Einhorn, chairman of orthopedic surgery at the Boston University School of Medicine.  The result, a bone that isn’t quite as good as new.

As it turns out the old adage is right — no pain, no gain.  When we use NSAIDs to block prostaglandins in an attempt to keep ourselves from feeling the pain of an injury, we are in fact stopping the healing mechanisms of the body.  Inflammation is a necessary process that increases blood flow to deliver nutrients and recruit the necessary cells to clean-up and rebuild to the area of the body that has been injured.  Pain is our body’s way of telling us it is time to let that area of the body rest.  Any medication that inhibits the inflammatory process in turn inhibits the body’s ability to heal itself.

So, what to do if you become injured?  Here are some great strategies that support your body in the healing process:

  • Rest the injured area and give it a chance to rebuild.
  • Keep the rest of your body moving.  Movement encourages blood flow and blood is what delivers all of the vital components needed to heal your injury.   As a bonus, movement creates endorphins which are natural pain relievers.
  • Ice the injured area.  Nothing works to relieve pain and reduce uncomfortable swelling quite like ice.  It is almost like magic!
  • Elevation and compression.  Both work to relieve uncomfortable swelling and reduce pain.  Simply raising the injured area above the level of your heart assists your body in maintaining adequate blood flow and reduces pain.  Compression supports the injured area which also reduces pain.
  • Go outside and get some sunshine.  Sunlight stimulates your body to synthesize Vitamin D which accelerates wound healing.
  • Eat your fruits and vegetables.  Vitamin C from whole foods also accelerates the healing process.  Dark green leafy vegetables contain the necessary minerals to rebuild bone and soft tissue.
  • Drink plenty of H2O.  Injuries create a ton of cellular debris that need to be cleared away and excreted.  Being well hydrated supports your body in getting rid of all that junk.

Sources:

http://www.medicinenet.com/cox-2_inhibitors/page2.htm

http://www.endurancecorner.com/Larry_Creswell/NSAIDs

http://www.chiro.org/LINKS/FULL/NSAIDs_and_Musculoskeletal_Treatment.html

http://www.caringmedical.com/sports_injury/nsaids.asp

http://www.arthritis.org/nsaids-fracture-healing.php

http://articles.boston.com/2009-06-22/news/29265257_1_bone-healing-osteoblasts-low-dose-aspirin

http://www.ncbi.nlm.nih.gov/pubmed/12953337

http://www.naturalnews.com/021797.html

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One Comment on “Is your pain reliever keeping you in pain?”

  1. Great Post Kathryn!! It had it all, education, excitement (sorry Evan), and an easy to remember point, well done. -Dr Nick.
    Give Evan our best

    Awesome post Kathryn!! It is so obvious that you are so at home in this position…and that it comes so naturally for you. Love you! -Jen


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