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If you take Advil or Aleve, please read this

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Last Edited: September 8, 2009, 5:29 pm

As many of you know, in July I broke my toe.  A recent X-ray confirms that it still hasn't healed after 6 weeks.   Since I can't be physically active, I'm spending way too much time online, and today I decided to research studies on ibuprofen (Advil, Motrin) and naproxyn sodium (Aleve) to help choose which over-the-counter drug will help me more.  The doctor gave me samples of Celebrex but it's done nothing at all to relieve the pain.  In fact, I'm much worse.  I was given a prescription for naprosyn, but I purchased the over-the-counter form of the drug, Aleve, instead.   I'm sure the anxiety of not working isn't helping either.  I hope I don't sound like a whiner, since this isn't a life threatening disease, but I'm going crazy wondering when the swelling will go down and I'll be able to put on a pair of shoes. 

Anyway, I came across these articles, all from reliable sources such as Massachusetts General Hospital and Consumer Reports. 

http://www.boston.com/news/health/articles/2009/06/22/nsaids_inhibit_bone_healing/

"Smoking and NSAIDs are probably the most important causes of failure in bone healing," says Dr. Malcolm Smith, chief of the Orthopedic Trauma Service at Massachusetts General Hospital. In fact, he said, with a patient who has had surgery to remove bone, "we give them NSAIDs to make sure the bone doesn’t grow back."

http://blogs.consumerreports.org/health/2009/03/ibuprofen-risky-for-broken-bones.html

"In one observational study of about 400 patients with broken legs, for example, those who routinely took NSAIDs were 10 times more likely to have healing complications, and took an average of two months longer to heal, compared with non-NSAID users."

http://www.newscientist.com/article/dn2364-painkillers-may-prevent-broken-bones-healing.html

These articles are a bit more technical, but the studies report the same results.  When an NSAID has been taken after a break, it has an adverse effect on healing. 

http://www.ncbi.nlm.nih.gov/pubmed/10963160?dopt=Abstract

"There was a marked association between nonunion and the use of NSAIDs after injury and delayed healing was noted in patients who took NSAIDs and whose fractures had united."

This is another study of people requiring back surgery.

http://www.ncbi.nlm.nih.gov/pubmed/9563116?dopt=Abstract

"CONCLUSION: These data suggest that nonsteroidal anti-inflammatory drugs significantly inhibit spinal fusion at doses typically used for postoperative pain control. The authors recommend that these drugs be avoided in the early postoperative period."

It really concerns me that the public hasn't been warned if there is good reason to believe these drugs might inhibit bone growth and be contributing to the increase in osteoporosis in our country, especially in post-menopausal women.  I also don't know why a doctor would tell a patient to take drugs that have been proven in scientific studies to delay healing when a bone is broken or fractured. The COX-2 inhibitors like Celebrex interfere with tendon strength and might block/delay healing.

Although this article is about athletes who take NSAIDs to prevent pain during a strenuous activity, note this comment

http://well.blogs.nytimes.com/2009/09/01/phys-ed-does-ibuprofen-help-or-hurt-during-exercise/

"NSAIDs work by inhibiting the production of prostaglandins,”substances that are involved in pain and also in the creation of collagen, Warden says. Collagen is the building block of most tissues. So fewer prostaglandins mean less collagen, “which inhibits the healing of tissue and bone injuries.."

So if you break a bone, remember this blog and ask for a painkiller that is not an NSAID or grin and bear the pain for a few weeks.  Tylenol is an alternative.   I haven't been able to find any scientific studies on scotch or vodka yet. 

 

Entry #198

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