The role of nonsteroidal anti-inflammatory drugs in the treatment of acute soft tissue injuries.

OBJECTIVE: Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used to hasten the return of injured athletes to competition after injury. Evidence demonstrates that while NSAIDs may speed recovery after acute soft tissue injuries, long-term healing may be compromised. This review aims to assess the effects of NSAIDs on inflammation and healing associated with acute soft tissue injury. DATA SOURCES: CINAHL (1982 to 1997), SPORT Discus (1977 to 1997), and MEDLINE (1993 to 1997) were searched using the keywords "NSAIDs," "musculoskeletal," "acute," "sprain," and ";strain." DATA SYNTHESIS: NSAIDs exhibit anti-inflammatory effects via prostaglandin inhibition, neutrophil migration suppression, and oxygen free-radical inhibition. Retardation of inflammatory processes after acute injury may limit the area of secondary tissue damage but may also retard healing. Animal models have demonstrated short-term benefits with NSAIDs after acute injury, along with long-term adverse effects on tissue structure and function. NSAIDs have exhibited few benefits in the treatment of delayed-onset muscle soreness. Clinical trials of NSAIDs in the treatment of acute soft tissue injuries have shown conflicting results and have been highly criticized. CONCLUSIONS/RECOMMENDATIONS: Based on the research literature, the short-term benefits of NSAIDs in the treatment of acute soft tissue injuries must be weighed against the potential long-term adverse effects on tissue healing, structure, and function.