Anti-inflammatory tablets
Anti-inflammatory tablets are used to reduce pain and swelling in the joints and other parts of the musculoskeletal system. In sports medicine, they are the most commonly used class of legal drug (pharmaceutical).
Cortisone is an anti-inflammatory drug. It is also a steroid drug, but not an anabolic steroid. Whilst cortisone is used commonly in injection format, it is far more common to use Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in tablet format. The most commonly used NSAIDs in Australia are Voltaren, Nurofen, Naprosyn, Celebrex and Mobic. Aspirin is also an anti-inflammatory drug.
Nurofen (Ibuprofen) and Voltaren, in low doses, are available without a doctor's prescription, so athletes commonly self-medicate with these tablets.
The advantages of anti-inflammatory tablets include a reduction in pain and swelling, and a side effect of blood thinning which is often beneficial. The benefits are substantial, including lower rates of heart attack , DVT and certain types of cancer (including bowel and breast). The major unwanted side effect is stomach upsets and stomach ulcers can occur . NSAIDs can be counterproductive if they allow an athlete to push through the pain barrier and worsen an injury. As a general rule, NSAID are not advised for injuries in which there is major structural damage, whereas they can be very helpful where the structural damage is minor, especially if swelling is a major feature.
Cox-2 NSAIDs such as Celebrex and Mobic are more expensive than standard NSAIDs and they have a lower risk of causing stomach ulcers. However, they also thin the blood less, so they are not associated with lower rates of heart attack, stroke and DVT, which regular NSAIDs help prevent. Vioxx, a very popular Cox-2 medication, has been recently withdrawn from sale because trials showed it increased the risk of heart attack and stroke in those taking it for longer than 18 months.
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