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NSAIDs: Should We Use Them for Mild Pain Relief?
Many of us use non-steroidal anti-inflammatory drugs, NSAIDs, regularly; some of us use them daily, and some use them prior to workouts on training days. Do they work? If so, how? Are these a good idea in terms of long-term health?
Here I’m talking about over-the-counter products like aspirin, ibuprofen (Advil, Motrin) and naproxen such as Aleve. Because they’re OTC, most of us assume they’re completely safe; heck, better than safe—your doctor may even have recommended a daily half-dose of aspirin to help stave off heart disease. But safe? That’s definitely not accurate, probably less that you might guess.
Pain Killers and Training
When we train, we purposely damage muscle tissue, the plan being for the amazing human body to repair itself stronger than it was before the workouts. This process actually works; the cells send a message to the CNS to start the healing process, and so it does.
However, when we take an NSAID for pain relief, the incoming chemistry destroys the prostaglandins, which are the chemical messengers between the damaged cells and the brain. This slows down the healing process, preventing the body’s best repair work. These cheap over-the-counter drugs literally hold back our training progress.
If occasional pain warrants, that’s one thing. But what about those who take the medications regularly, even preemptively? Does this sound like a good idea to you? That answer would have to be no.
Side Effects
What about dangerous side effects? Are these real; are they common?
- The prostaglandins that send the repair message also maintain the stomach lining, and when they’re destroyed by the NSAID drugs, this can damage the stomach lining and cause gastrointestinal bleeding.
- Regular use of both aspirin and Tylenol-like products are associated with increased risk of kidney failure—kidney failure, as in stuck in dialysis a few days a week, heading for a wait on the organ transplant list.
- Acetaminophen is the most common cause of liver failure here in the US.
- Aspirin thins the blood. This can be really bad if you’re bleeding and can’t get it to stop. In fact, pre-surgery instructions include specific directions to discontinue aspirin use a few days before surgery. By the way, fish oil is also included in the “discontinue†category for the same reason.
- Back to the doctoring with low-dose aspirin to protect against heart attacks—he or she told you to take an 81mg aspirin daily, and you’ve been doing it ever since. Unfortunately, the recommendation is no longer in vogue, but you may not have been back to that physician, or perhaps the doc forgot to bring it up again. It turns out the follow-up studies did not confirm the original work, and aspirin is now out of favor as a daily therapeutic protector. In fact, high-dose NSAIDs may even elevate the risk of heart attack. According to Doctor Mike Nichols, NSAIDs increase the chance of heart attacks more than 15% if there’s cardiovascular disease, and since most people who have CV disease don’t know it, this is meaningful.
And of course, all the general-population side effects change, sometimes drastically, when these pain killers are combined with other OTC or prescription drugs, or if taken by people with existing problems such as coronary heart disease or kidney or liver problems.
When most people read the above list of serious medical issues, human nature kicks in real fast, and we think, “That won’t happen to me.” Fair enough, maybe it won’t. But what about the less-serious cellular chemistry conversion that’s happening every single time? Sure, taking a pain killer for occasional pain isn’t a big deal, but is down-graded tissue repair something you want happening in your system regularly? Probably not. Those of you taking an Aleve before or after your workouts to stave off a mild case of DOMS would be far better served by a mouthful of branch-chain amino acids to help the system rebuild.
Dumping a half-dozen aspirin and chewing them for quick relief may be the hardcore musclebuilder way, but we’re in this gig for long-term health, too, and that picture of macho man is no longer working.
on April 8th, 2010 at 7:15 am
I have been taking 81 mg aspirin every morning for the last seven years. Three years ago I was diagnosed with stage II colon cancer. The way I discovered I was sick was I became extremely tired after only ten minutes on the treadmill. This was as a result of being anemic. My doc said taking an aspirin daily may have unmasked my cancer early by causing bleeding, which resulted in an early diagnosis. I’m having a physical in June and I will ask my doc if I should continue taking aspirin daily. Thanks for the post. – Mike
on April 9th, 2010 at 6:53 pm
I would worry more about the stomach, than anything else… Also sometimes the deep pain
will exceed the need to be wary..
Always in moderation. Live long and prosper.
Pray to Jesus to heal our nation!
on April 12th, 2010 at 1:35 pm
NSAIDS. I do use them, but rarely. Maybe i’m a fine specimen or something….I have put some serious sorness in the muscles these past few years. No pain no gain…Who said that!!!
It’s not pain… it is communication. ahha there is a muscle there…look at that! i think as we get older we learn to live with pains, all different kinds, from toe acks, to heart acks, to head acks and all things there in. I’ll use an IBPROFIN (spelling!) when I’m swollen and I get what I call a DOMS after shock. The drugs do appear to help ease the swelling, but most importantly; take a lesson, easy does it. Other than that this is what I do for muscle soreness. Foam roll & rolling pin, I rolls out the muscles that are soar, works good for the legs (IT bands especially) lower back. Yea I said Rolling pin, the pastry thingy that my grandma used when makeing her killer pies. My wife will use it to roll out my back and side. works real good at rolling out the beach wear (biceps). It hurts like hell at times, but it works, Good for the marriage too, must be so sweat to my other half (all the TIME) escpecially when I hand her a rolling pin and ask her to use it on me! Followed up with, ( now this one is so old no one would think of it) A hot epsom salt bath right after the hot, heavy rolling about with my wife. Remember to hydrate wilist soaking and afterword. crawl into bed and sleep comes sweetfully quick.
Other considerations; morning post bombing….Move slowly!
Have been varying active recovery excercise times streach polaties. right after bombing. I mean time it so to finnish the last rep of the last set and go straight up to the room and do an hour of streach polaties. it really stings but my recovery times are less and the DOMS is not so bad. A couple of easy laps in the pool right after work out instead of streach polaties is a nice diversion.
Some have sugested cold therapies…no way I live in Canada enough of cold!
Other than that. for me; it is suck it up this stuff is hard, pain is irrelivant!
on April 14th, 2010 at 11:11 pm
I’m 47 and have had occasional heart palpitations all my life. They’re not life threatening but the first ones can be scary until you find out what they are, a temporary skip in the normal rhythm. Sometimes dehydration can be the culprit (too much caffeine and not enough potassium), which the doctor said was quite common. I made sure I drank adequate amounts of water and never had any serious flutters for a long time. Two years ago, after greatly increasing my workout intensity and duration, I had a palpitation during exercise that was the worst to date. Knowing what it was, I didn’t go to the doctor, I just upped my potassium and continued on. With all the talk about aspirin, I also began taking one with my daily supplements.
For a while everything seemed fine until the palpitations came back again. I did some research and discovered that aspirin can lower your potassium levels. I stopped taking the aspirin about 6 months ago and haven’t had a reoccurrence since.
on May 27th, 2010 at 4:38 pm
Excellent article and commentary. I was recently speaking to a renal specialist and she indicated that a significant number of dialysis patients across the U.S. are requiring treatment not because of genetics or renal disease, but because their kidneys have been damaged over time by regular use of NSAIDs.
For full disclosure, I am biased and am the maker of StayActiv (a fast, effective and non-toxic anti-inflammatory alternative to ibuprofen and NSAIDs).
The prostaglandin effects of these COX inhibitors like aspirin and ibuprofen and naproxen is quite counter-productive to healing, as you say…and in multiple ways…not only in terms of the reduced muscle repair (reduced protein synthesis) but also from impairment of bone health/healing and also tendon and ligamant repair from interrupted tenocyte function. NSAIDs also increase oxidative stress and therefore act as an “anti-anti-oxident” which is very poor for overall health and systemic inflammation / cellular damage.
Thanks again for focusing on this important topic.
Mark Faulkner
VIREO SYSTEMS, INC.
PROMERA HEALTH, LLC
on July 15th, 2010 at 12:33 pm
I’m not for using NSAIDS just to ease muscle soreness post workouts. But NSAIDs are not all that bad as you say they are, as they are effective for people suffering from arthritis, tendonitis, fever, headache etc who can’t exercise because of their condition. Also side effects on the stomach can be reduced by taking misoprostol or omeprazole along side the NSAID. Also if the risks of using them are so large they wouldn’t be sold over the counter and on supermarket shelves. I’ve had tendonitis for about 8 months now on my wrist and knee and have been using diclofenac with no problems at all and has allowed carrying on my triathlon training.
on August 30th, 2010 at 9:13 am
Oh my, very informative.. i’ve been taking aspirins and pain killers whenever i feel something. My mom used to give me alot of those when i was a kid and didn’t fairly knew that it really had some side effects in the long run.. hopefully i won’t suffer any bad condition later in my life