Q: I’ve been dealing with on-and-off back pain for the past several months. My buddy suggested that I take 800mg of to reduce inflammation. This seems like an awful lot, and in my heart I just know it’s not a good thing. Is this contraindicated?
A: I’m not a fan of non-steroidal anti-inflammatory drugs (NSAIDs) for a variety of reasons:
NSAIDs drastically reduce post-exercise protein synthesis (1,2); as we all know, that’s a big no-no in the quest to get big n’ strong. I know individuals who have lost appreciable amounts of lean body mass and strength with even short-term reliance on NSAIDs. They noted markedly decreased recovery ability and performance in the gym.
I don’t need to tell you that they can do a number on your stomach in the long-term (and possibly the short-term).
Often, the NSAIDs are just providing symptomatic relief; in other words, they just mask the pain instead of actually reducing the causative inflammation. It’s a double-edged sword; on one hand, no one wants to live in pain, but on the other, one wants to know whether the underlying problem is actually getting better or not.
There are also psychological implications; most people will think that they’re getting better and thus want to jump the gun on doing things they shouldn’t even consider trying with their injury. Everything gets compounded, there are cookies missing from the cookie jars, the neighbor’s daughter is knocked up, and the mattress tags are nowhere to be found. It’s just a big mess…
As an interesting aside, there’s evidence to suggest that NSAID usage can lead to moderate sedation and transient impairments in cognitive and motor performance. In a study of 72 college-aged men, subjects that received 200 mg ibuprofen “performed significantly less well on a simple tracking task and made significantly more errors on a simple reaction-time task than the other two groups;” hand-eye coordination was clearly impaired (3).
All that said, each case is unique. NSAIDs certainly have a place in acute inflammation scenarios, as in the case of a traumatic injury or the initial onset of tendonitis. Kill down the inflammation with very high doses, and you can get into the initial stages of physical therapy much sooner. Ten to fourteen days should be the max; if it doesn’t work by then, it isn’t going to work, as there’s likely a more significant underlying problem than just
In your case, we’re dealing with a chronic situation. Based on how chronic your pain seems to be, I’d wager that it goes beyond just a little irritation. Unfortunately, many doctors are trigger happy with the cortisone shots and NSAID recommendations, so correcting the underlying problem (e.g. poor posture) takes a back burner to making everything feel better (even if it’s not!). Ultimately, the decision is up to you, as only you know how (in)tolerable the pain is. Whatever you do, make sure that you a) keep NSAID usage to 10-14 days and b) work to correct the underlying problem. Some other valuable implements for combating inflammation are high-dose fish oil supplementation and antioxidant therapy. I’ve heard mixed results regarding Wobenzyme and acetyl l-carnitine in cases of inflammation, so buyers beware.
Best of luck in getting back to pain-free training as soon as possible!