When To Take a Pill?

pillsMy good friend and book/blog reader, John Berry asked my opinion on when to take pain meds for a sore shoulder. So, here are my thoughts…

Five or six years ago, I used to take one or two Ibuprofen pills (Advil) every time I played tennis. Just from working hard on the court the day before, I was somewhat sore; so I took a pain pill.

I would say it was not an addiction, but more of a habit.

DeDe suggested it was not a good idea; so I stopped. And I felt NO WORSE than when I was taking the daily pills.

So, When To Take a Pain Pill?

In my opinion, feeling and playing with some pain is an OK thing. In most cases, it is just a natural soreness – which is a POSITIVE indication that you had a good workout the day before. So I take NO pill for that.

But if the pain will inhibit my performance on the court, then I might take something to smooth it over and allow myself to move freer and better. But if the pain is an indication of a small or potentially growing injury, then taking a pill may just mask the body’s warning; so there are three choices:

• Take the maximum dose of the medication (I believe that is two Aleves in the morning and then again at night) to serve as an anti-inflammatory medication (if that is what the problem is).

• Or, take the pills AND take time off from tennis (always tough for me to follow my own advice on that one!)

• Or, take NO pills but just the time off.

What do you think? (Especially if you have any real knowledge, compared to my “considered opinions”!)

What Addiction Is … and Isn’t

According to WebMD.com, Addiction is far more than a craving. It also means there are troubling consequences that can often disrupt someone’s personal life or job.

“Addiction means the individual has lost control over the use of the drug. They’re using it compulsively, there are consequences to using the drug, and they continue to use it anyway,” says Gary Reisfield, MD. He’s a chronic pain and addiction specialist at the University of Florida.
Tolerance and dependence are not the same as addiction.

Tolerance is common in people using opioids (such as hydrocodone, oxycodone, and morphine) for chronic pain. It means the body has become used to the drug, and it has less effect at a given dose, Reisfield says. Dependence means that there are unpleasant withdrawal symptoms if a person abruptly stops taking a drug.

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5 thoughts on “When To Take a Pill?

  1. George,

    I’ll bet you were just waiting for me to respond to this one.
    There are two components to athletic problems – pain and inflammation. Some medications will help just pain (acetominophen and opiates), while others alleviate both (aspirin, NSAID’s). If you need to prevent inflammation, one could take the latter group prior to playing. If it is pain, then the former group may be taken after the pain occurs. A word of caution – all medications have side effects. Some of the side effects, including death, are more serious than the problem they are supposed to be treating. NSAID’s in particular, when taken on a regular basis, increase the risk for cardiac events considerably. Allergic reactions to this class of drugs is also fairly common. NSAID’s include ibuprofen (Motrin, et al) and naproxen (Alleve).

    As far as when to take the medication here are my thoughts;

    1. If it is just acute pain from minor injury, I would take NSAID’s in their usual dosage when the pain occurs.
    2. If it is chronic pain, first have a diagnosis, and if it is not a major injury then do as above, but the NSAIDs may be taken prior to playing.
    3. If there is a major injury, I would refrain from tennis until the problem is corrected.

    In no case would I take the NSAIDs on a continuing basis because of their potential for adverse effects. If the pain is on a daily basis, I would consider discontinuing the activity until the body heals.

    Disclaimer: This is not meant to be a therapeutic guide for any specific medical problem

    Yes, Dr. Fenster – i was looking forward to your reply! tks, george

  2. Symptoms of an allergic reaction may be hives, difficulty breathing, other skin rash, feeling faint, nausea, vomiting to name the most common.

  3. In the world of professional sports, especially a long season like baseball, NSAIDS are used profusely. Until recently, pain medications, including injections were also very common. Because of the recent fervor over concussions and other injuries, the NFL has placed major restrictions on how they can be dispersed. In my opinion, it is not the use of these medications but the abuse of them. Our philosophy was with a acute injury, NSAIDS were prescribed for a short period of time (3 days) at its maximum dosage. If the NSAID is helpful, the athlete then would progressively decrease over the next 6 days.

    George, I agree with your scenario. Taking NSAIDS on a “routine” basis, even in a small dosage, serves very little, if any, benefit but can have adverse effects. The body fights minor inflammation (overuse) fairly well. Although there are times when pain medications are called for, it should not be used to “allow” the tennis player to compete in my opinion.

    Larry – thanks for your professional insights! george

  4. George I must say these are the types of subjects that make your site most worthy. You have a large following and of course most are tennis fanatics but many are Doctors tennis professionals and other experts. This subject should be of interest to most everyone that subscribes to your site. Most tennis players that I know take aspirin or advil before or after every match.
    I must assume that many readers like myself have had stents inserted to keep blood flowing normally. Because of the stent located in my LAD I only take one baby aspirin per day. I do take an Isotonix called OPC3 which is powder mixed with water which is a powerful antioxidont. Since taking this supplement about 6 years ago I have not found it necessary to take any other pills for pain. I am very lucky to be over seventy
    and play tennis 4 or 5 times per weeks virtually pain free.
    Thanks for another great subject like the many in your book!!

    Phil – thanks for the kind words and see you soon! george

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