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IBUPROFEN AND ACETAMINOPHEN:  EFFECT ON MUSCLE INFLAMMATION AFTER ECCENTRIC EXERCISE.
  Medicine & Science in Sports & Exercise, Vol. 35, No. 6, June 2003

            Jennifer M. Peterson, et al

 

ABSTRACT

NSAID therapy and/or acetaminophen are often used to treat muscle soreness after an intense exercise program.  NSAID’s are used as they inhibit the synthesis of prostaglandins, and reduce neutrophil chemotaxis and activation.  Analgesics have little anti-inflammatory effects, and block their pain via the reduction of prostaglandin formation.  Little has been done in the research community to assess the function of these drugs on injured muscle tissue after intense exercise.

 

A total of 24 males with no musculoskeletal problems, yet not participating in an exercise program for the previous 6 months, were used for this study.  There were 3 groups of 8:  a placebo group, acetaminophen group, and an ibuprofen group.  After a light warm up on the bicycle, a Cybex was used to perform injurious eccentric exercises to the knee extensors.  Muscle biopsies were taken before and after the exercise from the vastus lateralis muscle, in order to measure histological and histochemical composition.  A second post-exercise biopsy was taken the following day.  Drug administration was 4000 mg/day of acetaminophen, and 1200 mg/day of ibuprofen, while a third group received a placebo.

 

After the exercise, muscle neutrophil concentrations were not significantly altered, even 24 hours after exercise.  Muscle macrophage concentrations were elevated by 1.5-2.5x in all 3 groups 24 hours after exercise.  The drugs used did not change the muscle inflammation cell concentrations, and a surprising find was that the muscle protein synthesis was inhibited, which could lead to negative muscle growth capabilities.

 

COMMENTS

Delayed onset muscle soreness, or DOMS, is always a hot topic in healthcare and exercise circles.  The debate still rages as to exactly what is causing the pain, and I am not aware of any study that provides “smoking gun” evidence that one particular component is the cause.  Use of either ibuprofen/NSAID’s is used, or acetaminophen, to reduce the pain and “inflammation” caused by the beginning of a new exercise program, new training camp, etc. 

 

The article suggests that, at least 24 hours after the exercise, there is inflammation damage in the muscles, but that these drugs in the doses listed, do not significantly reduce the levels of inflammation.  They may, however, even reduce protein synthesis, which is the opposite of what the exercising person wants at that time.  I am not sure why they chose 24 hours instead of 48 hours, which is the point where DOMS is even more painful for most persons.  Perhaps the inflammatory cells concentrations would have been greater, and perhaps there might have been different results from the medications. 

 

This information is quite useful to those patients who are fearful of pain after starting the PT program, or for those who have muscle pain once they have started.

 

 


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