Friend or Foe: Part II

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7788 4/10/99<br>NONSTEROIDALS DELAY BONE

HEALING?<br>Gabe Mirkin, M.D.<br>Doctors often prescribe aspirin

and nonsteroidal medicines to people who suffer pain

from surgery and injury, but they do not help you

recover faster from muscle injuries (1,2,3) , broken

bones, joint damage, surgery including joint replacement

(12) or muscle soreness after hard exercise (4)/ and

they can cause diarrhea, belly pain and bleeding.

<br>Nonsteroidals include aspirin, diclofenac, Anaprox, Lodine,

Meclomen, Motrin, Nalfon, Naprosyn, Ponstel, Relafen,

Toradol, Tolectin, Indocin and ibuprofen. They block

prostaglandins that cause pain, but are also the first step in

healing, so several papers show that what you gain in pain

control, you may lose in actually delaying healing (6,7).

Continued use of nonsteroidals delays bone healing (8), and

taken over several months, they can increase the rate

of cartilaginous breakdown in joints of people who

have osteoarthritis (9,10,11). <br>Taking aspirin or

nonsteroidals before an athletic competition can help you to

compete more effectively by preventing soreness during

exercise and they do not hinder strength, speed, endurance

or coordination (5), but taking nonsteroidals before

every workout can delay recovery and increase your

chances of injuring yourself by preventing clotting and

increasing bleeding. Nonsteroidals block pain, but they may

delay healing.<br>1) JN Howell, RR Conatser, GS

Chleboun, DL Karapondo, AG Chila. The effect of

nonsteroidal anti-inflammatory drugs on recovery from

exercise-induced muscle injury - 1. Flurbiprofen. Journal of

Musculoskeletal Pain 6: 4 (1998):59-68. <br><br>2) H Labelle, R

Guibert. Efficacy of diclofenac in lateral epicondylitis

of the elbow also treated with immobilization.

Archives of Family Medicine 6: 3 (MAY-JUN 1997):257-262.

3)JF Reynolds, TD Noakes, MP Schwellnus, A Windt, P

Bowerbank. Non-steroidal anti-inflammatory drugs fail to

enhance healing of acute hamstring injuries treated with

physiotherapy. South African Medical Journal 85: 6 (JUN

1995):517-522. <br><br>4) JN Howell, RR Conatser, GS Chleboun,

DL Karapondo, AG Chila. The effect of nonsteroidal

anti-inflammatory drugs on recovery from exercise-induced muscle

injury - 2. Ibuprofen. Journal of Musculoskeletal Pain

6: 4 (1998):69-83.<br><br>5) Roi GS, Garagiola U,

Verza P, Spadari G, Radice D, Zecca L, Cerretelli P.

Aspirin does not affect exercise. Int J Sports Med

1994;15(5):224-227.<br><br>6) Almekinders, L.C. and Gilbert, J.A. Healing of

experimental muscle strains and the effects of nonsteroidal

antiinflammatory medication. The American J. of Sports Medicine.

14(4):303-308,1986. <br><br>7) Alkemekinders. Aspirin Healing

injuries Am J of Sportsmed 1986;14(4): 303-308. 8) RD

Altman, LL Latta, R Keer, K Renfree, FJ Hornicek, K

Banovac. Effect of nonsteroidal antiinflammatory drugs on

fracture healing: A laboratory study in rats. Journal of

Orthopaedic Trauma 9: 5 (1995):392-400.<br><br>9) EC

Huskisson, H Berry, P Gishen, RW Jubb, J Whitehead. Effects

of antiinflammatory drugs on the progression of

osteoarthritis of the knee. Journal of Rheumatology 22: 10 (OCT

1995):1941-1946.<br><br>10) Lancet: September, 1989 Arthritis.<br><br>11)

Donnelly. British J of Sports Medicine.

1988;22:35-38.<br><br>12) S Sell, M Teschner, C Gaissmaier, F i, SA

Weidner, W Kusswetter. Is there any impact of diclofenac

on bone cells and their progenitors related to

arthroplasty? Zeitschrift Fur Rheumatologie, 1999, Vol 58, Iss

1, pp 13-20.s Teschner M, Univ Tubingen, Klin

Orthopadie, Hoppe Seyler Str 3, D-72076 Tubingen,

GERMANY<br><br><br>Health Topics from • The Dr. Gabe Mirkin Show • Box 10,

Kensington MD 20895

[Guest guest]

Intresting article...I may have to show it to my OS to see what he thinks.

Thank you....

[Guest guest]

Well, let me sum up what these doctors are

saying. Aspirin, IBU Profin, etc. can keep you from

healing if taken too much. Now, controling pain is one

thing. But, a lil' pain won't kill you, it'll just hurt.

Now, since you've been diagnosed w/ advanced stages of

CP, I suggest you should keep away from pain

medication as much as possible. When your knees hurt so bad

that falling over might happen, go ahead and take some

IBU Profin. Those aren't steriodal, so you won't be

affected body-wise. When you just experience everyday

pain, such as occuring sharp pains or just a lasting

pain or a " neadle " type pain, that I like to call,

don't get crazy and take anything. I have occuring pain

all the time, and I just keep on taking the

medication my doctor perscribed, which is an

anti-inflammitory. If you are taking those, make sure you take them

everyday or whatever your doc. has said. I don't take IBU

Profin. I've only taken it once, and that was when I

didn't have my medicine at the right time. So, in

conclusion, don't take any pain medication unless in extreme

and uncommon pain. Don't excercise. Only PT is

allowed. The most you are allowed, as most doctors say, is

walking, and that should be kept to a minimum. It's good

to keep your knees enough shape to walk, but

anything more is too much. Even brisk walking is bad. So,

please, don't over-do yourself, and keep medication like

aspirin out of you as much as possible.<br><br> -