Thursday, September 21

How the use of ibuprofen and other anti-inflammatories can be counterproductive

Every day when you wake up in the morning, or after exercising, your back hurts, or your knee hurts, and without thinking you take an ibuprofen. This is a normal gesture for many people. Inflammation is bad, so you have to control it with anti-inflammatories. However, several recent studies indicate that this is actually not a good idea, and that the shot of anti-inflammatories can backfire.

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Nonsteroidal anti-inflammatory drugs, or NSAIDs, are a category of drugs that we know by their formulas: ibuprofen, naproxen, diclofenac, and even aspirin, the lifelong aspirin. They are one of the most consumed drugs. It must be taken into account that back pain is the second chronic ailment in Spain, below hypertension, and that the usual prescription is these medications.

These anti-inflammatories are used to relieve pain, reduce inflammation, and lower temperature. They serve the same for a headache as for a painful menstruation, a sprain, or the muscular pains of the flu. But, despite its widespread use, even long-term, in recent years it has been highlighted in the scientific literature that its side effects are not negligible, especially in older people.

A recent review of studies lists these risks of NSAIDs when taken continuously:

  • Gastritis and gastric ulcer: it is estimated that up to 35% of ulcers may be caused by NSAIDs.
  • They affect the kidneys and can cause kidney failure.
  • They increase the risk of brain and heart attacks by up to two times.
  • They affect cognitive functions and increase the risk of dementia.

The well-known risk of ulcers and gastrointestinal problems is often attempted to be counteracted with acid-control medications such as omeprazole. However, it has also been seen that omeprazole and other similar drugs alter the microbiota and increase inflammation.

Why do we need inflammation?

Inflammation itself is neither good nor bad. Imagine that we have sprained an ankle, which begins to swell and hurt. This is the acute phase, right after an injury, and here inflammation is needed to bring fresh oxygen and nutrients to the affected tissues and organs and jump-start the healing process.

In this acute phase, the excessive use of anti-inflammatories can interfere with the natural healing process of the injury. In a meta-study with athletes NSAIDs, such as ibuprofen and naproxen, were found to reduce collagen mass at the site of injury. Collagen is precisely the tissue that the body needs to heal itself. As if that were not enough, NSAIDs reduce the production of insulin-like growth factora hormone that accelerates the healing and regeneration of tissues.

Although NSAIDs relieve joint pain and reduce inflammation in the short term for a couple of weeks, they also delay healing times and increase injury recurrence rates by up to 25%. The result is that athletes, even those who only exercise once a week, are able to return to activity more quickly, but in the medium term the injury returns, because that joint is weaker than before.

Even in the subacute phase, between two and six weeks after the injury, some inflammation is also necessary so that the healing process does not stop. The authors of the study go so far as to say that “they do not recommend the use of anti-inflammatories in muscle injuries, bone fractures or chronic tendinopathies.”

anti-inflammatories that inflame

Paradoxically, long-term use of NSAIDs can actually increase levels of low-grade chronic inflammation, which is the type of inflammation associated with cardiovascular disease, diabetes, and depression. NSAIDs work by inhibiting enzymes that regulate the production of prostaglandins, chemical messengers that trigger inflammation. However, a study has revealed that this could affect your body’s natural ability to manage inflammation, and lead to a state of chronic inflammation when treatment is stopped.

Don’t forget that runaway inflammation is also a problem. In the case of injuries to the joints, bones and muscles, if the inflammation is excessive or prolonged it can cause tissue degeneration. However, the expert authors of the studies cited above agree that nonsteroidal anti-inflammatory drugs should be used as directed by the doctor, and always in the short term, at most for one or two weeks, and only when there is excessive inflammation or unbearable pain. There are other well-known solutions to treat inflammation: keep the injured limb elevated, apply ice, apply compression, and also use supplements such as turmeric, vitamin D or omega-3, which are modulators (not suppressors) of inflammation.

In addition, physical exercise and especially strength exercises, with progressive loads Using pain as a measure of the effort we can make, they have been revealed as the most effective solution to recover from injuries and prevent them in the future. Taking ibuprofen pills as if they were candy to be able to function day to day is a patch that, in the long run, can take its toll on us.

* Darío Pescador is editor and director of the quo magazine and author of the book your best self Posted by Oberon.

What is all this based on?