Pain is the body’s warning signal that something is wrong. If the pain is due to overuse or arthritis there are many things to consider. In all likelihood, one of the first things a person will reach for is an over-the-counter anti-inflammatory medicine.

Non-steroidal anti-inflammatory medicines work by blocking the synthesis of cyclooxygenase, the enzyme responsible for the production of pro-inflammatory prostaglandins. The two different pathways that are blocked are COX-1 and COX-2.

Despite the negative publicity surrounding COX-2 drugs, it is clear that all anti-inflammatory drugs have potential cardiovascular risks. These drugs also may inhibit bone and tendon healing. They may also block the absorption of nutrients... So the weekend warrior needs to take notice.

Nonetheless, anti-inflammatory drugs remain a bulwark for the treatment of painful episodes.

Here are some simple suggestions:

If you’re going to undertake an activity that you’re sure will cause a problem, it’s OK to pop a small amount... say 200 mgs of ibuprofen before you do whatever you’re going to do. Unless it’s a marathon. Dehydration and anti-inflammatory drugs do not mix!

After your activity, it’s also OK to pop a bit of ibuprofen or naproxen (200 mgs). Just make sure you’re well hydrated. Also do not take these medicines if you have any underlying liver, kidney, or heart disease!

If you already take anti-inflammatory drugs on a regular basis, remain well-hydrated, and avoid alcohol when exercising or undertaking strenuous activity. With the recent data regarding cardiovascular risk, it’s a good idea to get your heart checked out.

Make sure you take your anti-inflammatory medicines with food. Sometimes people who develop indigestion with anti-inflammatory medicines but who do not have an ulcer will benefit from taking a proton pump inhibitor medicine such as Nexium or Protonix.

If you absolutely can’t take anti-inflammatory medicines because of a true allergy or if you have an ulcer- or another valid reason- you can try acetaminophen (Tylenol). The primary concerns here are that you not take this drug with alcohol (liver toxicity is increased) and you should not take this drug if you have significant liver or kidney disease.

Always consult with your physician prior to taking these medicines on a regular basis. Anti-inflammatory drugs may affect the metabolism of other prescription drugs.

Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: http://www.arthritis-treatment-and-relief.com

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