Inflammation Is A Good Thing and Why You Should Avoid NSAIDs
Your injury can't heal without inflammation
First things first. This one is gonna be a bit “sciency”. I’ve done my best to make it as simple as possible but this is gonna feel like a bit of an anatomy lecture.
One of the biggest misconceptions regarding acute inflammation is that its a bad thing and efforts should be made to reduce it. This could not be any more wrong.
Inflammation is the first part of healing and is necessary for improvement. Any effort to reduce inflammation will delay healing. We will break down the phases of acute inflammation to reinforce this point.
We are going to be looking at the acute phase of inflammation as there seems to be the most confusion here. This phase begins immediately after any injury and lasts for 3 days. I’ll do my best to keep it as brief and simple as I can. There are three types of changes that occur in this stage:
Vascular changes
Cellular changes
Chemical changes
Vascular Changes
Vasodilation (opening of blood vessels) begins 15 minutes after injury and lasts several hours. Vessel permeability increases (cells can flow through vessel walls easier)
Exudate (protein rich fluid) enters the area. This starts the healing response. Exudate presents as visible swelling, bruising, warmth and temporary loss of function (source)
These signs/symptoms are NECESSARY for healing to occur. Anyone trying to decrease/delay this from occurring is going to slow your healing
Cellular Changes and Acute Inflammation
Most important change here is the accumulation of white blood cells. Phagocytes (primarily neutrophils) eat the debris from the damaged tissue
Most of these are in the blood. However, if trauma is severe enough, more are released from the bone marrow. These white blood cells enter the injured area via the increased vessel permeability. When these cells are at the site of injury days/weeks after injury, chronic inflammation has set in
Chemical Changes
The movement of the white blood cells mentioned above are made possible by chemotactic factors. The movement of white blood cells through the blood vessels is known as chemotaxis
There are a number of chemical compounds that influence and get the inflammation cascade starting. I’m not here to write a paper so we will address one. Histamine triggers the vasodilation and vessel permeability needed for the healing process to begin
This is a gross over simplification of the acute inflammation phase
TLDR.
Inflammation is not bad at all
The healing process requires it. Any efforts to slow or reduce this effect will reduce the ability to heal.
Ibuprofen and Naproxen are commonly prescribed anti inflammatory medications. However, they often do more harm than good. I’ll explain the dark side of NSAID risk below
To understand why NSAIDS are bad, we need to quickly dive into some inflammatory mediators/pathways in the body: Cox 1 and 2
These are enzymes that create prostaglandins (needed for inflammation response), create thromboxane (helps clotting), provide blood flow to the kidneys
COX 1 Pathway and NSAID Risk
helps keep platelets together to stop bleeding (clot)
facilitates blood flow to the kidneys
protects your stomach lining
Dangers of Cox 1 Inhibition:
GI distress (source)
Ulcers (found in 10-30% of frequent NSAIDS users)
Intestinal bleeding
Cox 2 Pathway and NSAID Risk
primarily works to assist with inflammation
it is produced on an as needed basis by the body
Dangers of Cox 2 Inhibition:
Stroke
Blood clot
Heart attack
These were extremely brief overviews but should give an idea as to what these enzymes are responsible for
There can be cases made to try and inhibit these enzymes in certain diseases/conditions
The problem with Ibuprofen and Naproxen (and other NSAIDs) is that they are “non selective Cox inhibitors”
These means that they decrease the Cox 1 and 2 enzymes without bias, which is a bad deal
Dangers of General Cox Inhibition
Sodium and water retention
Hypertension
Kidney damage
Overall NSAID risk:
Elevated blood pressure
Increased risk of kidney failure
Blood pressure meds become less effective
Reduce the anti blood clotting effects of Aspirin
Increased risk for cardiovascular pathology
NSAIDS are bad and you should do everything in your power to avoid them. Inflammation is a natural part of healing and you should not risk organ health to reduce a normal and needed occurrence