I know lots of people do what they're told. I see it with people, I see it with animals. Everyone does what they think is best. I'm not questioning the person that you listen to has an education, but I am asking you to question the advice
It makes me come off as an asshole a lot of times, but things I have said on this board concerning all sorts of things has been said to get people to dig a little deeper and try to find answers. I guess I'm not very good at it, because i'm usually met with resistance rather than inquiry. I'm not singling you or your response out, so don't take it personally (unless you want to
) But I posed a couple questions and rather than, hmmm, I should check into that, I got, i do what i'm told by the doctor and it works.
But does it?
If sprained ligaments heal as quickly and are 30% stronger with NO intervention over NSAID treatment, is it working?
From here:
http://archinte.jamanetwork.com/article.aspx?articleid=616696
Anti-inflammatories can delay healing and delay it significantly, even in muscles with their tremendous blood supply. In one study on muscle strains, Piroxicam essentially wiped out the entire inflammatory proliferative phase of healing (days 0-4). At day two there were essentially no macrophages (cells that clean up the area) in the area and by day four after the muscle strain, there was very little muscle regeneration compared to the normal healing process. The muscle strength at this time was only about 40 percent of normal.
From here:
(Kulick, M. Oral ibuprofen: evaluation of its effect on peritendinous adhesions and the breaking strength of a tenorrhaphy. The Journal of Hand Surgery. 1986; 11A:100-119.)
This one showed a very dramatic decrease in strength. 12 newtons of force to cause failure of the tendon after 4-6 weeks on the control groups and only 2.5 or 3.5 Newtons of force (depending on NSAID used) to cause failure in the NSAID groups.
Here's another rat study similar to the one I referenced above another one
http://ajs.sagepub.com/content/29/6/801.short
Celecoxib-treated/injured ligaments were found to have a 32% lower load to failure than untreated/injured ligaments. The results of this study do not support use of cyclooxygenase-2 specific inhibitors in the treatment of ligament injuries.
another on knees
http://ajs.sagepub.com/content/34/7/1094.short
After 2 weeks of intervention, ligaments treated with active low-intensity pulsed ultrasound were 34.2% stronger, 27.0% stiffer, and could absorb 54.4% more energy before failure than could ligaments treated with inactive low-intensity pulsed ultrasound, whereas ligaments from the NSAID group could absorb 33.3% less energy than could ligaments from the VEH group.
Beyond 4 and 12 weeks differences were not noted.
another Rat study
http://ajs.sagepub.com/content/34/3/362.short
Traditional and cyclooxygenase-2–specific nonsteroidal anti-inflammatory drugs significantly inhibited tendon-to-bone healing. This inhibition appears linked to cyclooxygenase-2............If the results of this study are verified in a larger animal model, the common practice of administering non-steroidal anti-inflammatory drugs after rotator cuff repair should be reconsidered.
Some more get into a lot of detail on fibroblasts, macrophages or the lack of them in NSAID treated humans and animals and prostaglandin production and how NSAID's affect all this and there subsequent effect on healing tissues.
Almost all of the NSAID literature that is "positive" deals with cost and the amount of time to get back to activity due to decreased pain. NSAIDs do show pretty positive results in those 2 areas. They are relatively cheap. Much cheaper than going to see a therapist with US or laser and some hands on modalities. And they do take pain away rather quickly, making people feel like they are "better". One big study used to "prove" the use of NSAIDS showed those two things, it also showed that ligament laxity and such was also present, but ignored that part.
But most of the literature in the past 10-15 years hasn't been all that positive in terms of how they impact the actual healing of ligaments and tendons. I would think healing is priority number 1 and anything that interferes with that can it really be beneficial?
Anyway, i don't expect everyone to have the same conclusions I do. (Highly intelligent beings will of course arrive at the same conclusions
), but mostly I would like people to dig a bit further sometimes, take a more active role in what they're told, etc.