You've had a tough workout at the gym, and you're sore. You pop an aspirin or ibuprofen for relief.
While this may solve a short-term problem, regular use of common, over-the-counter drugs to banish pain or inflammation can cause long-term problems.
"The most common, minor side effects of aspirin or ibuprofen are GI (gastrointestinal) symptoms: nausea, diarrhea, little bit of stomach upset," says Casey Frieder, a chiropractor at Ashland-based Hands on Wellness. "The more serious problem of taking these regularly ... is both are toxic to the liver."
Aspirin and ibuprofen are nonsteroidal, anti-inflammatory drugs, or NSAIDs. In addition to cutting pain, they reduce inflammation by blocking enzymes that function as the body's precursor to inflammation. Because inflammation is a natural response that leads to healing, use of NSAIDs slows the healing process.
"The inflammatory response happens for a reason," says Frieder. "Pain is our body's way of bringing attention to a region "» inflammation has this purpose, so to just go upstream and cut off the inflammation is maybe not always the best choice."
Endurance athletes have been known to take ibuprofen during long races to dull the pain brought on by muscle inflammation.
"They decrease blood flow to the kidneys," says Dr. Neil Olsen, a family-practice physician in Central Point and an accomplished ultramarathoner. "During a long endurance event, you're going to be a little dehydrated, your body's going to be shunting flow away from the kidneys, anyway, so to further decrease flow to the kidneys, it's a bad time to do that to them — it can cause injury."
Several elite ultramarathoners have ended up in the hospital with life-threatening kidney failure after taking ibuprofen during or immediately after a long race. Though not related to athletic activity, there is another link Olsen points out between ibuprofen and kidney failure.
"Something like half the people on (kidney) dialysis, it's because of (using) nonsteroidal anti-inflammatories," explains Olsen. "Most of those are people with congestive heart failure, with low blood flow."
Several nonsynthetic options are available to reduce inflammation, options that work with the body's healing processes instead of against them.
"Bromelain is a proteolytic enzyme — meaning that it breaks down proteins — that's derived from pineapple," says Frieder. "It goes into the body and eats up inflammatory proteins. So compared to the ibuprofen and the aspirin, it's not going upstream and shutting off the inflammatory response, but after an injury you're going to have dead cells, so the body needs to clean that up."
Rachel Jones, an Ashland resident and patient of Frieder, used bromelain to reduce inflammation and pain to help heal from a back injury.
"It was getting to the point where I had to lift my legs into my vehicle," admits Jones. "I had never heard of an enzyme being used as an anti-inflammatory. I did take it for two weeks. It took a little over a week for results to kick in."
Jones initially was skeptical about using an enzyme to deal with inflammation, so to test if her early results constituted a placebo effect, she stopped using bromelain before she was fully recovered.
"I started feeling some symptoms again and started taking bromelain again, and the symptoms did subside," says Jones.
Vitamin C is known to aid in the repair of soft tissues: muscles, tendons and ligaments.
"Studies ... show that vitamin C reverses the symptoms of delayed-onset muscle soreness," says Frieder. "This is what we all experience when we go out and do a big event, or we go for a long bike ride when we haven't ridden our bike all winter. Then you're really sore in 24 hours."
The best approach to inflammation may be prevention: eating foods high in vitamin C and other key anti-oxidants and flavonoids.
"The foundation of any serious athlete's preventative, healing-tissue approach is a really healthy diet: lots of fruits and vegetables," says Frieder. "The foods that are the highest in anti-oxidants and flavonoids are fruits and vegetables."
Real foods — not just supplements — can be the best anti-inflammatories if eaten regularly. Research has shown that curcumin, found in the spice turmeric, sour-cherry juice, green tea and several types of kelp top the list. Drinking extra water helps to speed recovery by flushing cellular debris associated with the body's inflammatory response.
Applying ice or a cold pack to an injury or a sore area is a time-tested method for safely reducing inflammation. Olsen likes to sit in a cold creek following a tough workout. Frieder prefers a direct ice massage.
"The way I like to do that is to take an ice cube and hold it in a towel and rub it directly over the area with the inflammation. The treatment time is going to be closer to 10 minutes until the area really feels like it's numbed up."
When Olsen thinks about his exercise-induced pain, he's not in a rush to get rid of it.
"The idea that we can or should take away all pain isn't realistic or healthy," he says. "You've earned the soreness you get after a hard workout. Embrace it. It will go away."