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Dr. Daniel C. Eby

Orthopedic Surgery & Sports Medicine

What are NSAIDs and how do they work?

NSAID is an abbreviation for non-steroidal anti-inflammatory drugs. Most often these medications can be found over-the-counter at your local pharmacy. There are higher strength options available from the provider by prescription, such as meloxicam.

This group of medications works by decreasing the general inflammation throughout your body. NSAIDs can be helpful in treating muscle aches and pains, as well as symptoms from arthritis. 

NSAIDs not only relieve pain, but also help to decrease inflammation, prevent blood clots, and reduce fevers. They work by decreasing an enzyme in our body called cyclooxygenase or COX for short. COX-2 is produced by our bodies to help heal injured or inflamed joints.

When too much inflammation is in a joint, you may experience pain. NSAIDs work to decrease inflammation and pain. 

While very helpful in many diseases, most NSAIDs also decrease COX-1. COX-1 works to protect our stomach and maintain our kidney function. By decreasing COX-1 as well as COX-2, there can be unwanted side effects.

Common Side Effects

  • Throat, stomach and intestinal upset, and ulcers. 
  • Kidney dysfunction
  • Increased bruising

Common NSAIDs

You may recognize them by their generic names:

  • meloxicam
  • ibuprofen
  • naproxen
  • diclofenac
  • celecoxib
  • indomethacin
  • aspirin in high doses

Or you may recognize these medications by their brand name:

  • Mobic
  • Motrin or Advil
  • Aleve
  • Voltaren
  • Celebrex
  • Indocin

Should I apply ice or heat to an injury?

Ice should be used in the acute stage of an injury (within the first 24-48 hours), or whenever there is swelling. Ice helps to reduce inflammation by decreasing blood flow to the area in which cold is applied.

Heat increases blood flow and may promote pain relief after swelling subsides. Heat may also be used to warm up muscles prior to exercise or physical therapy.

What is an epidural?

An epidural is a potent steroid injection that helps decrease the inflammation of compressed spinal nerves to relieve pain in the back, neck, arms or legs. Cortisone is injected directly into the spinal canal for pain relief from conditions such as herniated discs, spinal stenosis, or radiculopathy. Some patients may need only one injection, but it usually takes two or three injections, given two weeks apart, to provide significant pain relief.

What is a cortisone/corticosteroid injection?

Cortisone is a steroid that is produced naturally in the body. Synthetically-produced cortisone can also be injected into soft tissues and joints to help decrease inflammation. While cortisone is not a pain reliever, pain may diminish as a result of reduced inflammation. In orthopaedics, cortisone injections are commonly used as a treatment for chronic conditions such as bursitis, tendinitis, and arthritis.