Treating Pain and Inflammation with Ibuprofen, Diclofenac and Vioxx

DISCLOSURE:  Please see your Physician before taking any kind of drug, either orally or topically.

If you’ve run track for a while, especially sprints, then you’ve probably experienced injuries.

If you are a Masters sprinter like me, then you know injuries are part of the game.

Injuries come in 2 flavours: Pain & Inflammation.  (one can write a thesis on pain and inflammation)

So how do you treat it using drugs?

I can talk about some of my past experiences..

It was over 20 years ago when I treated my Achilles injury with Advil (Ibuprofen) taking 3 pills every 4 hours… that’s right, up to 15 pills a day for the first 3 days… (A 100 pill bottle disappears quite fast!) This was terrible for the stomach, and I don’t recommend it, at least not long term.  If you do take large doses of Advil, I recommend quitting coffee, alcohol and other acidic foods from your diet.

It was over 15 years ago when I tried Diclofenac for the first time as a topical gel in Canada.  Commercial creams weren’t available so it was a prescription in an egg-white suspension.  As long as you weren’t allergic to eggs, you were okay!  Today, you can buy Diclofenac either as a pills or creams, most notably under the brand name Voltaren, at least in Europe.  (Do a Google Image search for Voltaren and you can see the worldwide varieties, both creams and pills)

 

voltaren emulgel

Lastly, over 10 years ago, I did try Vioxx (Rofecoxib), but in 2004, it was withdrawn from the market because of concerns about increased risk of heart attack and stroke associated with long-term, high-dosage use.  Vioxx was quite harsh on the stomach from my experience, and often I would take it with food.

What have we Learned?

Diclofenac, a nonsteroidal anti-inflammatory drug (or NSAID) medication is often prescribed to relieve pain and reduce inflammation caused by arthritis.  Earlier this year, there was a push to have it withdrawn from the market because of the cardiovascular risks of anti-inflammatory drugs, based on analysis of several studies.  They found that people taking Diclofenac were 40% more likely to suffer a heart attack than those taking Naproxen (trade name Aleve), which is considered the safest drug-like to minimize cardiovascular risk.

All drugs have risks, and some feel it’s better to use creams and gels compared to swallowing pills.  The worst you can do with a gel is a skin rash, whereas taking pills can affect your stomach, and eventually your heart!

I discussed creams, gels, and ointments in several past articles:

In a perfect world, creams are better because it goes right where you need it, applying it directly on the skin with hopes it penetrates to the muscles or soft tissue.  It doesn’t have to reach the bloodstream first, or stomach for that matter.

Again, please see your doctor before taking any kind of drug.

  • Please be VERY careful when taking NSAIDs. They are one of the largest causes of acute kidney failure in young adults. Not many people understand how bad NSAIDs are for your kidneys.

    In addition, athletes/coaches should understand that your body’s natural ability to handle exercise induced inflammation is an adaptation that is necessary to safely/successfully advance in training (increased volume/intensity). If you are regularly taking anti-inflammatory medication or antioxidants (data not great in humans), you are reducing the stress response required to handle the sudden in increase in inflammation. I do not recommend taking NSAIDs/antioxidants to my athletes before or after our exercise sessions (if they have minor pains/aches). But this is just one opinion.

    • @Jack, thanks for weighing in. Yes, creams are a better alternative than pills, but in any case, no drug is safe and always see your doctor first.