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Nonsteroidal Antiinflammatory Drugs

 Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most prescribed medications worldwide.  In sports medicine, they are often referred to as performance “enabling” drugs.

 Common NSAIDs like Motrin, Naproxyn, Toradol, Voltaren and Celebrex can be administered orally, by injection or applied to the skin.  As opposed to steroids, the NSAIDs have fewer side effects and do not build muscle like androgenic steroid drugs.

 Inflammation is a normal response of the human body to injury.  NSAIDs are effective in treating headache, injured nerves, arthritis and painful chronic conditions.  In sports, NSAIDs are primarily used to treat acute muscle tears (strains), ligamentous injuries (sprains) and joint trauma (bursitis).

 The classic inflammatory response causes signs of swelling, elevated temperature, redness and pain that are readily apparent to an observer.  At a microscopic level, there is an intense cellular response where blood flow increases to the affected region allowing chemicals and white blood cells to leave the bloodstream and attack the injury.

 While the inflammatory response is essential to good health, it can cause damage if it becomes chronic. NSAIDs are designed to reduce inflammation by blocking the cyclooxygenase enzymes (COX-1 and COX-2) and subsequently halting the production of prostaglandins, essential components of the inflammatory response.

 Although NSAIDs have an analgesic effect, they reduce pain by altering the actual process causing the pain, as opposed to opiate drugs that merely block pain receptors.

 It is not uncommon in sports to have more than one ongoing injury.  NSAIDs do not target a specific injury and work at multiple areas simultaneously.

 Although generally safe, potential side effects of NSAIDs include stomach ulcers, kidney damage and elevation of blood pressure.

 In sports, where chronic musculoskeletal injuries are common NSAIDs have extended the careers of many athletes.   After consultation with a physician, NSAIDs may be able to keep you in the game.

 Anthony G. Alessi, MD, is Stroke Center Medical Director at The William W. Backus Hospital and in private practice at NeuroDiagnostics, LLC, in Norwich. E-mail him at aalessi@wwbh.org, or listen to his podcasts, comment on his blog or buy his book at www.backushospital.org.