4 ms·

I frankly disagree that antiinflammatory drugs having "long term costs". I'd be very interested if you have a paper to back that claim up. A couple decades ago

by Ovah 5y ago

I frankly disagree that antiinflammatory drugs having "long term costs". I'd be very interested if you have a paper to back that claim up. A couple decades ago it was common for rheumatic patients to end up in wheelchairs. Today that's very uncommon. I agree that most antirheumatic drugs, and most drugs in general, treat the symptoms rather than provide an outright cure. But that's enough to drastically reduce disease severity and increase quality of life. Actual cures might be ideal but we are far from there research-wise - at least for most rheumatic conditions.

nradov 5y ago
Acute inflammation as the result of an injury isn't something that should be suppressed. We now understand that it should be allowed to persist as part of the healing process, so long as it isn't causing other serious problems. Persistent, chronic inflammation is another thing altogether.
- edmundsauto 5y ago
  Wait, really? You're not supposed to ice or take NSAIDs after an injury? Not doubting, just wondering when this changed and if other people have been following this advice.
  - nradov 5y ago
    Icing (and cold therapy in general) has been pretty thoroughly debunked now except for some very limited, specific scenarios. It might feel good, but there's no reliable evidence that it actually helps with long-term recovery or healing. "Good to Go" by Christie Aschwanden contains a great summary of icing (and other athletic recovery modalities). https://wwnorton.com/books/9780393357714 https://wwnorton.com/books/9780393357714 NSAIDs can inhibit certain types of tissue healing. Some people eat them like candy because they're available OTC but the side effects can be significant. https://journals.physiology.org/doi/full/10.1152/japplphysiol.00053.2013 https://journals.physiology.org/doi/full/10.1152/japplphysio... https://academic.oup.com/ptj/article/97/8/807/3826991 https://academic.oup.com/ptj/article/97/8/807/3826991
    - edmundsauto 5y ago
      Some more information that's a bit more accessible to the layperson - https://www.nytimes.com/2021/04/21/well/move/exercise-icing-sore-muscles.html https://www.nytimes.com/2021/04/21/well/move/exercise-icing-... TLDR, inflammation response is part of healing and icing limits that.
klyrs 5y ago
> The major side effects of NSAIDs are related to their effects on the stomach and bowels (gastrointestinal system). Some 10% to 50% of patients are unable to tolerate treatment with NSAIDs because of side effects, including abdominal pain, diarrhea, and upset stomach. Approximately 15% of patients on long-term treatment with NSAIDs develop a peptic ulcer (ulceration of the stomach or duodenum). Even though many of these patients with ulcers do not have symptoms and are unaware of their ulcers, they are at risk of developing serious ulcer complications, such as bleeding or perforation of the stomach. This is for a lay audience, but it's not remotely controversial: https://www.medicinenet.com/nonsteroidal_anti-inflammatory_drugs_and_ulcers/article.htm https://www.medicinenet.com/nonsteroidal_anti-inflammatory_d...
- Ovah 5y ago
  Fair point, my statement was too general. NSAID indeed shouldn't be used willy nilly. The same goes for cortisone and long term use. My point should have specifically referred to biologicals such as anti-TNF and other anti-cytokine treatments.

by Ovah 5y ago

nradov 5y ago

Acute inflammation as the result of an injury isn't something that should be suppressed. We now understand that it should be allowed to persist as part of the healing process, so long as it isn't causing other serious problems. Persistent, chronic inflammation is another thing altogether.

edmundsauto 5y ago
Wait, really? You're not supposed to ice or take NSAIDs after an injury? Not doubting, just wondering when this changed and if other people have been following this advice.
- nradov 5y ago
  Icing (and cold therapy in general) has been pretty thoroughly debunked now except for some very limited, specific scenarios. It might feel good, but there's no reliable evidence that it actually helps with long-term recovery or healing. "Good to Go" by Christie Aschwanden contains a great summary of icing (and other athletic recovery modalities). https://wwnorton.com/books/9780393357714 https://wwnorton.com/books/9780393357714 NSAIDs can inhibit certain types of tissue healing. Some people eat them like candy because they're available OTC but the side effects can be significant. https://journals.physiology.org/doi/full/10.1152/japplphysiol.00053.2013 https://journals.physiology.org/doi/full/10.1152/japplphysio... https://academic.oup.com/ptj/article/97/8/807/3826991 https://academic.oup.com/ptj/article/97/8/807/3826991
  - edmundsauto 5y ago
    Some more information that's a bit more accessible to the layperson - https://www.nytimes.com/2021/04/21/well/move/exercise-icing-sore-muscles.html https://www.nytimes.com/2021/04/21/well/move/exercise-icing-... TLDR, inflammation response is part of healing and icing limits that.

klyrs 5y ago

> The major side effects of NSAIDs are related to their effects on the stomach and bowels (gastrointestinal system). Some 10% to 50% of patients are unable to tolerate treatment with NSAIDs because of side effects, including abdominal pain, diarrhea, and upset stomach. Approximately 15% of patients on long-term treatment with NSAIDs develop a peptic ulcer (ulceration of the stomach or duodenum). Even though many of these patients with ulcers do not have symptoms and are unaware of their ulcers, they are at risk of developing serious ulcer complications, such as bleeding or perforation of the stomach. This is for a lay audience, but it's not remotely controversial: https://www.medicinenet.com/nonsteroidal_anti-inflammatory_drugs_and_ulcers/article.htm https://www.medicinenet.com/nonsteroidal_anti-inflammatory_d...

Ovah 5y ago
Fair point, my statement was too general. NSAID indeed shouldn't be used willy nilly. The same goes for cortisone and long term use. My point should have specifically referred to biologicals such as anti-TNF and other anti-cytokine treatments.