Ibuprofen: Benefits and Risks

[Ramon]

I read an interesting article from a tennis newsletter on Ibuprofen:

http://www.active.com/nutrition/Arti...-Vitamin-I.htm

It basically explains that the mechanism that results in an anti-inflammatory effect also inhibits enzymes that promote repair and muscle building. The author recommends taking Ibuprofen for acute pain but not as a regular supplement to avoid soreness after exercise. I recently had an acute shoulder injury, and I found Ibuprofen to be helpful to get me through competitive matches, but I don't plan to take it regularly once it starts to feel better.

Any thoughts?

[ollinger]

Do a search and you'll find many reasons to use as little of it as possible. It clearly inhibits healing, might increase the risk of injury such as tendon rupture, tends to increase blood pressure (which goes up in any event during exercise, so further increase can be harmful), and so on. About the only benefit I'm aware of other than reducing pain (which can be done much more safely with moderate doses of Tylenol) is that ibuprofen used daily may reduce the risk of Alzheimer's dementia (which is now felt to have an inflammatory component associated with the amyloid deposition in the brain).

[charliefedererer]

Originally Posted by Ramon

I read an interesting article from a tennis newsletter on Ibuprofen:

http://www.active.com/nutrition/Arti...-Vitamin-I.htm

It basically explains that the mechanism that results in an anti-inflammatory effect also inhibits enzymes that promote repair and muscle building. The author recommends taking Ibuprofen for acute pain but not as a regular supplement to avoid soreness after exercise. I recently had an acute shoulder injury, and I found Ibuprofen to be helpful to get me through competitive matches, but I don't plan to take it regularly once it starts to feel better.

Any thoughts?

Use as little ibuprofen as possible!


Ibuprofen masks pain, allowing players to continue to abuse their bodies.



There once was a theory that ibuprofen could prevent joint damage by decreasing inflammation. No evidence for that theory has been produced.

Instead, many more suffer worse muscle/tendon/ligament/joint injuries because ibuprofen masks the pain that should have warned players to stop playing.

[Itagaki]

Originally Posted by charliefedererer

Use as little ibuprofen as possible!


Ibuprofen masks pain, allowing players to continue to abuse their bodies.



There once was a theory that ibuprofen could prevent joint damage by decreasing inflammation. No evidence for that theory has been produced.

Instead, many more suffer worse muscle/tendon/ligament/joint injuries because ibuprofen masks the pain that should have warned players to stop playing.

Part of the problem is the usual recommended dosage for ibuprofen is completely analgesic, wont do **** for inflammation.

According to a dentist friend, anything less than 2400mg/day is going to do squat for inflammation. This is about the prescription level of ibuprofen (800mg 3x daily). I've seen some recommendations of taking 3200mg/day for 5 days straight, then going off it completely to actually affect the inflammation. This is of course accompanied by rest

[rufus_smith]

I'm in the health professions and the article is a little misleading when it seems to support "inflammation" as a healing mechanism that should not be thwarted by ibuprofen. I can guarantee you too much inflammation is a bad thing for your joints and tendons. Any a high pain or swelling needs to be reduced as soon as possible to prevent tissue damage. Ice packs are a safe way to reduce it but are not practical for long periods of time. Ibuprofen will can be quite helpful when used properly.

[charliefedererer]

Originally Posted by rufus_smith

I'm in the health professions and the article is a little misleading when it seems to support "inflammation" as a healing mechanism that should not be thwarted by ibuprofen. I can guarantee you too much inflammation is a bad thing for your joints and tendons. Any a high pain or swelling needs to be reduced as soon as possible to prevent tissue damage. Ice packs are a safe way to reduce it but are not practical for long periods of time. Ibuprofen will can be quite helpful when used properly.

Can you cite any study that proves your theory?

[charliefedererer]

Originally Posted by Itagaki

Part of the problem is the usual recommended dosage for ibuprofen is completely analgesic, wont do **** for inflammation.

According to a dentist friend, anything less than 2400mg/day is going to do squat for inflammation. This is about the prescription level of ibuprofen (800mg 3x daily). I've seen some recommendations of taking 3200mg/day for 5 days straight, then going off it completely to actually affect the inflammation. This is of course accompanied by rest

Can you cite any study that proves your theory?

[Itagaki]

Originally Posted by charliefedererer

Can you cite any study that proves your theory?

Well it's certainly not my theory

But unfortunately no, i've only taken the statements at face value from those that had experience dealing with it. Never cared to do the research myself.

However, I'm fairly confident that prescription strength ibuprofen tablets are 800mg and usually prescribed to be taken 3-4 times daily

[charliefedererer]

Originally Posted by Itagaki

Well it's certainly not my theory

But unfortunately no, i've only taken the statements at face value from those that had experience dealing with it. Never cared to do the research myself.

However, I'm fairly confident that prescription strength ibuprofen tablets are 800mg and usually prescribed to be taken 3-4 times daily

The reason I asked is that I have done literature searches multiple times to try and find one human study that shows taking high dose ibuprofen has had a demonstrable effect on ANY disease or injury.

I have not found any.

I have asked the question many times here, and no one has provided such a study.




There is a move afoot in medicine termed "evidence based medicine".

It is aimed to try and separate out theoretical benefits of treatments [even if having some degreee of sound scientific basis] from those that have actually been "proven" in a reasonable study.


So far, I believe that the widespread belief that high dose ibuprofen has beneficial effects for inflammatory processes has yet to be proven.

Indeed, the studies done so far, even in inflammatory diseases such as arthritis, have not shown a change in the underlying disease process.



Could it possibly be that there are so many inflammatory pathways involving so many different types of mediators and cytokines, that interruption of just one of these pathways [cyclooxygenase] by ibuprofen does not have a clinical effect?



Ibuprofen does NOT interrupt the inflammatory cycle at multiple points like steroids do.








Now I won't dispute that ibuprofen is a powerful medication with morbidity and mortality associated with it's cardiac, renal and hepatic side effects.

But is precisely because the multiple severe side effects are so well documented that the burden of proof ought to show that ibuprofen is effective in treating the underlying process enough to demonstrate a documented change in the condition that is supposedly treating.

[Itagaki]

Originally Posted by charliefedererer

The reason I asked is that I have done literature searches multiple times to try and find one human study that shows taking high dose ibuprofen has had a demonstrable effect on ANY disease or injury.

I have not found any.

I have asked the question many times here, and no one has provided such a study.




There is a move afoot in medicine termed "evidence based medicine".

It is aimed to try and separate out theoretical benefits of treatments [even if having some degreee of sound scientific basis] from those that have actually been "proven" in a reasonable study.


So far, I believe that the widespread belief that high dose ibuprofen has beneficial effects for inflammatory processes has yet to be proven.

Indeed, the studies done so far, even in inflammatory diseases such as arthritis, have not shown a change in the underlying disease process.



Could it possibly be that there are so many inflammatory pathways involving so many different types of mediators and cytokines, that interruption of just one of these pathways [cyclooxygenase] by ibuprofen does not have a clinical effect?

Hmm, that's actually very interesting to me. Is there any anti-inflammatory medicine that has been proven effective? Especially OTC drugs I.e. Naproxen, aspirin etc

[charliefedererer]

Originally Posted by Itagaki

Hmm, that's actually very interesting to me. Is there any anti-inflammatory medicine that has been proven effective? Especially OTC drugs I.e. Naproxen, aspirin etc

No.

I edited my above post to show some of the other multiple inflammatory pathways.

Cyclo-oxygenase inhibitors like ibuprofen and naproxen only inhibit the following pathway:




Although that is not to say that the cyclo-oxygenase pathway does not potentially have demonstrated physiologic functions in multiple organs.

[coolblue123]

Had 3 completely torn ligaments and a impact fractured on ankle. 800mg of Ibuprofen didn't really help that much.

I just rested and took Fish Oil. Got this advice from another tt member. It helped alot.

http://www.livestrong.com/article/24...orn-ligaments/

[charliefedererer]

^^^ Glad to hear you got some help from this forum.

Hope that ankle is healed. It sounds like a nasty injury.

[cluckcluck]

My wife and I talked about this just the other day. She said during exercise is bad to take Ibuprofen because it can easily damage the liver. I don't recall exactly what she said but now I only take it after a hard match/practice if I need it.

[ollinger]

^ Not sure what your wife is referring to, the more important effects are on the kidney, thus the problem with blood pressure.

[rufus_smith]

here is one of the first confirmatory studies showing the benefit of ibuprofen for arthritis :

http://www.ncbi.nlm.nih.gov/pmc/arti...031152/?page=6

here's a review of the benefits of ibuprofen for several medical conditions:
http://www.omjournal.org/ReviewArtic...ofClinical.pdf

good luck

[Chotobaka]

Originally Posted by ollinger

^ Not sure what your wife is referring to, the more important effects are on the kidney, thus the problem with blood pressure.

Correct. Ibuprofen, when used at high doses or for extended periods of time, can effect the kidneys. Acetaminophen may effect the liver when used in the same fashion.

[Ramon]

Wow! I didn't know Ibuprofen had those kind of risks. It also seems that every other pain killer has risks too.

Any opinions on which pain killers have the least amount of risks and side effects?

[Bowtiesarecool]

Originally Posted by Ramon

Wow! I didn't know Ibuprofen had those kind of risks. It also seems that every other pain killer has risks too.

Any opinions on which pain killers have the least amount of risks and side effects?

Mari juwana?

[charliefedererer]

Originally Posted by rufus_smith

here is one of the first confirmatory studies showing the benefit of ibuprofen for arthritis :

http://www.ncbi.nlm.nih.gov/pmc/arti...031152/?page=6

here's a review of the benefits of ibuprofen for several medical conditions:
http://www.omjournal.org/ReviewArtic...ofClinical.pdf

good luck

The first "study" had only 9 patients! 9 people is a starting team in baseball, but it is not a real study.
Still, it is interesting that there was no improvement in joint stiffness, or grip strength with ibuprofen - only with the steroid prednisolone.
[By the way using a steroid in the study was a bad idea - the effects of the steroid can last for several weeks after a course, thus it is hard to make conclusions about the patients that received steroids before getting the ibuprofen, aspirin or lactose.]
Yes, ibuprofen did relieve some pain compared to placebo - but no more than aspirin (no Tylenol was used in the study.)
My point above is that ibuprofen has not been shown to objectively change signs of inflammation, like joint stiffness or or grip strength.
It is a fairly good pain reliever - but many patients are told that ibuprofen is effectively decreasing the inflammation and therefore lessening the damage caused by the underlying disease.
This tiny "study" does not show that.


The second paper you cite is a review with no data being provided.

I was really hoping you had something to back up your post:
"I'm in the health professions and the article is a little misleading when it seems to support "inflammation" as a healing mechanism that should not be thwarted by ibuprofen. I can guarantee you too much inflammation is a bad thing for your joints and tendons. Any a high pain or swelling needs to be reduced as soon as possible to prevent tissue damage. Ice packs are a safe way to reduce it but are not practical for long periods of time. Ibuprofen will can be quite helpful when used properly."

That is, that you have some information that shows that ibuprofen is effective in decreasing inflammation in joints and tendons.

(I have never doubted ibuprofen is a pretty good pain reliever.
But as this is a tennis health and fitness forum, the widespread belief that ibuprofen can decrease the inflammation in joints and tendons after injuries I still believe has never been proven.)