Over the Counter NSAIDS, When and How to Use Them

Inflammation is a natural response to injury and illness. Here, Marci McLeod, MS, SCAT, ATC discusses what Nonsteroidal Anti-Inflammatories are, when to use them, and alternatives to taking them.

What are NSAIDs?

Over-the-counter (OTC) Nonsteroidal Anti-inflammatory Drugs, NSAIDs for short, are a class of drugs frequently used to treat mild to moderate painful conditions, such as menstrual cramps and soft-tissue injuries. They generally come in pill form and are taken by mouth. NSAIDs can reduce inflammation (anti-inflammatory), reduce fever (antipyretic), and relieve pain (analgesic). Therefore, NSAIDs are popular among athletes to relieve pain from conditions such as headache, inflammation, stiffness, and soreness.

Common OTC NSAIDs that can be found in nearly any store and are popular with athletes are:

NSAIDs

Generic Name	Brand Name	Typical Dosage	Recommended Use for:
Aspirin	Bayer	Every 4 to 6 hours	Signs of heart attack
Acetaminophen	Tylenol	Every 4 to 6 hours	Headaches, menstrual cramps
Ibuprofen;	Advil	Every 4 to 6 hours	Acute injuries, i.e., joint sprain or muscle strain
Naproxen	Aleve	Every 12 hours	Chronic injuries, ie. tendinitis

What are some side effects of prolonged use?

Over-the-counter NSAIDs are generally safe for healthy adults and children (follow children’s dosage on the label). However, with any drug, there comes a large amount of possible side effects. The most common side effect reported among athletes using ibuprofen or naproxen is gastric irritation and nausea. This effect occurs because these and similar NSAIDs are processed and broken down in the stomach. Those who take these regularly for several weeks or months could cause more adverse reactions, such as stomach ulcers. The most common side effect reported with long-term use of acetaminophen is liver damage because this NSAID is processed and broken down in the liver. It is especially important not to consume alcohol while taking acetaminophen.

What are alternatives to taking NSAIDs?

There are many inexpensive alternatives to taking oral medications for pain relief. Instead of reaching for the bottle of medicine, try using these suggestions.

1. Headache - can sometimes be the result of dehydration or poor nutrition. Try drinking a bottle of water and eating a snack before taking that Tylenol.
2. Menstrual Cramps - Heat application. Apply a hot pack to the abdomen and/or lower back, or take a hot bath.
3. Acute Injury - Cold application and therapeutic exercise. Apply an ice pack to the painful and swollen area for no more than 20 minutes, then move the injured area through a gentle range of motion. 
4. Chronic Injury - Heat and cold application, therapeutic exercise, topical creams, and massage. Apply a heat pack for 20 minutes to the sore area. You can also alternate heat and cold applications using 4 minutes of heat to 1 minute of cold for 20 minutes. You may also apply a topical cream such as Biofreeze or IcyHot and massage the sore area until it is fully absorbed. After each treatment, stretch the area through a full range of motion.

Here is a chart to summarize when to take an NSAID and when to use an alternative to promote healing while reducing the risk of side effects:

 

Marci McLeod, MS, ATC, SCAT, is the outreach Athletic Trainer for MUSC Health Kershaw Medical Center at Camden High School. Schedule an appointment with MUSC Health Sports Medicine.