NSAID’s: Adding Insult to Injury

Fact: When an injury is sustained, the natural reaction of our body is to produce an inflammatory response directly to the area. This is an essential characteristic of the healing process. Without inflammation, the injury would simply never heal.

So if that is a fact, why is our natural response when injured to immediately REDUCE inflammation by slapping on some ice or taking handfuls of NSAID’s (Non-Steroidal Anti-Inflammatory Drugs)? This may be one of the primary reasons your acute injury has become a chronic one.

One of the most intriguing aspects about why I got into massage therapy was learning about the body’s ability to heal itself. With a little added assistance through the use of manual therapy, a therapist has the capability to facilitate the natural healing process of the body.

Most of us will take NSAIDs with the goal to reduce pain, however, at what cost are we popping these pills? To understand the importance of how taking NSAIDs may impact your health, I will try to explain how they are actually working.

When we pop an ibuprofen, you are blocking the release of COX1 and COX2 enzymes. These enzymes play a key role in the production of prostaglandins, the chemical that is released when the tissues are damaged. Prostaglandins cause the tissues to swell.

So you may be thinking; what’s wrong with that? Isn’t this what I want to happen? Well, Yes….and No. Prostaglandins are ALSO produced to protect the lining of the stomach and GI tract. Since NSAIDs block COX-1 enzymes they slow down the manufacturing of this vital prostaglandin. This is why your GI tract may become irritated and damaged if proper dosing is not observed. It may cause gastrointestinal bleeding and ulcers.

NSAIDs also reduce the blood flow to the kidneys, which makes them work more slowly. When your kidneys are not working well, fluid builds up in your body. The more fluid in your bloodstream, the higher your blood pressure may rise. Taking high dosages of NSAIDs can damage your kidneys, eventually leading to kidney failure and require dialysis.

There is another type of prescription NSAID that only blocks Cox-2 enzymes. Cox-2 inhibitors only affect Cox-2 enzymes and not Cox-1. Cox-1 and Cox-2 enzymes are naturally in balance in our body. By blocking one and not the other, unforeseen things may occur. By offsetting this balance, you could place yourself at serious risk for heart attacks since the level of COX-1 enzymes go unchecked.

Ultimately, my experience has shown me that most of us take these NSAID’s to reduce pain first and the anti-inflammatory effects are just a ‘bonus’. If you truly want to reduce the pain you feel, but also want to allow your body to efficiently repair the damaged tissue, I would suggest using some ice for no longer than 10 minutes at a time. In a previous blog I discussed the new research behind why R.I.C.E. (Rest Ice Compression Elevation) is no longer the recommended protocol when treating acute injuries. However, the use of ice in short duration to reduce pain is still recommended in acute situations.

The next time you suffer an acute injury, or even feel the need to reduce pain, I would strongly consider the use of ice, kinesiology tape or a topical analgesic such as Biofreeze that will offer you the same relief (for shorter periods) as well as not interfere with your body’s need to repair.

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