COACHES HEALTH – THE HEALTH RISKS OF INFLAMMATION AND PAIN CONTROL
As former athletes in a variety of sports, almost every coach will eventually be forced to make decisions about their choice of medication to control joint inflammation and pain. Eventually, previous injuries and/or age is certain to produce some degree of arthritis, pain, and inflammation that disrupts daily lives.
While OTC (over the counter) and PRESCRIPTION NSAID (non steroidal anti-inflammatory drugs) medication is quite effective, there are health risks associated with regular and high dose usage.
Like all other drugs, each of the following NSAID medications produces numerous side effects; some of which impose serious health risks:
Aspirin* (Anacin, Ascriptin, Bayer, Bufferin, Ecotrin, Excedrin) Choline and magnesium salicylates (CMT, Tricosal, Trilisate)
Choline salicylate (Arthropan)
Diclofenac potassium (Cataflam)
Diclofenac sodium (Voltaren, Voltaren XR)
Diclofenac sodium with misoprostol (Arthrotec)
Etodolac (Lodine, Lodine XL)
Fenoprofen calcium (Nalfon)
Ibuprofen (Advil, Motrin, Motrin IB, Nuprin)
Indomethacin (Indocin, Indocin SR)
Ketoprofen (Actron, Orudis, Orudis KT, Oruvail)
Magnesium salicylate (Arthritab, Bayer Select, Doan’s Pills, Magan,
Meclofenamate sodium (Meclomen)
Mefenamic acid (Ponstel)
Naproxen (Naprosyn, Naprelan*)
Naproxen sodium (Aleve, Anaprox)
Salsalate (Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab)
Sodium salicylate (various generics)
Tolmetin sodium (Tolectin)
* OTC drugs are in bold
Acetaminophen (Paracetamol; Tylenol) is not listed since it belongs to a category of drugs called analgesics (pain relievers) and antipyretics (fever reducers). Exactly how acetaminophen works is unknown. Acetaminophen does increase the pain threshold, thus requiring a greater amount of pain to develop before it is felt. Acetaminophen also reduces fever through its action on the heat-regulating center of the brain. Although Acetaminophen relieves pain in mild arthritis, it has no effect on joint inflammation and swelling. Paracetamol, unlike other common analgesics such as aspirin and ibuprofen, also has no anti-inflammatory properties.
According to the results of a recent Danish study, NSAID medications (OTC and Prescription), raise the risk of heart disease and death in healthy people without underlying health conditions. The risks are dose related and mostly associated with high doses of the drug, and, in most cases, deaths occurred in people who had been taking the drugs for only two weeks. Researcher Emil Loldrup Fosbol, MD, of
The most disturbing finding was that Diclofenac (brand names include Cataflam, Voltaren) was as risky as the now-banned Vioxx. Both diclofenac and Vioxx nearly doubled the risk of death from heart disease among healthy people in the Fosbol study. Although diclofenac is available in the
Previous studies of NSAID risk involved subjects with underlying health conditions whereas the Fosbol study used detailed medical records in more than a million healthy people from 1997 to 2005. Although NSAIDs increased the risk of death from heart disease, the risk was small. Among the 1,028,437 people who took NSAIDs, there were 769 deaths from heart disease and stroke.
In 2007, an American Heart Association panel warned that treating chronic pain with NSAIDs other than aspirin increases a person’s risk of heart attack and stroke.
According to lead author of the AHA statement, Elliot M. Antman of
According to Howard S. Weintraub, MD, clinical director of the
Coaches and others who regularly take an OTC or prescription NSAID, should reexamine their use and discuss the matter with their physician to decide whether it is necessary to continue the drug and at what dose.
Source: The Fosbol study appears in the June 8 online edition of the AHA journal
Circulation: Cardiovascular Quality and Outcomes.