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Health & Medical UnderGround >> NSAIDS=bad??

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7/11/09 12:43 AM
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TEOMOFE
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I had a boo boo tonight. At the insistence of my gf, I took some NSAID's (Panafen - codine + ibuprofen).

NSAID's have never really made sense to me. If the site is injured, then sure as heck you want blood pumping in there to remove detritus, esp considering ligaments are virtually avascular.

Now, I can understand the argument for preventing chaotic collagen meshwork formation, so stretching / traction sometime after injury makes sense...but NSAIDs seem to work directly opposite to the body's healing mechanism. What's more...long term NSAID use might actually (in theory) lead to ligament weakening

So - I dunno. Other than pain relief, NSAID = Crap

Agree or disagree?

(OTOH, Pharma 101 was some time ago, so...I'm probably forgetting something obvious)
7/11/09 3:08 PM
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WidespreadPanic
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Edited: 07/11/09 3:08 PM
Member Since: 12/29/06
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You don't say what the injury was. NSAIDs have a place, probably, but mostly for pain relief for specific types of injuries.

The mechanism is interruption of the prostaglandin pathway, so if you need clotting (i.e. an open injury) then something else may be indicated. (Prostaglandins act as messenger molecules in the process of inflammation, and NSAIDs inhibit them).

So muscle strain or DOMS, or headache, they may be indicated. Severe contusions, bruising, open wounds, probably not indicated.
 
7/11/09 3:25 PM
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TEOMOFE
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Fwiw -

Hyperextended elbow


My understanding is - NSAID's reduce the swelling (which leads to lesser pain). OTOH, doesn't this increase the time taken to heal?

Wouldn't a simple painkiller be a better bet from hyper-extension injuries?

(Genuine question)
7/11/09 3:43 PM
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WidespreadPanic
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Rest, Ice, Compression, Elevation and maybe aspirin if the pain keeps you from sleeping. Did you see your MD? Ever had this condition before? How severe was the hyperextension? Swelling, redness, heat?

Your question is 'does this increase the time needed to heal?' isn't specific enough. If you plan on taking more than the suggested dose for days on end, it might. Using NSAIDs overnight to allow sleeping for a day or two will probably have little deleterious effect on healing.

If your injury is severe and the pain is severe, see your MD.

$.02

7/12/09 6:37 AM
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TEOMOFE
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Edited: 07/12/09 6:38 AM
Member Since: 2/9/09
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Well, the injury was minor, so that's no drama.

In anycase, I'm much more interested in the rationale for using NSAID's with athletic injuries.

If as you say prostaglandin etc are released, which accumulate and lead to pain/swelling, why would one want to slow down the removal of them with NSAIDs?

(I'm aware that some time needs to be taken to splint the injured area to prevent further injury and promote orderly collegen reproliferation)

Further, wouldn't a reduction in swelling lead to a kind of 'log-jam', that may be potentially injurious to full regeneration?

Seems silly to me (mask the symptoms but at the same time, increase the healing time) but I might be misunderstanding something

One could make a similar comment about Ice and Compression (but less so about Rest (prevents reinjury) and Elevation (help reduce odema / increase drainage)

Just tryin' to sort out the sense of it all. Any ideas?
7/13/09 2:02 PM
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WidespreadPanic
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 Though it's true that inflammation is accompanyied by actions designed by the body to enable repair, it can sometimes go too far. As you know flu and cold symptoms are just due to the body's inflammation response, swelling of the nasal passages, congestion, and other symptoms. What the body is trying to do, apparently, is raise the heat in the nasal passages to allow the body to fight the infection closing them off and raising blood supply.

But this is not always desired, as in the case of a minor contusion or a headache. For the person, it's better to, they perceive, to reduce the swelling and symptoms. It might delay healing, but it's a trade-off for them.

In the case of a head cold, it's going to run the course, so taking anti-histamines and cold remedies probably do reduce the suffering. For the person, reduced suffering is probably worth the slightly prolonged healing.


7/13/09 5:34 PM
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martinburke
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^^^ I think that's probably right. During the acute phase of injury, inflammation can be excessive and non-specific.

Ice is sometimes used in manual therapy to coax collagen into healing with the grain of the tissue, and not so much in a chaotic meshwork. The ice(frozen in a paper cup which is then peeled back to expose the ice edge) is used in the same manner as a massage tool, working with the grain of the injured tissue.

At the same time, the ice is reducing swelling. Some clients seem to get more pain relief from ice and not from heat, but they're in the minority, it seems.

Not the most pleasant thing in the world, but it seems to work pretty damn well.

After the acute phase has passed, cross-fiber friction can be used on ligaments to engage the inflammatory process in a controlled manner.
7/27/09 12:42 AM
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MMADC
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I use ibuprofen cream for injuries such as the one you initially posted about. I have found them to be one of the most reliable ways of relieving pain without prescription meds. I rely on ibuprofen cream myself and feel as though I wouldn't be still doing MMA training without it.
9/7/09 10:23 PM
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AFTC
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NSAIDS are extremely hard on your kidneys. My Ortho never mentioned this and has given me lots of them over the years. (kidney disease runs in my family) So now I only use the tylenol and tap quickly.
9/10/09 12:57 AM
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cuzz63
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I have Kidney damage and the only thing I can account for it is long term use of Ibuprofin.

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