When Anti-Inflammatories Can Cause You Pain

I understand that the headline to this article is a little provocative. You're probably sitting there wondering - “wait, what?!”

Now, before I get a Cease and Desist letter from a big Pharmaceutical, let me explain what I mean.

Anti-inflammatory medication is used to reduce pain caused by inflammation as a result of immediate trauma. Examples of such injuries include twisting your knee while hiking, pulling a hamsting while playing football or hurting your back lifting a heavy object - any injury where pain is caused by an accident at a point in time.

Reducing pain by taking anti-inflammatories sounds like a good thing. And sometimes it is. But in many cases it isn’t. There are two reasons why, and if you take anti-inflammatories regularly then you must read on..

Reason One: Anti-inflammatories treat the symptoms, not the cause

When you take anti-inflammatory drugs, all you’re really doing is blocking a symptom, you're not fixing the problem.

Consequently, once you stop taking the anti-inflammatory, the pain will most likely come back because the problem with your body that is causing the inflammation the first place hasn’t been addressed.

If your pain/inflammation has been going on for three months or more, the chances of having a permanent, chronic problem sky rocket. We see if often in our clinic. I’ll give you a common example.

Example of pain caused by anti-inflammatory medication:

Patient A presents with a 6 month history of lower back pain which came on after moving house and shifting heavy furniture. So they took some anti-inflammatories and after a few days the pain went away, so they stopped taking them.

A day or two later, the pain came back. So they took some more anti-inflammatories and the pain went again.

This cycle repeats itself until finally six months later the patient presents for treatment because the anti-inflammatories are having less of an effect, and the back pain is still there. The reason for this is that now 6 months later, the mechanical problem is very entrenched.

A bulging disc in the lower back which was caused by the original injury has been repeatedly stressed and “re-bulged” time and time again because of muscular weakness and poor movement control.  The anti-inflammatories have masked this problem until it’s more than just inflammation causing the pain, and now we have a major back injury to deal with.

There are even changes in pain-pathways and pain perception that can cause pain even after the physical injury has healed. If Patient A hadn’t masked his symptoms in the first place, he would’ve taken it easy until the disc healed, and if it hadn't gotten better within a few weeks due to the fact his injury needed the help of Physio intervention, he would’ve sought help and had the problem fixed!

Reason Two: Our bodies need inflamation to heal

Yes, inflammation is a crucial part of the healing process. When tissues in our bodies get damaged, cells break and chemicals in the cells trigger inflammation. Inflammation has several, crucial roles.

The first is to cause pain and this is a good thing. Pain is what convinces you to stop using the injured body part so that it can heal! The inflammation also acts to attract the cells that clean up the broken, dead material, and also attract the cells to repair the broken part.

Yes we still want to limit excessive swelling with the RICE process (rest, ice, compression, elevation), but we don’t want to stop inflammation in the first two to three days because it’s crucial to get a strong and effective healing process.

Evidence has also shown that anti-inflammatory side effects include an increased risk of stroke, and have a whole host of other nasties, so why would you ever want to take them?! There are of course good reasons, but you should always be guided by an expert who fully understands your body and your pathology.

For arthritic conditions, anti-inflammatories are needed to suppress symptoms for quality of life. In some injuries where inflammation lingers after it’s needed and causes altered movement patterns, anti-inflammatories can be very useful at restoring normal movement, as this unloads the injured tissue so it can heal.

But the bottom line?

Don’t just buy over-the-counter anti-inflammatories if you’ve hurt yourself. Understand that the pain is your body telling you to rest it. Return to normal movement and activities as soon as possible, and if you can’t do this within a week – seek help! Come in for a Free Initial Assessment for our help and guidance for optimal lifelong physical health.

Further reading:

Best Health Victoria has further advice about side-effects and dangers of anti-inflammatories.
And more specifically when it comes to increasing risk of stroke.

Nathan Rickard - Physiotherapist and Director, Back In Motion Hawthorn

Nathan is a Physiotherapist who believes in physical rehabilitation to optimize the mechanics of the body.  This is what gets great results, not just a quick fix.  He is also focused on holistic health and fitness, which not only cures injuries, but prevents future injuries and poor health that is a symptom of our modern “sit down” lives.  More specifically, he has a special interest in lower back pain, knee and ankle injuries, running and exercise related injuries and running and sports-specific movement analysis. He practices what he preaches with a balanced gym, running and Clinical Exercise program.