The old saying, “Familiarity breeds contempt,” may have more than a kernel of truth for over-the-counter drugs. Actually, the attitude most Americans hold toward these familiar nonprescription brands might be better described as ignorance or inattention than actual contempt.

Too often we don’t know about all of the potential effects of a medication that we can buy off the shelf.  Even many doctors who are well aware of the potential for popular NSAID pain relievers to cause intestinal injury or increase the risk for cardiovascular complications may not know that these drugs could slow healing from a bone fracture.

Q. I fell on the tennis court and broke my arm badly. I started taking big doses of ibuprofen (with my doctor’s approval) to control pain and reduce swelling.

When I went to see my chiropractor for a back adjustment, he admonished me not to take any NSAIDs. He said they interfere with bone healing. How is that possible?

A. We know it seems puzzling that the very medicine you are taking for pain could impair bone healing. Nevertheless, there is substantial animal research to suggest that NSAIDs like ibuprofen, naproxen, diclofenac or indomethacin can slow the healing of certain fractures (Acta Orthopaedica, April, 2015; Current Opinion in Rheumatology, July, 2013).

It appears that inflammation plays an important role in recruiting stem cells to help heal fractures. Suppressing inflammation with an NSAID could be counterproductive.

Short-term use to ease discomfort seems relatively safe, but longer-term reliance on NSAIDs may affect your recovery. You probably don’t want to take anything that would slow healing from a bone fracture.

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  1. mary3

    I am unable to find an article about what to ”DO” to help bone healing.
    Is there one somewhere? Certainly would appreciate. Thank you

  2. Henry

    Very interesting – but what amount of time fits “short-term” and “long-term”. 2 days, 2 weeks, 2 months? Recovering from a fracture and I don’t think I could have slept without 600 mg of ibuprofen 3 times a day for the first two weeks. Then I tapered off gradually (400 -> 200) for another 3 weeks and then pretty much stopped except for 200mg every few days.

  3. Betty
    new York

    Recently had triple arthrodesis on my ankle.

    Advised by my surgeon NOT to take NSAIDS due to delayed bone healing. Never knew this before. He did say if I needed one occasionally I could use it but not to make it a habit. Have had no problems with healing at all. And have not resorted to taking any NSAIDS. Am healing well with no problems.

  4. Mark
    North Carolina

    I was taking Aleve a couple of times a day for soreness related to having too much to do and not enough time to get it done. I developed Erythema multiforme. The doctor said that the exact cause could not be determined but, he felt strongly that it was the NSAID drug in Aleve that caused it. My doctor told me never to take an NSAID drug for any reason. It’s been a motivator for me to live and eat reasonably healthy so I don’t have pains, etc..

    Erythema multiforme is the lesser form of Steven Johnson’s Syndrome which is fatal most of the time and a horrible way to die. NSAIDs should be outlawed if you ask me.

  5. Judy
    Durham, NC

    The surgeon who performed my recent back surgery (decompression and fusion) insisted that I not take any NSAIDs during the first 6 months after surgery. Fortunately, my pain was being managed with other drugs.

  6. Barbara
    Dallas, texas

    I have been thinking about this for some time now. Just as fever is the body’s way of fighting off illness, inflammation is the body at work to heal injury. Ice and anti inflammatory meds seem almost counter intuitive. Could this be correct?

  7. Sandy
    newport News, VA

    Fascinating. My husband keeps trying to get me to take a small aspirin daily, which he does. I have recently been diagnosed with osteoporosis. Would aspirin slow my already bad bone growth?

  8. O.G.

    When I had a hip replacement, and then, later, when I had three discs in my neck replaced, BOTH my surgeons, their two P.A.s, and three RNs told me NOT to take any NSAIDs for at least three months because they retarded bone healing.

    They may not have been at large and famous surgery centers or hospitals, but they were apparently savvier than many of their peers… and this was two and three years ago.

    There’s absolutely no reason every health care professional shouldn’t be aware of this problem, and advise her/his patients likewise.

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