# Most effective OTC anti-inflammatory? **URL:** \ **Category:** Factual Questions\ **Created:** [February 13, 2007, 9:29am UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999 "2007-02-13T09:29:36Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![SenorBeef](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senorbeef/32/2220_2.png) [@SenorBeef](https://boards.straightdope.com/u/SenorBeef)\ **Post date:** [February 13, 2007, 9:29am UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/1 "2007-02-13T09:29:36Z")
I have, what I suspect to be, a torn rotator cuff. Don’t have money for an MRI to confirm that, but even if it were, chances are the doctor is just going to tell me to ice it and take anti-inflammatories until it heals naturally, unless it’s so severe that it requires surgery. So, skipping that part, I’m going to give the ice and anti-inflammatory thing a try. I think all over the counter type pain relievers all have anti-inflammatory properties. Aspirin, acetominophen, ibuprofin, NSAIDs, etc. But I have no idea how they compare in that capacity. Is one of those types of medications - or any over the country medication at all - clearly the most effective for reducing inflamation from a muscle injury to let it heal? What’s my best bet? Edit: I hope this isn’t construed as trying to make the SDMB my doctor. I’m not looking for a diagnosis - I only gave background info to elaborate in case different drugs are better for different types of inflammation. I’m strictly asking which medication is known to be most effective for that purpose. ---
**Author:** ![Seven](https://avatars.discourse-cdn.com/v4/letter/s/3d9bf3/32.png) [@Seven](https://boards.straightdope.com/u/Seven)\ **Post date:** [February 13, 2007, 10:03am UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/2 "2007-02-13T10:03:13Z")
Hey, welcome to the club. I’m waiting for the results on my xray at the moment for my rotator cuff. I just started taking Methoxisal (which is [methocarbamol](http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682579.html) and acetylsalicylic acid). Methoxisal is OTC here, not sure in the States. So far, I’ve been pleased with the results. It has helped to take the dull roar of pain away - but I still hurt. Side effects of this drug are minimal. I’m not getting drowsy off it. I read it might make my piss turn funny colours (brown, black, blue, green, etc) and I’m looking forward to that. As of yet, nothing though. ---
**Author:** ![Coil](https://avatars.discourse-cdn.com/v4/letter/c/bb73d2/32.png) [@Coil](https://boards.straightdope.com/u/Coil)\ **Post date:** [February 13, 2007, 10:37am UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/3 "2007-02-13T10:37:15Z")
IANAD and all that. But my impression from listening to experts in the area is that the NSAIDS (acetominophen, ibuprofen etc) are on average on the population level equally good at what they do. There are however differences which may make a substance work better or worse for the individual patient both effectwise and side effects. I’d ask a doctor or at the pharmacy. ---
**Author:** ![Philster](https://avatars.discourse-cdn.com/v4/letter/p/13edae/32.png) [@Philster](https://boards.straightdope.com/u/Philster)\ **Post date:** [February 13, 2007, 1:41pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/4 "2007-02-13T13:41:18Z")
IANAD, but for sports injuries, such as back problems, shoulders, elbows and knees, they will lean on ibuprofen, and often as high as 800mg per dose. For much more specific pain, like a toothache, acetaminophen is usually prescribed, based on my experience. Of course, since you will check with an actual doc, make sure you bring up options in case ibuprofen upsets your stomache (much as aspirin might). ---
**Author:** ![crazyjoe](https://avatars.discourse-cdn.com/v4/letter/c/f14d63/32.png) [@crazyjoe](https://boards.straightdope.com/u/crazyjoe)\ **Post date:** [February 13, 2007, 3:01pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/5 "2007-02-13T15:01:35Z")
I am fairly sure that of all the drugs classified as NSAIDs, acetaminophin is the one with the least anti-inflammatory ability. I am not really even sure if it’s considered an NSAID. It’s mostly just pain releif. ---
**Author:** ![norinew](https://avatars.discourse-cdn.com/v4/letter/n/eb9ed0/32.png) [@norinew](https://boards.straightdope.com/u/norinew)\ **Post date:** [February 13, 2007, 3:07pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/6 "2007-02-13T15:07:08Z")
Of all the NSAIDs out there, I’ve found Aleve (naproxyn sodium) to be most effective for acute pain. Standard disclaimer: IANAD, pharmacist, or even a college graduate. ---
**Author:** ![Joey\_P](https://avatars.discourse-cdn.com/v4/letter/j/919ad9/32.png) [@Joey\_P](https://boards.straightdope.com/u/Joey_P)\ **Post date:** [February 13, 2007, 3:09pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/7 "2007-02-13T15:09:58Z")
[QUOTE=crazyjoe] I am fairly sure that of all the drugs classified as NSAIDs, acetaminophin is the one with the least anti-inflammatory ability. [/QUOTE] But I read here somewhere (I think it ws QtM) that acetaminophin and ibuproffen together will work better then either of them along. (Greater then the sum of their parts type thing). As for OTC NSAIDS, I want to say Naproxen is the strongest, also (IME) the roughest on your stomach. ---
**Author:** ![CookingWithGas](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cookingwithgas/32/485_2.png) [@CookingWithGas](https://boards.straightdope.com/u/CookingWithGas)\ **Post date:** [February 13, 2007, 3:16pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/8 "2007-02-13T15:16:13Z")
[QUOTE=SenorBeef] I think all over the counter type pain relievers all have anti-inflammatory properties. Aspirin, acetominophen, ibuprofin, NSAIDs, etc. [/QUOTE] Generally true except that Acetaminophen (e.g., Tylenol) is not an anti-inflammatory. NSAID is a generic category, meaning non-steroidal anti-inflammatory drug. Aspirin and Ibuprofen fall into this category, as well as Naproxen (Alleve), and lots of others. Which one’s best? Usually your doctor would decide based on the problem he’s treating and how you specific system responds to different drugs. Once I had an inflamed shoulder and my doctor prescribed Ibuprofen (stronger than the OTC version). ---
**Author:** ![Max\_Torque](https://avatars.discourse-cdn.com/v4/letter/m/e9bcb4/32.png) [@Max\_Torque](https://boards.straightdope.com/u/Max_Torque)\ **Post date:** [February 13, 2007, 5:59pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/9 "2007-02-13T17:59:29Z")
I used to be a big fan of Orudis (ketoprofen), but it seems to have been taken off the market here in the states. Whether that’s for financial reasons or if it’s been pulled by the Feds, I have no idea. I do know that old bottles of the stuff appear to fetch a handsome price on eBay. ---
**Author:** ![ZipperJJ](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/zipperjj/32/211_2.png) [@ZipperJJ](https://boards.straightdope.com/u/ZipperJJ)\ **Post date:** [February 13, 2007, 6:04pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/10 "2007-02-13T18:04:53Z")
Personally, some ice and a couple Aleve will cure all of my bone-and-muscle ails. When my dad went to the ER one day because he couldn’t walk (back problems), they sent him home with a big bottle of Naproxen (Aleve). Didn’t do anything for his actual problem, which was cleared up many months later with surgery, but you figure that if Naproxen is what they give a dude who can’t walk it should be good enough for me & you. But don’t over-take the stuff. I was heavy into ibuprofen when I was having problems with my TMJ and it resulted in an ulcer. Follow the pharmacist’s orders (they will help you with OTC stuff not just prescription stuff). ---
**Author:** ![StuffLikeThatThere](https://avatars.discourse-cdn.com/v4/letter/s/bc8723/32.png) [@StuffLikeThatThere](https://boards.straightdope.com/u/StuffLikeThatThere)\ **Post date:** [February 13, 2007, 6:07pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/11 "2007-02-13T18:07:01Z")
Ibuprofen is generally used at our house for minor aches and pains. Mr. Stuff has recently been having some bad back pain, related to moving crap to our new house. He called our doctor (whom we lurrrrrrve) and was told to get some Aleve and use it for awhile. He’s much happier. ---
**Author:** ![gotpasswords](https://avatars.discourse-cdn.com/v4/letter/g/c57346/32.png) [@gotpasswords](https://boards.straightdope.com/u/gotpasswords)\ **Post date:** [February 13, 2007, 6:15pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/12 "2007-02-13T18:15:33Z")
[QUOTE=Joey P] But I read here somewhere (I think it ws QtM) that acetaminophin and ibuproffen together will work better then either of them along. (Greater then the sum of their parts type thing). [/QUOTE] The ten-dollar word for that effect is “potentiate.” I believe what the good doctor mentioned somewhere else was to alternate the two meds on a normal dosing schedule without doubling up on either. (As a category, NSAIDs can be pretty rough on your GI tract and liver/kidneys.) Hopefully he’ll come along soon to clarify that. Whatever you take, you need to take it religiously: > [@Qadgop the Mercotan](#): > > Also, be advised that if you want to use Ibuprofen and other NSAIDS for the purposes of fighting inflammation, you need to take it regularly, around the clock, in adequate doses, for at least a week to see a significant effect. If you’re looking at using Tylenol, there’s a reason they’ve been saying “We want you to follow the directions!” in their advertising recently. The margin of error between successfully managing pain and death by liver failure can be surprisingly small. Two extra-strength Tylenol every six hours = 4 grams of acetominophen per day. Liver failure has been seen in patients taking as little as 8 grams per day - just twice the regular dose. ---
**Author:** ![AskNott](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asknott/32/5790_2.png) [@AskNott](https://boards.straightdope.com/u/AskNott)\ **Post date:** [February 13, 2007, 8:33pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/13 "2007-02-13T20:33:06Z")
[QUOTE=Joey P] … As for OTC NSAIDS, I want to say Naproxen is the strongest, also (IME) the roughest on your stomach. [/QUOTE] As my doctor told me, different people react differently to different NSAIDs. On his advice, I tried several kinds, and I settled on naproxen (generic Aleve.) Unlike your experience, for me, _naproxen was kinder to my stomach than the rest._ I’ve been taking 3 or 4 a day for years, with never any gastric bleeding. Yes, that’s more than the label indicates, but I have my doctor’s okay on the safety of that dose. ---
**Author:** ![norinew](https://avatars.discourse-cdn.com/v4/letter/n/eb9ed0/32.png) [@norinew](https://boards.straightdope.com/u/norinew)\ **Post date:** [February 13, 2007, 8:37pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/14 "2007-02-13T20:37:15Z")
Just before Christmas, I had a kidney stone removed via cystoscope. They put in a nifty little thing called a stent, to keep the urethra from closing up. I’ve had this done ten times before, with no problems. But _this_ time. . .about a half hour after the stent came out, _enormous_ pain. It felt like a really bad kidney stone attack, but the pain radiated all the way down into my groin. Percocet, 15mg at a time, wasn’t doing anything but taking the very edge off the pain. I called the doctor’s office, and was diagnosed, over the phone, with a little condition called “renal colic”. The nurse reassuringly told me it should resolve itself within 24 hours. My thought was, I’d kill myself before I’d go through 24 hours of this. She told me to take an Aleve along with the Percocet. That did the trick. 🆒 ---
**Author:** ![thirdname](https://avatars.discourse-cdn.com/v4/letter/t/d07c76/32.png) [@thirdname](https://boards.straightdope.com/u/thirdname)\ **Post date:** [February 13, 2007, 10:19pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/15 "2007-02-13T22:19:26Z")
I’ve thought about starting a thread about anti-imflammatories. If inflammation is harmful, and reducing it aids healing, why does it happen in the first place? I wonder this every time I take an NSAID; it might make things feel better, but is it helping? Sometimes I wonder whether it’s similar to trying to reduce a fever. Of couse I could be wrong; maybe inflammation stiffens things up and protects against re-injury but doesn’t promote healing, or something like that. ---
**Author:** ![outlierrn](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/outlierrn/32/3005_2.png) [@outlierrn](https://boards.straightdope.com/u/outlierrn)\ **Post date:** [February 13, 2007, 10:48pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/16 "2007-02-13T22:48:18Z")
IANADoctor and I cannot advise you. When cells are hurt, they release chemicals that tickle pain receptor sites. They also cause vasodilation, bringing more blood flow to the area. This is what causes the visible swelling and warm feeling. It’s a good thing in that it brings more oxygen and damage control and repair chemicals to the injury. OTOH, there is no negative feedback mechanism that shuts off the process. This means that after you’re doing what your supposed to, the pain continues. Also, the swelling doesn’t stop even when your cells are so swollen that they’re as vulnerable to more damage as an overipe fruit. NSAIDs, of which Tylenol is NOT, inhibit the formation of these chemicals, reducing pain. Since said chemicals are similar to those that line the GI track to protect it from harsh digestive juices you get the potential for gastric complications. We don’t have any Motrin suppositories for this reason, and we always recommend something in the stomach when using higher doses of motrin such as 600-800mg, doesn’t have to be a full stomach, but not empty either. I favor Motrin for my PERSONAL musculoskeletal pain, but YMMV, so some people favor other preparations, to the best of my knowledge, despite what the marketing dept might say, different drugs are more effective for different people, and there is no one best solution. the shoulder is a complicated joint, and physical therapy is often a part of rotator cuff healing ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [February 13, 2007, 10:55pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/17 "2007-02-13T22:55:42Z")
[QUOTE=norinew] Of all the NSAIDs out there, I’ve found Aleve (naproxyn sodium) to be most effective for acute pain. . [/QUOTE] Well, not for me- but it _is_ the best IMHO OTC anti-inflammatory. For pain, it’s OK. In my experience, unlike what **Joey P** sez, it is the \*least \*likely to tear up your stomach as you take a lot less. ---
**Author:** ![cmyk](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cmyk/32/3353_2.png) [@cmyk](https://boards.straightdope.com/u/cmyk)\ **Post date:** [February 13, 2007, 11:12pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/18 "2007-02-13T23:12:53Z")
slight hijack: Is Naproxen pronounced “Nap-Rah-Syn” or Nuh-Prox-In"? I only asked because I’ve been pronouncing it the latter, but I just heard my GP pronounce it the former. ---
**Author:** ![norinew](https://avatars.discourse-cdn.com/v4/letter/n/eb9ed0/32.png) [@norinew](https://boards.straightdope.com/u/norinew)\ **Post date:** [February 13, 2007, 11:25pm UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/19 "2007-02-13T23:25:51Z")
[QUOTE=cmyk] slight hijack: Is Naproxen pronounced “Nap-Rah-Syn” or Nuh-Prox-In"? I only asked because I’ve been pronouncing it the latter, but I just heard my GP pronounce it the former. [/QUOTE] IIRC, Naprosyn (pronounced NAP-ro-sin) was a brand of naproxen sodium that was available by prescription before it was sold OTC. But the actual generic name of the drug is na-PROX-en. ---
**Author:** ![sdguy](https://avatars.discourse-cdn.com/v4/letter/s/8dc957/32.png) [@sdguy](https://boards.straightdope.com/u/sdguy)\ **Post date:** [February 14, 2007, 4:15am UTC](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999/20 "2007-02-14T04:15:29Z")
[QUOTE=Max Torque] I used to be a big fan of Orudis (ketoprofen), but it seems to have been taken off the market here in the states. Whether that’s for financial reasons or if it’s been pulled by the Feds, I have no idea. I do know that old bottles of the stuff appear to fetch a handsome price on eBay. [/QUOTE] Orudis rocks!!! They took it off the market because there was not much demand. It was confusing enough. You can buy it on the internet but it’s costly. [Next page](https://boards.straightdope.com/t/most-effective-otc-anti-inflammatory/391999.md?page=2)