Nonsteroidal anti-inflammatory medications (NSAIDs), such as Advil and Motrin, are readily available, over-the-counter medications that are commonly used and prescribed to manage pain and swelling associated with skeletal injuries. Despite this, the available experimental and clinical evidence indicates that NSAID therapy can impair bone fracture healing and tendon-to-bone (enthesis) healing. ~ Dr. Broussard
NSAID therapy effects on healing of bone, tendon, and the enthesis
J Appl Physiol (1985). 2013 Sep;115(6):892-9. doi: 10.1152/japplphysiol.00053.2013. Epub 2013 Jul 18.
Bailey Su
PMID: 23869068 PMCID: PMC3764618 DOI: 10.1152/japplphysiol.00053.2013
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for the treatment of skeletal injuries. The ability of NSAIDs to reduce pain and inflammation is well-established. However, the effects of NSAID therapy on healing of skeletal injuries is less defined. NSAIDs inhibit cyclooxygenase activity to reduce synthesis of prostaglandins, which are proinflammatory, lipid-signaling molecules. Inhibition of cyclooxygenase activity can impact many physiological processes. The effects of NSAID therapy on healing of bone, tendon, and the tendon-to-bone junction (enthesis) have been studied in animal and cell culture models, but human studies are few. Use of different NSAIDs with different pharmacological properties, differences in dosing regimens, and differences in study models and outcome measures have complicated comparisons between studies. In this review, we summarize the mechanisms by which bone, tendon, and enthesis healing occurs, and describe the effects of NSAID therapy on each of these processes. Determining the impact of NSAID therapy on healing of skeletal tissues will enable clinicians to appropriately manage the patient’s condition and improve healing outcomes.