Non-steroidal Anti-inflammatory Medications (NSAIDs)
Non-steroidal anti-inflammatory medications (NSAID's) are used to treat swelling around and within joints. The benefit in using these medications is the reduction of swelling within tissues that causes the pain following injuries and surgeries. Reducing the amount of swelling will have a direct impact on the amount of discomfort that is caused. The use of these medications has recently increased substantially. New preparations of these kinds of medications have been developed and are having an increasingly beneficial effect for most people while simultaneously reducing the side effects that they cause.
The original medication in this class of drugs is aspirin. While aspirin is still used as an anti-inflammatory medication its large number of side effects and less specific affect on inflammation and swelling makes its use less common today. Today the most common anti-inflammatories used are ibuprofen and naproxen. These go by the trade names of Advil, Motrin IB, and Aleve. These medications are sold over the counter at lower than prescription levels and are sold primarily for their pain relieving effect. At these doses they cannot be assumed to have anti-inflammatory effects. Other NSAID's include Relafen, Lodine, Voltaren, Celebrex and Vioxx. These newer generation NSAID's have been developed to reduce GI side effects; however the risk of these side effects has not been completely eliminated.
NSAID's work to inhibit the production of prostaglandins. Prostaglandins are the primary mediators of inflammation and swelling. While this sounds simple, prostaglandins also have other beneficial effects within the body, including protecting the lining of the stomach. While inhibiting prostaglandin production, NSAID's will lessen the protective effect that they have in the stomach. This is the reason that the primary side effect of NSAID's is an upset stomach and possibly some nausea.
These gastrointestinal (GI) side effects can occur in approximately 7% of individuals and are rarely severe and usually reversible. More serious side effects occur from continual usage of NSAID's or in individuals who have previous history of significant GI ulcer disease. For this reason, it is appropriate to monitor kidney and liver function with long-term use of NSAID's and to be very judicious in use of NSAID's in people with ulcer disease.
Use of these medications in treatment of musculoskeletal injuries is usually done for short periods of time. The use in this situation is safe, often effective and a common adjunct to standard physical therapy or activity modification treatments. Use of NSAID's for longer periods of time is often done for systemic arthritic problems or degenerative joint diseases. In these settings, surveillance of kidney and liver function as well as care to be sure that exacerbation of existing ulcer disease problems do not exist, is important.