Posts tagged NSAIDs
Non Steroidal Anti Inflammatory Drugs for Sciatica
NSAIDs-anti inflammatory drugs-Sciatica-treatment

Our previous posts have documented the success of Physical Therapy treatments on sciatica, radiating pain down the back of leg, compared to other conservative treatments and surgery.  Specifically, no differences have been noted between surgery and PT at long term follow up.  Another medical intervention for sciatica includes non steroidal anti inflammatory drugs (NSAIDs).  These are one the most common medications prescribed for sciatica and a recent study sheds light on their lack of effectiveness of this condition.

Authors in the Spine Journal updated a review article including all research papers documenting the effectiveness of NSAIDs on patients with sciatica (Rasmussen-Barr et al. 2017).  The authors included 10 papers including 1651 patients with sciatica who were prescribed NSAIDs for their symptoms.  The authors found minimal support for the use of NSAIDs for symptoms of sciatica and some evidence showing the effects on NSAIDs were equal to the placebo pill condition.  The authors also described the higher rates of adverse effects in patients taking NSAIDs over a placebo pill.  

These minimal benefits and higher risks must be considered when utilizing NSAIDs for sciatica symptoms.  Patients are encouraged to meet with their local PT for the effective treatment of sciatica symptoms.  

Ibuprofen's Impact on Muscle Growth and Development

Non Steroid Anti Inflammatory Drugs (NSAIDS) such as ibuprofen are the most common drugs listed on our patients intake paperwork.  Patients are often using these drugs due to their beneficial effects on pain and inflammation.  Due to being sold over the counter these drugs are often thought to be free of side effects, but they lead to close to 80,000 hospitalizations and 8,000 deaths due to gastrointestinal bleeding.  In addition to these serious consequences, NSAIDs are also thought to delay or prevent healing after acute ligamentous and bone injury as well as reduce the beneficial adaptations to exercise.

A recent article in the American Journal of Sports Medicine studied the impact of NSAID use on the effects of an exercise program (Rooney et al. 2016).  The authors conducted an animal study placing animals in either an exercise or sedentary group.  Within each group half of the animals were placed on NSAIDs and were followed over the 8 week course of exercise.  The authors found the NSAIDs did not impair the beneficial mechanical adaptations to exercise such as stiffness or tissue quality, but did decrease the cross sectional size of the muscle.  The results of the study suggest the animal's medication use attenuated the normal growth of the muscles in response to the exercise.    

This study adds to the existing literature on the impact of NSAIDs on healing and adaptations to exercise.  Patients are advised to speak with their primary care doctor regarding these medications, their effects and side effects.