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Smart Relief

Smart Relief

Features
By Kellee Katagi
posted: 03/06/2003

It's a rare skier who hasn't experienced aches and pains after a few high-octane days on the slopes. Over-the-counter medicine can alleviate many of these ailments, but not all painkillers do the same job. Knowing which one to take when-and which to steer clear of-can help you feel better, quicker.

Before you reach for whatever pill bottle is on the shelf, ask yourself what kind of pain you're experiencing. Are your feet aching from tight boots? Or is it more serious-a tweaked knee, deep shoulder pain or a swollen joint? Learn to listen to your body so you can tell which symptoms are routine and which signal a bigger problem. "If you hurt your knee and there's a large amount of swelling right away, that's usually a sign you damaged your ACL," says Dr. Steve Bannar, an orthopedic surgeon at the Tahoe Fracture and Orthopedic Medical Clinic in South Lake Tahoe, Calif. If you suspect an injury, don't pop a few pills and get back on your skis; seek treatment right away. Use medicine for pain relief, never as a substitute for rest, rehab and recovery.

Most OTC painkillers fall into one of two categories: acetaminophen (Tylenol, Aspirin-Free Excedrin) and nonsteroidal anti-inflammatory drugs or NSAIDs (aspirin, ibuprofen, ketoprofen, naproxen). Both types relieve pain and reduce fever by decreasing the pain signals carried to the brain, but only NSAIDs fight inflammation, which accompanies common ski injuries such as strains, sprains and tears. Experts disagree on whether decreasing inflammation speeds up the healing process, but they do agree that it can make you feel better, faster. Don't expect an immediate fix, though: You'll have to use the medicine regularly for several days, allowing it to build up in your bloodstream, before the anti-inflammatory effects kick in. Also, be aware that NSAIDs (or any other painkillers) do not accelerate recovery from typical post-exercise muscle soreness and fatigue.

NSAIDs' anti-inflammatory effects make them generally a better choice for skiers, says Dr. Terry Orr, head team physician for the U.S. men's alpine ski team (although he adds that ice can work wonders on inflammation). There are reasons to use aceteminophen, however: Opt for Tylenol if you're younger than 12, if you have a head injury or lots of bleeding or bruising (which NSAIDs can exacerbate), or if anti-inflammatories trigger allergic reactions or upset your stomach-a common side effect. The same mechanism that helps NSAIDs reduce swelling also inhibits the production of prostaglandins, chemicals that protect the lining of the stomach. In the short-term, that can cause indigestion. In the long-term, it can lead to ulcers or gastrointestinal bleeding. That's why, as most painkiller bottles warn, you shouldn't take NSAIDs continuously for more than 10 days-even the coated and time-release varieties, which limit indigestion but not long-term damage. For chronic pain or slow-healing injuries, consult your doctor about prescription pain relievers. Also, alcohol and caffeine make your stomach more sensitive, so consider limiting your consumption when taking painkillers. Liver damage can ensue if you take pain relievers with three or more alcoholic drinks.

If you decide NSAIDs are your best bet, the options are many. Each drug can affect people differently, so the choice comes down to which one works for you. Use the guide to the right to determine which might suit you best. Whatever you choose, stick to the recommended dosage. "People tend to think that a little is good, so more must be better," Bannar says. "With pain relievers, that's not the case." Inflammation FightersInflamation Fighters

  • Aspirin (Anacin, Bayer, Bufferin, Ecotrin) Aspirin-in use since the 1800s-is the oldest and least expensive NSAID. It is a powerful anti-inflammatory, which also means it's more likely to irritate your stomach; as with most drugs, the more effective it is, the more potential side effects it has.
  • Ibuprofen (Addvil, Nuprin) Ibuprofen was introduced in 1974 as an alternative to aspirin that is easier on the stomach. Lower doses of ibuprofen can relieve pain, but higher doses (900 to 3,200 milligrams per day) are needed to control inflammation. It can take up to seven days for the anti-inflammatory effect to kick in.
  • Ketoprofen (Actron, Orudis KT) Ketoprofen has been used as a prescription drug for more than 20 years, but was first approved as an OTC painkiller in 1995. Arguably the most potent OTC anti-inflammatory, it's also potentially the hardest on your stomach. And don't take it before bed: It can irritate your throat if you lie down within 15 to 30 minutes of ingestion.
  • Naproxen (Aleve) Prescription forms of naproxen fight inflammation, but Aleve (the OTC version) only relieves pain and reduces fever. One dose (two tablets) lasts eight to 12 hours, as opposed to four hours for recommended doses of ibuprofen and aspirin.
  • Cox-2 inhibitors (Vioxx, Celebrex) The latest NSAID advancement is Cox-2 inhibitors, medicines introduced in 1999 that control pain and inflammation but don't inhibit the enzymes that protect the stomach lining. Cox-2s are expensive and have not yet been approved for OTC use, but they are thought to be easieron your insides than other NSAIDs. Talk to your doctor about them if you have a history of stomach, liver or kidney trouble.

    The Natural Way
    Looking for a natural way to ease inflammatory pain? Recent studies show that omega-3 fatty acids, found in various fish and vegetable oils, may reduce inflammation. Omega-3 suppresses inflammatory substances in red blood cells, which in turn decreases swelling in nagging joints. Avid skiers should take 3 grams of omega-3 (in capsule or liquid form) coupled with 1 gram of vitamin E daily during the ski season, recommends Dr. Artemis Simopoulos, author of Omega Diet and president of the Center for Genetics, Nutrition and Health. In that dosage, omega-3 may reduce swelling within a couple of weeks.
    -Meg Loucks

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