Bregante,

Hi mate, I am sure I would recognise you by face but not sure from your forum name. No doubt I will bump into you at sedgley at some point. You must be back riding if you are on here.

Cheers mate,

Kurt.

Generally post surgery consultants seem to avoid anti inflammatory medication with the same justification, which I think is not a bad acid test..

The limiting of NSAIDs post surgery is more to do with decreased clotting/increased bleeding rather than inflammation.

I hope I don’t get any one with lower back pain today if I prescribe dicolfenac I might be breaking no NICE guideline.

Wanmankylung, is that not relevant when considering healing following an acute muscle injury?

This podcast is a discussion between the editor of the British Journal of Sports Medicine and Professor Lars Nordsletten a Sports Physician supports the consideration for avoiding NSAIDS immediately post injury.

Professor Lars Nordsletten on NSAIDs and COX-2 inhibitors in sports medicine: A cautionary tale by BMJ talk medicine https://soundcloud.com/bmjpodcasts/professor-lars-nordsletten-on on #SoundCloud

and another one from the BJSM with discussion on NSAIDS

“Mythbuster” on NSAIDs in sports medicine, challenging nutrition dogma, and evidence-based practice by BMJ talk medicine https://soundcloud.com/bmjpodcasts/mythbuster-on-nsaids-in-sports on #SoundCloud

I had a spinal fusion 2 months ago and the surgeon told me to avoid NSAIDS because they inhibit the heing process as well as increase the risk of bleeding.

Surgery is different vickypea.

Wanmankylung, is that not relevant when considering healing following an acute muscle injury?

That would depend on the nature of the injury. But for back ache there’s not likely to be a hell of a lot of bleeding.

Dunno? Only basing my opinion on the use of NSAIDs immediately post injury on current literature and experts in the field. Obviously we would give different advice, which is fine everyone can have their opinion on how to best manage an injury depending on the evidence we choose to influence our practice.

We have no or very littke evidence here and can’t do an assessment so best that the OP follows NHS advice, which mentions NSAIDS, until they can seek help. Me if he fits the acute back injury criteria without any of the complications then I’d be prestibing codeine, paracetamol, diclofenic and possibly diazepam if they’re were no contraindications.

Drac – is that so that the constipation takes their mind off the back ache?

Something like that.

I’d be prescribing codeine, paracetamol, diclofenic and possibly diazepam

That is exactly what I was given after I was hit by a minicab on the club run and left with a couple of stable spine fractures. It helped deal with the pain and I dealt with the constipation later. I did end up in the land of the fairies mind.

EDIT : No, I’ve just remembered, it wasn’t diclofenic that I was given to take with codeine, paracetamol, and diazepam, it was tramadol, that’s what sent me to the land of the fairies.

I know surgery is different to the OP’s situation, but wanmankylung said above that limiting NSAIDS post-surgery is more to do with increased bleeding. But surely that is most relevant in the short term, whilst longer-term avoidance of them post surgery is related to inhibition of healing?

Yeah tramadol is supposed to be wonderful. I’ll add that I wouldn’t necessarily prescribe all those that’s the options I have.

No Vickypea they avoid them post surgery for increased bleeding, they’re used long term post surgery to reduce inflammation to allow healing and aid pain relief. Even Paracetamol is a pretty good antiinflamatorty. Current guidelines for acute back pain is to consider NSAIDs. If I didn’t consider using them I’d have to give a good reason not to, reading an article wouldn’t really be any good for me as I’m not a practitioner.