Pain is part of being an athlete.
From the bumps and bruises that occur during competition to the standard soreness that accompanies weight room training, athletes know about dealing with pain. To help them dull those aches, many turn to a simple solution—over-the-counter (OTC) pain relievers. These products are easy to find, affordable and effective. But are they something athletes should be using on a regular basis? Here's what athletes need to know about OTC pain relievers.
What are OTC Pain Relievers?
The category of pain relievers (also frequently referred to as painkillers) is broad.
At the most powerful end of the spectrum are opioids like fentanyl, morphine and oxycodone. These are highly potent drugs for pain relief and cannot be legally obtained without a prescription. According to the National Institute on Drug Abuse, "[these drugs] interact with opioid receptors on nerve cells in the body and brain. Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but they are frequently abused because they produce euphoria in addition to pain relief."
On the lower end of the painkiller strength spectrum, you'll find OTC drugs like acetaminophen, naproxen and ibuprofen. These drugs go by brand names such as Tylenol, Aleve, Advil and Motrin. They can be purchased without a prescription and are typically abused far less than prescription opioids due to their lower potency. OTC pain relievers are widely available—you probably have some in your cabinet right now. Their accessibility is a big reason why many athletes take them to help deal with sports-related pain. The Mayo Clinic recommends the use of OTC pain relievers for a variety of common sports injuries, including sprains and strains.
How Do OTC Pain Relievers Work?
According to the American Academy of Family Physicians, acetaminophen (the active ingredient in brands such as Tylenol) relieves pain by affecting the parts of the brain that register pain. It also helps bring down the body's internal temperature if it's elevated above normal levels, which is why it's often used to combat fevers.
Non-steroidal anti-inflammatory drugs (NSAIDS) refers to products made with aspirin, ibuprofen and naproxen. NSAIDs reduce pain and inflammation by blocking enzymes that produce prostaglandins, a group of naturally-occuring fatty acids that play a major role in pain and inflammation. Like acetaminophen, NSAIDs also help regulate body temperature.
What are the Dangers of OTC Pain Relievers?
Just because OTC pain relievers are widely available doesn't mean they aren't without dangers.
According to the FDA, frequent overuse of acetaminophen can lead to liver damage and death. Per the Harvard Men's Health Watch, "The body breaks down most of the acetaminophen in a normal dose and eliminates it in the urine. But some of the drug is converted into a byproduct that is toxic to the liver. If you take too much—all at once or over a period of days—more toxin can build up than the body can handle."
Tens of thousands of people become ill every year from taking too much acetaminophen, but that shouldn't be an issue for you if you stick to the recommended dosage guidelines. Also, heavy alcohol drinkers (those who consume more than three drinks per day) are at an increased risk of liver damage while taking acetaminophen. The Harvard Medical School recommends never exceeding a 3,900mg dose of acetaminophen within a 24-hour period.
NSAIDs also have their own issues. Per the Harvard Health Letter, "The risks of NSAIDs are not very high, but they are real. Regular, long-term use of NSAIDs has been linked to ulcers, stomach bleeding, liver damage, high blood pressure, and increased risk of heart attacks or heart failure. . .the vast majority of people taking NSAIDS will not have heart problems or any other problems. However, we now recognize that there is some heart risk from these medicines."
That covers the general dangers of most OTC pain relievers, but you should always consult your doctor to find out which OTC pain reliever best fits your personal needs. For example, you may be on a medication that reacts unfavorably with certain types of pain relievers. If that's the case, certain OTC pain relievers could do more harm than good.
How Should Athletes Use OTC Pain Relievers?
There's nothing wrong with taking an OTC pain reliever occasionally as long as you read the label and follow the dosage guidelines. If you're dealing with an injury or an especially hellacious day of soreness, there's no harm in downing some Advil or Aleve (providing you know your body can handle it).
However, athletes should not be using OTC pain relievers on an everyday basis.
For one, it increases your risk of long-term health effects down the road. Second, if you're experiencing so much pain that you're truly in need of pain relievers every day for an extended period of time, there are likely other issues at play. Remember, pain relievers do little to actually help an injury heal. As such, they should only be used to complement proper treatment—never instead of it. If you find yourself so sore that you're regularly relying on OTC pain relievers, you need to re-examine your recovery methods and workout schedule. Either way, chronic pain is something you should visit your doctor to discuss.
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