We are always told to use ice or NSAIDs for swelling and inflammation, and medication to reduce fever.
These are immune responses. I know suppressing them makes us more comfortable, but doesn’t it work against what our body is doing to fight infection?
Ice and anti-fever medications are for patient comfort, and really don’t affect the outcome either way in the vast majority of cases. The general medical consensus is to use them if you feel they help make you more comfortable, but it’s also ok to go without.
Note that NSAIDs only fight inflammation when taken in sufficient dosage at a sufficient frequency for a sufficient length of time. For ibuprofen, one needs generally 2400 mg a day in divided doses for at least 2 weeks to truly reduce inflammation; for naproxen it would be 1000 mg a day for a similar length, for meloxicam 15 mg a day for a similar length. And frankly they only need to fight inflammation where there’s a significant inflammatory condition going on, like a rheumatoid disease. Otherwise NSAIDs only reduce pain and fever with episodic dosing.
Sometimes, yeah. But I think what tends to happen is when we get infected, and our immune response cooks the nasty little varmints effectively, we don’t feel miserable for terribly long, perhaps don’t even notice. That leaves mainly the times when our immune response isn’t having the desired effect, and so our system keeps ratcheting up the temp and meanwhile the varmints are making painful things happen in our tissues, and this combo we notice. We are for the most part not going to successfully cook the flu buggies to death by running a protracted temp, we’re just gonna make ourselves more miserable trying.
I’ve had an inflammed abdominal muscle for months that wouldn’t heal and finally booked an appointment with my GP. The doctor told me that NASIDs can treat the problem and that it was a misconception that all they did was hide the pain. He put me on a course which I’ve finished and finally the pain has mostly gone. So according to my doctor they do have a healing effect - or at least give space to the body to heal. I am no doctor however, so I am merely repeating my layman’s understanding of what he was telling me.
He may well have put you on a sufficient dosage for a sufficient length of time to fight inflammation. I certainly prescribed NSAIDs that way countless times in my career.
Sadly, in my decades as a medical director supervising physicians, I found far too many to be underinformed about how NSAIDs really worked for inflammation.
That is a lot more than the 200mg every 8 hours that is written on the bottle. Won’t that hurt your stomach?
Yes adequate doses of anti inflammatory meds can stop me times treat inflammation when that is the problem.
But in the context of infection in which inflammation is both part of the needed functional body response, and a problem, for comfort and sometimes more? NSAIDs will just take a small edge off. Not enough to block the big picture items.
Ibuprofen and other NSAIDs can cause gastric irritation at about any dosing level, yes. Which is why I tended to put folks on chronic nsaids on an acid reducer like omprazole or similar while they needed to take it regularly. But even then it can still cause GI bleeding, so nsaids need to be used with great caution. Nsaids are hard on the kidneys too, for at risk people.
Ever since I was prescribed 800mg ibuprofen pills (real horse pills they were) for migraines I never take a single 200mg pill. 600mg is my go-to dose for headaches, 400mg if I catch it early, 800mg if I wait too long.
Mrs. Martian will go on naproxen when her knee arthritis flares up. She finally has an ortho who told her to take it for ten days to two weeks even after the pain goes away. Until then we thought she was heading for her second knee replacement, but using that regimen as needed has made things much better. Really wish she had gotten that advice before her first knee replacement…
I have knee issues and nsaids help. Once it flares up, i need to go on nsaids for a week or more to clear it up. But used prophylactically, one dose can do the trick.
I used to go horse back riding with a friend. It was fun, but the next day i couldn’t walk. My husband suggested i try taking ibuprofen before the ride (i took two tablets) and i was fine the next day. I did this enough both ways that i consider it a successfully reproduced experimental result.
Yes, reducing the pain, and even prophylactically treating it ahead of time can have such benefits. But it doesn’t seem that using it for very short periods of time contributes much, if at all, to inflammation reduction.
My hypothesis is that it reduced inflammation enough WHILE I WAS RIDING that there was less damage to the knee, and so less subsequent inflammation. I dunno the mechanism for certain, but I know it worked.
Once everything is inflamed, there’s a vicious cycle and it takes a lot more to get it under control. I even once had to have a cortisone shot. Pretty weird, but knee pain that I’d had for a couple of months went away and hasn’t returned – that was several years ago.
Well, current research evidence tends to support a different mechanism: Pain relief due to NSAID reducing pain via preventing the body’s automatic inflammation response to pain stimulus. That may sound like splitting hairs (probably because it is just that) but it does seem to be a different molecular mechanism from NSAID’s ability to reduce inflammation that’s already present when NSAIDs are begun. The closer you look at the biological details the more complicated it gets, and the more headaches I get trying to understand it all.
And cortisone is a wonderful treatment for certain types of joint pain. Sometimes it will resolve painful joint issues for years with a single dose.
Huh. That’s really interesting. Thanks.
And they guy who shot me up with cortisone gave me a long lecture about how he couldn’t do it very often, but as the problem hasn’t recurred in (looking up medical records) 5 years now, and it was pretty painful for months before that, I feel it was well worth it. And yes, I don’t want a lot of cortisone if I can avoid it. But that one shot was really worth it. The closest thing to a medical “magic bullet” I’ve ever experienced. I guess maybe vaccines, too, but an absence of developing a problem is less striking than resolving a problem.
So, take an NSAID and call us in the morning …
IANAD so hopefully @Qadgop_the_Mercotan will say something if I’m wrong but, I believe, there can be cases where your body over-reacts to the disease. Your body gets too hot, too inflamed, etc. and that could cause other complications. Evolution isn’t perfect. And so it might be better to reduce your body’s natural defenses and use other medical interventions to help pick up the slack.
That said, if you’re in the territory where you’re feeling like your inflammation/fever might cause secondary complications, you should be in a hospital and a doctor should be the one weighing the options and making these decisions.