Sore Muscles? For Pain Relief, Avoid NSAIDs

Q: I get very sore after my leg workouts. Sometimes it’s so bad I find it hard to get around. Is it OK to take ibuprofen to help reduce the pain?

A:

As a general rule, I advise against taking ibuprofen, or any type of non-steroidal inflammatory drug (NSAID). Ibuprofen works by blocking an enzyme called cyclooxygenase (COX). COX catalyzes the production of various prostanoids that play a role in inflammation and algesia. Theoretically, reducing prostanoids should help to alleviate localized muscle muscular pain.

Most research, however, fails to support the efficacy of NSAIDs in reducing muscle soreness. Creatine kinase levels (a marker of muscle damage) have not been shown to be significantly different between those taking NSAIDs and a placebo group, indicating that NSAIDs have little effect on attenuating the root cause of pain. Moreover, the majority of studies show no differences in self-described pain ratings associated with muscle soreness after taking NSAIDs. This is particularly true in severe cases of muscle soreness, when a pain reliever would be of greatest value.

While a lack of effectiveness in reducing post-workout pain is certainly reason enough to avoid NSAIDs, there is a larger issue for serious exercisers. Namely, prostaglandins are known to regulate protein metabolism. Specifically, they help to stimulate protein synthesis, which is the mechanism by which muscles repair themselves and grow stronger. Studies have shown that post-exercise protein synthesis is virtually non-existent following consumption of NSAIDs. And if your muscles don’t synthesize protein after a workout, you won’t see any appreciable improvement in muscle development.

Bottom line: try to steer clear of ibuprofen or any other NSAIDs whenever possible. Understand that the inflammatory response following an intense training session is part of the healing process that is necessary to develop your muscles. Shortchange healing, and you shortchange muscular results.

So, what to do about the pain from soreness? The best advice is to stay active – don’t just lie in bed or sit around at your desk all day. An active recovery will help to maintain blood flow to the affected muscles, which will aid in healing. There is some evidence that massage can help to restore muscle function and reduce achiness. It’s certainly worth a try. If nothing else, it can provide temporary relief by taking your mind off the pain.