Smart Relief

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