Non-steroidal anti-inflammatory drugs in sports medicine: guidelines for practical but sensible use: Table 1

Abstract

Introduction:Non-steroidal anti-inflammatory drugs (NSAID) are commonly used in sports medicine. NSAID have known anti-inflammatory, analgesic, antipyretic and antithrombotic effects, although their in-vivo effects in treating musculoskeletal injuries in humans remain largely unknown. NSAID analgesic action is not significantly greater than paracetamol for musculoskeletal injury but they have a higher risk profile, with side-effects including asthma exacerbation, gastrointestinal and renal side-effects, hypertension and other cardiovascular diseases.Discussion:The authors recommend an approach to NSAID use in sports medicine whereby simple analgesia is preferentially used when analgesia is the primary desired outcome. However, based both on the current pathophysiological understanding of most injury presentations and the frequency that inflammation may actually be a component of the injury complex, it is premature to suppose that NSAID are not useful to the physician managing sports injuries. The prescribing of NSAID should be cautious and both situation and pathology specific. Both dose and duration minimisation should be prioritised and combined with simple principles of protection, rest, ice, compression, elevation (PRICE), which should allow NSAID-sparing. NSAID use should always be coupled with appropriate physical rehabilitation.Conclusion:NSAID are probably most useful for treating nerve and soft-tissue impingements, inflammatory arthropathies and tenosynovitis. They are not generally indicated for isolated chronic tendinopathy, or for fractures. The use of NSAID in treating muscle injury is controversial. Conditions in which NSAID use requires more careful assessment include ligament injury, joint injury, osteoarthritis, haematoma and postoperatively.

Human inflammatory and resolving lipid mediator responses to resistance exercise and ibuprofen treatment

“…105). The use of NSAIDs is common among elite athletes (37,101), in the clinical treatment soft tissue injury (67), and in efforts to relieve the muscular soreness that follows intense or unaccustomed physical activity (44). The efficacy of such interventions has, however, been brought into question, and concerns have been raised regarding possible long-term negative implications on muscle growth and regeneration (78).…”

Effect of an acute dose of omega-3 fish oil following exercise-induced muscle damage

“…While physical therapies have shown some success in alleviating symptoms of EIMD, nutritional supplementation is also widely used to facilitate recovery following EIMD, with a number of studies considering the efficacy of non-steroidal anti-inflammatory drugs for example (Bourgeois et al, 1999;Paoloni et al, 2009). Omega-3 fish oil is a supplement which has increased in popularity as it has potent anti-inflammatory effects and is associated with a lower risk of coronary heart disease (Hu et al, 2002).…”

Sternal stress fracture in a gymnast: A case report and literature review

“…10 Unless their use is contraindicated, non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for alleviation of pain and inflammation in impingement injuries, tenosynovitis and inflammatory arthropathy. 12 However,…”

“…Paracetamol is recommended for acute and chronic musculoskeletal pain. 12 Absence from further training is mandatory for healing and preventing complications. Preventive measures may incorporate neuromuscular training programmes to enhance proper skill mechanics.…”