Advil, Tylenol, Motrin, other? (Page 2)

Are NSAIDs also dangerous for sprint or olympic distances, or on a 2-3 hour training ride, for instance?

Edited by cpfint 2009-07-08 2:50 PM

Okay, short of screaming at the top of my lungs ........

WHY IN THE HELL DO YOU NEED THEM IN THE FIRST PLACE????????

Is it a doctor's recommendation?  Do you have a chronic injury that requires it?  Or is it just to mask the soreness of training?

Nice job Rick...it is the typical Forum circular motion that occurs when anyone asks a question around here.

Post of the day in the "Frustrated Guy Who Actually May Know What He is Talking About" category.

Mike

x2.

you dont have pain becasue of an Advil deficit.

I'd like to add a clarification here (an additional one, I guess).

My use of NSAIDS--IB, in particular--is 100% a-okayed by my orthopedic surgeon--recommended, in fact. I am not trying to train through a sudden injury or DOMS of any sort. I have a chronic condition that isn't going away--I am bone on bone full thickness articular cartilige lesions in my lateral knee. No healthy meniscus left. I have arthritis that also runs in the patellofemoral area, and on the medial side. Also bone spurs, and bone marrow edema. A few advil before I run allows me to do so with slightly less discomfort.

I am fully aware of the risks that come with it, including the dehydration/kidney/etc. problems, and the fact that taking advil before a run may hide OTHER issues. Taking an NSAID is a calculated risk. I do not race long--half marathons and Oly races are as long as I go. I eat and drink appropriately. Aside from running, I rarely, if ever, take any analgesics...even during a migraine.

Well, Daremo, you kind of are screaming at the top of your lungs by cursing and typing in all caps. I've taken them when I've done multi-day rides and my butt hurts on the 2nd or 3rd day. I didn't know about the risk until today, and I'll definitely change my use (which was minimal anyway). I know the answer I'll get is to ride more, suck it up and deal with it, and I'm not trying to argue with that. I just wondered if the risk of kidney failure is still as high with less intense or lengthy events. I was hoping to get some scientific/medical perspective on that question.

Edited by cpfint 2009-07-08 3:11 PM

My caps lock wasn't yelling at you in particular.  It was about the whole topic.  Call me a glutton for punsihment, but I simply don't understand people's needs to mask discomfort with drugs.  Sorry if I came off as that (confronting you specifically).

I can totally understand if there is some underlying medical reason that someone needed to take them to participate.  But my reaction there would be what I said earlier - if there is pain, you shouldn't be doing it as you may cause a heck of a lot more damage.

As for back to back to back riding?  A good saddle and some good shorts will do wonders.  And yes, seat time.

Also, like I mentioned previously, over the counter drugs rarely work at all for me.  I do not notice much of a difference when I take them for anything (except prescription strength type pain killers which I've only had when I got my wisdom teeth pulled).  So that plays into why I don't get the need for them a lot - they simply don't work on top of the other real serious issues with them.

Just an aside, but don't expect that orthopedists (or many other docs) are going to be keenly aware of the effect of NSAID's on kidneys, particularly in combination with exercise. 

You've obviously never had menstrual cramps.

But you are sure PMS'ing like you do....

Ok, quick question. Is aspirin an NSAID? I don't really keep Advil or Tylenol in the house, but I have taken an aspirin from time to time. I googled it and one said it was and the others didn't group it as one.

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x2  There are many who feel NSAIDs are one of the most Over Prescribed meds out there.  Osteoarthritis for example is a degenerative condition, not an inflamatory condition so the idea that an anti-inflamatory is needed is questionable at best.  This is particularly problematic for elderly patients who may have renal issues already associated with age, hypertension, diabetes, etc. This doesn't even touch on the very high rate of GI bleeding from overuse of NSAIDs.

My advice for everyone is to question why you are taking an NSAID?  If you do not have an inflamatory condition, tylenol is probably a better alternative for initial pain relief, unless of course you have liver issues.   

 

Edited by dscottmd 2009-07-08 4:03 PM

I never use it during racing or training. The only time I ever use Motrin or Advil is when I start to feel my gout creeping up. I take 2 before bed and by the next morning, I'm good to go. Granted, this only happens a couple of times per year.

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Perfect example of an inflamatory arthritis, Gout. NSAIDs are one of the preferred treatments for it. They are wonderful drugs when used appropriately. Unfortunately, many patients and physicians use them for routine and long term pain control. Not good.

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Yep, once I got it diagnosed and now that I know what to look for I can usually knock it out rather quickly. Before I went to the Doctor, I thought for sure I had broken my toe somehow. It was that painful.

hmm so my Primary care provider told me that when I have swelling in my joints (he labeled it tendonitus) I am assuming that is possibly inflamation related. He recomended Icing and/or Heat (alternating) to help relieve the swelling as well as taking Ibuprofin or Advil. Not being a medical person I am not sure if Tendonitus is considered an Inflammatory condition. Anyway per my earlier post...I don't hardly ever take it and even when I do it is the smallest effective dose for me that I take so I am not worried about my kidneys, just curious at this point.

what makes you say that?  as an orthopaedic surgeon myself and someone who spends a lot of time around orthopaedic surgeons and someone who very very frequently recommends and prescribes NSAIDS (along with my colleagues,) everyone i work with (myself included) is quite aware of NSAID affects on kidneys.  most conscientious orthopods will recommend q6mos blood work (BUN/Cre) to check kidney function in patients who are chronic NSAID takers.... there are very few conditions out there we would recommend chronic NSAID use for, anyway, aside from gout or the rare osteoid osteoma.  they're great drugs, don't get me wrong, but they need to be used smartly.

orthopaedic surgeons prescribe NSAIDS extremely frequently ... it's kinda poor form to do that and not have any idea at least that the drugs are metabolized by the kidneys and can have adverse effects IF there are other hits on the kidneys as well (i.e. dehydration.)   

for overall healthy people, the risk of GI bleeding (and generalized GI upset, more frequently) is likely the biggest detractor to NSAID use and the one most often pointed out.  however, it is a good point to know that if you are doing endurance events, the potential for dehydration already puts your kidneys on high alert, and if you combine that with the NSAID of your choice, it can lead to badness, and ESPECIALLY if you are taking other potentially nephrotoxic drugs (ACE inhibitors come to mind.)  not always, and really not super-likely if your kidneys are otherwise fantastic, but it is a risk.  like almost all things in medicine - it's a risk-benefit analysis.   

(for the med inclined; it's from 1999 but still a decent review: Am J Med; 1999 May 31;106(5B):13S-24S )

tangent: someone mentioned osteoarthritis as a condition for which NSAIDS are not helpful because it's degenerative and not inflammatory .... the reaction your body has to the bone-on-bone / cartilage degeneration problems of osteoarthritis IS inflammatory.  it's why a degenerative/osteoarthritic knee swells when it's exerted and painful.  while the process itself isn't inherently an inflammatory destructive one, the body's reaction to it is inflammatory.  NSAIDS can calm that down.  

Edited by novas 2009-07-08 8:08 PM

Experience.  It's nothing against orthopedists. 

well, that's a big, blanket statement.  and my experience tells me otherwise.    at the end of the day, all generalizations, i guess.  

 

Edited by novas 2009-07-08 8:10 PM

So what about the whole aspirin a day for older folks being good for the heart?

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