Pain Killers and NSAIDs Do More Harm Than Good For Joint Pain and Tendon Injuries

Non-steroidal anti-inflammatory (NSAIDs) drugs are widely encouraged for use in the early stages after muscle or tendon injury, but according to a review in the Scandinavian Journal of Medicine and Science in Sports, they can do more harm than good, impeding recovery.

NSAIDs also negative affect electrolyte balance: Studies of endurance athletes using NSAIDs have found these drugs lead to greater risk of dehydration and hyponatremia, or dangerously low sodium levels.

Use of NSAIDs is rampant among athletes and there is limited awareness about the negative side effects of their use. For example, in a group of elite triathletes, 60 percent had used NSAIDs regularly in the previous three months prior to the study, and nearly 50 percent consumed an NSAID the day before a race.

There are two types of muscular injuries that are regularly treated with NSAIDs: 1) Classic muscle ruptures or strains and 2) muscle contusions.

A muscle strain occurs at the connection point between the muscle fiber and connective tissue of the tendon. Tendon injuries take a long time to fully heal because there is an intricate muscle-matrix reconstruction that is necessary to be good as new. Healing tendons can take as long as 12 weeks if not reinjured or overused—an extremely common problem, especially with the use of NSAIDs because the pain response can be blunted.

Contusions come from direct blunt force trauma to the muscle and are more common in contact sports. They lead to damage to the vascular system of the muscle, leading to a buildup of blood that causes a hematoma. A side effect of contusion injuries is compromised tendon strength because tendons have poor blood flow, meaning that waste products don’t get removed effectively.

NSAIDs get in the way of long-term tendon and muscle repair because they reduce the activity of satellite cells to regenerate—these are the cells that rebuild the connective tissue that joins your muscle with the bone. NSAIDs have been shown to blunt the muscle hypertrophy response by as much as 50 to 75 percent in animals, and we know that they suppress protein synthesis following a single bout of exercise.

In the short-term, NSAIDs have some benefits. NSAIDs may effectively decrease swelling and help get rid of adhesions on the tendon that have to be eliminated before the satellite cells can do their work.

The bottom line is that NSAIDs may be useful in the immediate period after an injury to blunt acute pain, but they will trip you up in the long-term. Additionally, there are natural solutions that can have the same anti-inflammatory effect, while not inhibiting full recovery.

Topical creams that contain curcumin or gotu kola have shown to get rid of inflammation, start the de-adhesion process, and increase blood flow to the tendon. Gotu kola has been shown to strengthen connective tissue and speed wound healing, while curcumin is probably one of the most effective anti-inflammatory nutrients you can take.