When I first got injured I immediately started researching and quizzing my husband about what I should and shouldn’t be doing.  I wanted to make sure I wasn’t doing anything that would jeopardize the healing process.

One of the first thing I remember Wes telling me was to not take NSAIDS.  NSAIDS stands for Non-Steroidal Anti-Inflammatory Drugs. There is a whole bunch of them but the main ones you have heard of:

  • Ibuprofen
  • Aspirin
  • Diclofenac
  • Naproxen

How do NSAIDS work?

NSAIDS obviously are used for cases where pain and inflammation are present. You take them for headaches, body aches, and even to help reduce fevers.

NSAIDS work to reduce inflammation by blocking a key enzyme of the inflammation process called cyclooxygenase, which converts arachidonic acid to prostaglandins and leukotrienes.  Prostaglandins are what cause inflammation, so when NSAIDS work to block the process it in return reduces inflammation.


How does bone repair itself?

The bone healing process after a fracture typically works as such.

Stress Fracture Healing


As soon as the fracture begins it forms a hematoma around the site of the fracture.  At this point the inflammatory agents begin forming around the area to begin to initiate the healing process.

Inflammation helps to trigger cell division and growth of new blood vessels to help heal.  At this point the soft callus begins to form around the area.

Eventually as the process continues a hard callus begins to replace the soft around the broken area of the bone. As time continues, very strong bone replaces the weaker bone.  This is “remodeling” the bone and thus makes it the only tissue to heal without a scar.


So what’s the problem with NSAIDS and bone healing?

If you haven’t figured it out already, inflammation plays a key role in the healing and remodeling of bone.  If it weren’t for the inflammation process then the callus would not be as quick to form around the weak area.

NSAIDS as I stated above help to reduce inflammation by blocking the enzyme that begins the process.  If you are block the enzyme, not allowing the inflammation process to begin, then you are essentially slowing down the bone healing process. Inflammation is the key component to the bone healing process.
If you are one who enjoys reading studies here are a few:

Effects on Non-steroidal Anti-Inflammatory Drugs on Osseointegration: A Review.
The Detrimental Effects of Systemic Ibuprofen Delivery on Tendon Healing are Time-Dependent
Timing Matters: NSAIDS interfere with the late proliferation stage of repaired rotator cuff tendon healing in rats
Non-steroidal anti-inflammatory drugs’ impact on nonunion and infection rates in long-bone fractures.
NSAIDS and Fracture Healing
NSAIDS can have adverse effects on bone healing.
NSAIDS Prevent Proper Fracture Healing
Do Non-steroidal anti-inflammatory drugs affect bone healing? A critical analysis.


Other reasons I avoid NSAIDS

1. GI Issues – NSAIDS have been shown to cause a disruption of the stomach lining causing things such as: nausea/vomiting, dyspepsia, gastric ulceration, and diarrhea.  This has mainly been found in those who take NSAIDS very often. Not just for the occasional headache.

2. Delay of Muscle Healing – Along with NSAIDS interfering in the bone healing process, there has also been some research done showing that it can also delay muscle healing. This isn’t quite as discussed as the bone healing interference, but you can read more about it here.


Options for NSAID replacement

Of course, when I was dealing with my stress fracture I was in pain. It isn’t always easy to just sit there and “take” the pain.  If I have to take something I try to take a natural anti-inflammatory such as:

These are all three items that we have at home and that I took during my recovery process, and even though they still can delay the bone healing process since they are anti-inflammatories I prefer the natural forms over NSAIDS.


I know this is a little bit different of a post, but since I do on occasion get comments and emails from some of you who are either just getting diagnosed with a stress fracture or going through the healing process and want information on things you can do.  This is one of the biggest things that I made sure to eliminate when going through the healing process.


Have you ever tried a natural form of anti-inflammatories?