NSAIDS: Contraction-induced muscle injury - why NSAIDS don't help

Taking over-the-counter nonsteroidal antiinflammatory drugs (NSAIDS) or analgesics to treat contraction-induced muscle injury is not only ineffective but may even be harmful, according to a new US study.

The researchers found that therapeutic doses of both of these drugs reduced protein synthesis after eccentric contractions, which may have a negative impact on muscle growth after exercise.

Most previous investigations into the effectiveness of NSAIDS or painkillers for treating contraction-induced muscle injury have focused on soreness, muscle dysfunction and blood creatine kinase activity as outcomes. And, although a few studies have reported beneficial effects on one or more of these outcomes, most have not.

Speculating that these disappointing findings may be due to an inability of these drugs to blunt muscle inflammatory cell concentrations after injurious exercise, the US research team set out to examine the influence of ibuprofen (a common NSAID) and acetaminophen (Tylenol – a common analgesic) on muscle neutrophil and macrophage concentrations after novel eccentric contractions.

Twenty-four young men were divided into three groups, receiving maximal over-the-counter doses of ibuprofen, acetaminophen or placebo in four doses after exhausting eccentric contractions of the knee extensors. Biopsies from the vastus lateralis muscles in the leg were taken before and 24 hours after exercise, with the following results:

  • Concentrations of muscle neutrophils (white blood cells that provide an important defence against infection) were not significantly altered in any group 24 hours after the exercise protocol;
  • Concentrations of muscle macrophages (scavenger cells) were elevated by a factor of 1.5-2 in all three treatment groups after exercise but were unaffected by treatment with ibuprofen or acetaminophen when compared with placebo;
  • Muscle soreness, blood creatine kinase activity and muscle prostaglandin E2 concentrations were similarly unaffected by drug treatment;
  • Both drugs reduced protein synthesis and concentrations of prostaglandin F2α after exercise.

’Taken together,’ conclude the researchers, ‘these data may indicate that therapeutic dosing of ibuprofen or acetaminophen does not influence muscle soreness and inflammation but impairs protein synthesis in humans after eccentric exercise.’

Medicine and Science in Sports and Exercise, vol 35, no 6 pp892-896, 2003

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