Why Aren't Anti-Inflammatories Always Recommended for Acute Injuries?

For many years, the standard advice following an acute injury was to reduce inflammation as quickly as possible. This often meant using ice, rest and anti-inflammatory medication such as ibuprofen.

Our understanding of injury recovery has changed. Inflammation isn't simply something that needs to be stopped — it is an important part of the body's natural healing process.

Why do we need inflammation?

After an injury such as an ankle sprain, muscle strain or tendon injury, inflammation is part of the body's initial response. It helps remove damaged tissue and activates cells and chemical signals involved in repair.

This means that inflammation itself isn't necessarily the problem. In fact, suppressing this response too aggressively could potentially interfere with some aspects of tissue healing.

Where do anti-inflammatories fit in?

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, reduce inflammation by inhibiting enzymes involved in the production of prostaglandins.

They can be effective at reducing pain, but the evidence that they improve recovery from acute soft-tissue injuries is much less convincing. Reviews of the available research have found limited and sometimes conflicting evidence regarding their effects on healing and function.

There are also particular concerns around some types of tissue. Research has raised questions about NSAIDs and tendon-to-bone healing, although much of the evidence comes from animal or laboratory studies and the clinical evidence remains limited.

Does this mean you shouldn't take ibuprofen after an injury?

Not necessarily.

NSAIDs can still have a role in managing pain following an acute injury. Whether they are appropriate depends on the individual, the type of injury, other medications and medical conditions, and the potential benefits versus risks.

The important change is that they are no longer viewed as an automatic part of treating every acute injury.

What should you do instead?

Modern injury management generally focuses on appropriate movement and progressive rehabilitation, rather than simply trying to eliminate inflammation.

Depending on the injury, this might include:

• Protecting the injured area initially

• Maintaining comfortable movement

• Gradually increasing weight-bearing or activity

• Restoring range of movement

• Progressive strengthening

• Balance and coordination exercises

• Gradually returning to normal activities and sport

Pain and swelling are useful pieces of information that can help guide how quickly activity should be progressed.

The bottom line

Inflammation is a normal and necessary part of healing. Rather than automatically trying to suppress it, modern rehabilitation aims to manage symptoms while allowing the body to progress through its natural healing and adaptation processes.

This doesn't mean that anti-inflammatory medication is "bad" or should never be used. It means that its use should be individualised rather than automatic.