The Ankle Part 3: I Have Sprained My Ankle. Do I Take Anti Inflammatory Medication?
13 Aug 2015
Over the last few years, much debate has surrounded the use of non-steroidal, anti-inflammatory drugs (NSAID’s) and their indications for acute injury. Given the ankle is one of the most commonly injured body parts, it is wise to be up-to-date with the current research.
NSAID’s are medications with analgesic (pain reducing), antipyretic (fever reducing) effects. In higher doses they also have an anti-inflammatory effect, meaning they reduce inflammation. As the name suggests, they do not contain steroid, which are a separate class of anti-inflammatory drugs.
Following an acute sprain of the ankle and inflammatory cascade occurs, as the body calls on it’s clever systems to both immobilise the part and commence the healing and repair process. Swelling, inflammation and pain usually result. The theory behind taking NSAID’s is that these effects are minimised, promoting a faster recovery and return to sport (or life).
The question is however, is this a good idea or a bad idea?
Unfortunately the jury is still out…….
A 2014 paper by van de Bekerom et al., showed that taking NSAID's following an ankle sprain resulted in superior results for pain and swelling at short and medium term follow up when compared with placebo.
On the other side of the argument, a relatively recent summary of the literature by Tiemstra, J.D., (2012) demonstrates “at this time, the evidence does not support the systematic use or superiority of NSAID’s for the treatment of the inflammatory response to acute ankle sprains”.
So who do we believe and what to do from here?
From a clinical perspective, taking oral NSAID’s does seem to speed up the recovery following a sprain. Whether it interferes significantly with the healing process and impairs the long term tissue recovery is yet to be proved. On a purely common sense level it does seem odd to be tinkering with our bodies natural response to injury. Our bodies are very clever at deciding what is necessary to facilitate healing.
Yet in this day and age, we are in such a rush to not miss a single day or sport, work or social activities the pressures are getting larger, not smaller.
Ultimately I will leave the decision up to you and your healthcare professional, but I wonder where we will be in 20 or 30 years. Perhaps the “revolutionary” new treatment advice for ankle sprains will be rest until it feels better and then some gradual rehabilitation...