The Problem With Ibuprofen

Written By Dylan Baker

Picture this:

You're in the heart of training for your next race or season. A nagging injury keeps bothering you. What do you do? You pop a couple of ibuprofen and push through the training, race, or game. And yes, it probably reduced your pain, allowing you to play through it. Unfortunately, this comes at a cost.

What if I told you that taking ibuprofen is actually hindering your recovery?

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) reduce pain and inflammation by inhibiting (stopping) COX enzymes, which slows the production of prostaglandins. These prostaglandins can sensitize pain receptors and nerve endings, which is why slowing their production decreases the pain you experience.

So, why would you want these prostaglandins if they cause pain?

Essentially, prostaglandins act as signaling molecules that orchestrate the complex cascade of events involved in tissue repair, from initiating the inflammatory response to promoting cell growth and bone matrix remodeling. This is pretty important work.

Why would you want an inflammatory response?

If you follow social media, you might think "inflammation = bad." But inflammation is simply your body’s repair system. We need an inflammatory response to heal damaged tissue. The inflammatory response occurs in three phases:

  • Acute Phase: This is like your body’s first responders. Your body sends chemicals and nutrients, including prostaglandins, to the area to begin cleanup. This causes swelling and heat. Your body is bringing necessary resources to clean the damaged area and prepare for rebuilding.

  • Proliferative/Regenerative Phase: This is the construction crew. Your body rebuilds the damaged tissue, even laying more nerve fibers and blood vessels (a process called neurovascularization).

  • Remodeling/Scarring Phase: This is the crew that adds the finishing touches. The tissue becomes stronger and more resilient to future injuries. Some people get stuck in “chronic inflammation” here. If your body is constantly repairing without finishing, health issues arise. The causes of chronic inflammation are numerous and deserve a separate blog post.

So, normal, healthy inflammation = good. Chronic inflammation = bad and requires investigation to understand why your body isn’t finishing the job.

The bottom line:

Now you understand how NSAIDs work, what the inflammatory response is and why it's important, and how they interact. Essentially, ibuprofen prevents your body from rebuilding tissue broken down by physical activity.

I understand now that NSAIDs hinder healing. But what about my pain? I have practice, games, races, training, etc.

This is where I come in. If you have an injury or nagging pain, choose a provider who understands not only how your body heals, but how to target the root cause of your injury. Then, develop a plan that incorporates manual therapy (adjustments, soft tissue massage), rehab exercises, nutrition, and lifestyle choices to assist healing and build resilience, making you stronger than before.

References

Ghosh N, Kolade OO, Shontz E, Rosenthal Y, Zuckerman JD, Bosco JA 3rd, Virk MS. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and Their Effect on Musculoskeletal Soft-Tissue Healing: A Scoping Review. JBJS Rev. 2019 Dec;7(12):e4. doi: 10.2106/JBJS.RVW.19.00055. PMID: 31851037. 

Soares CLR, Wilairatana P, Silva LR, Moreira PS, Vilar Barbosa NMM, da Silva PR, Coutinho HDM, de Menezes IRA, Felipe CFB. Biochemical aspects of the inflammatory process: A narrative review. Biomed Pharmacother. 2023 Dec;168:115764. doi: 10.1016/j.biopha.2023.115764. Epub 2023 Oct 26. PMID: 37897973.

Dylan Baker