Should I take an anti-inflammatory?

It seems to be the question on the tip of everyone’s lips: should I take an anti-inflammatory?

It might be a freshly sprained ankle, a torn muscle or just a sore back but it’s hard to know the right thing to do.

You probably remember the ads for Voltaren gel or you’ve seen the marketing poster for Nurofen or Advil.

Knowing the right time to take an anti-inflammatory is the key though.

It might be a easy way of speeding up your early recovery…or it might be an act of accidental self-sabotage that delays your return.

Here’s a simple guide on when anti-inflammatories are appropriate & recommended and when they’re going to slow you down.

Disclaimer: stating the obvious but this advice isn’t specific to your situation. It shouldn’t be the sole guide of your decision.

It can be used to understand the reasons behind your doctor or physiotherapist’s advice.

Types of anti-inflammatories

In this post we are covering over the counter anti-inflammatory these such as Nurofen and Advil (pharmaceutical name: ibuprofen) and Voltaren (pharmaceutical name: diclofenac).

We’ll also cover Voltaren Emugel at the end of the post.

Note that Panadol (pharmaceutical name: paracetamol) is not primarily an anti-inflammatory and so it’s not part of this post.

Also worth noting that we’re not covering prescription anti-inflammatory medication. We’re making the assumption that a doctor has decided it was a good option for you, which is better than advice you’ll get on the internet (like this post).

The rules

Do you have any bruising? Don’t use anti inflammatories.

Fresh bruising is a sign that you’ve damaged blood vessels in the injury.

Anti-inflammatory medication reduces the blood ability to clot.

This means that your bleeding will be worse and more extensive if you take an anti-inflammatory.

Have you injured a muscle? Don’t use anti inflammatories.

If your injury relates to a muscle strain or muscle tear with a sudden onset of pain, an anti-inflammatory will increase the bleed inside the muscle.

This will extend your recovery and make the pain worse.

There are some categories of muscle tear that can use anti inflammatories but it’s best to wait for medical confirmation of the severity of the injury rather than taking the risk.

Do you have a bone stress injury? Don’t use anti inflammatories.

If it feels like a bony ache, and the bone is tender to touch, an anti-inflammatory will reduce the ability of the bone to regenerate.

This potentially makes the condition worse.

An anti-inflammatory will also take away the pain on activity and, although this sounds like a good thing, it means you can overdo the loading without realising that you’re worsening the condition.

Got post exercise soreness? Don’t use anti-inflammatories.

If you’re getting repetitive post exercise soreness, not just after your first session, then your body is not responding appropriately to the load.

You need to review whether you’re overloading in training or if your body is reacting abnormally to normal loads.

Got morning stiffness in your joints? Use anti-inflammatories.

Stiffness after a prolonged period of immobility, such as sleeping, is typically an indication of an inflammatory process.

If it just feels like your joints are a bit rusty, you can take anti-inflammatory the night before to minimise the morning reaction.

You shouldn’t need more than 3 or 4 days of medication if it’s going to be effective.

If you need longer or if the joint stiffness comes back after you stop the medication, you need to get a health professional to diagnose what’s going on.

Voltaren Emugel vs Voltaren tablets

Should I take an anti inflammatory tablet or use the gel?

The decision of using the gel or the tablets really relates to two factors.

  1. How focal the injury is, and
  2. the depth of the pathology.

The gel should only be used for small discrete areas of inflammation.

The gel also has a limitation that it can only penetrate a few millimetres under the skin.

So it’s really only suitable for one or two joints close to the surface like fingers and an elbow.

For larger or widespread reactions or for structures that are deeper than few millimetres such as knees and lower back, you’re best to use the anti-inflammatory tablets if the list above suggest they’re in your favour.