In many cases, pain is caused by inflammation. Anti-inflammatory drugs (NSAIDs) block the cascade of chemical reactions that cause inflammation. In this way, they reduce pain and swelling.
There are many NSAIDs available. The ‘traditional’ or ‘non-selective’ NSAIDs include Aspirin (Disprin), Ibuprofen (Nurofen, Brufen) and Diclofenac (Voltaren). ‘Selective’ or ‘COX-2’ agents include Celecoxib (Celebrex).
All of these medicines can be of use to treat injury or joint pain, where inflammation is present. They are of particular use where there is inflammation in a nearby joint (causing redness, swelling and pain) that may affect muscle function. Some people may respond better to one medicine to another, but no one medicine is stronger than another.
There are common side-effects to these medicines:
Burning stomach pain. Some NSAIDs can damage the protective lining of the stomach. This affects about 10% of people who take NSAIDs, and can be dangerous in older people who are on cortisone tablets or have heart disease. If you vomit up coffee ground material, this is serious and you should see a doctor the same day.
Fluid accumulation. You may notice swollen ankles – this is more common in older people. NSAIDs reduce blood flow to the kidneys. In people who are dehydrated (e.g. athletes on hot days) this can cause acute kidney failure, so keep up your fluid intake, especially in hot weather.
In rare cases, people with asthma who take NSAIDs may notice wheezy breathing. This is serious and should be reported to your doctor.
Pregnant women should not take NSAIDs, as they can affect the blood circulation in the unborn child.
The selec tive (COX-2) agents were developed to cause less burning stomach pain but may not be suitable for all people. They require a prescription from a doctor.
You should always take anti-inflammatory medicines with food to minimise the risk of gut upset.
Some of the non-selective NSAIDs are available without a prescription (Nurofen, Voltaren Rapid). It is usually safe to take these tablets for a few days, but if pain or swelling is continuing then you should see a doctor in case you need some other form of treatment.