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Is it a good or bad idea to take Ibuprofen (or other NSAID) before exercise to help prevent things like knee or shoulder pain? I have heard that (a) you should not, because it will mask the pain that indicates damage, and (b) it's OK because it reduces inflammation which can reduce the damage to the joint or tendon.

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2 Answers

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Taking ibuprofen or other NSAIDs (anti-inflammatories that reduce pain and swelling) before for exercise can mask pain. Pain can be a warning sign to stop an exercise to prevent joint or soft tissue damage. Therefore, if you take it before exercise, you risk aggravating a problem.*

However, if you have painful joints that prevent you from exercising, an anti-inflammatory medication taken before exercise may allow you to tolerate gentle exercise and gain the benefits of exercise. This would be a case for discussing its use with your doctor. Long term or regular use of ibuprofen has side effects.

Side Effects and Warnings

From Medline Plus side effects include:

  1. “People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as ibuprofen may have a higher risk of having a heart attack or a stroke than people who do not take these medications."

  2. "NSAIDs such as ibuprofen may cause ulcers, bleeding, or holes in the stomach or intestine."

Medline also gives a long list of things that you should discuss with your doctor &/or pharmacist before using ibuprofen or NSAIDs. (medications, vitamins, nutritional supplements, herbal products, age, health conditions etc.)

*Also, you didn’t mention what type of exercise. There have been problems with athletes taking ibuprofen before Endurance Events. This includes reduced levels of sodium in the blood (hyponatremia) and altered renal (kidney) function.

This article, Ibuprofen-NSAIDs and Endurance describes several studies and found mixed results, including

... it did NOT prevent muscle cell injury

...may hinder markers for muscle soreness

...runners who consumed NSAIDs before the marathon were diagnosed with altered renal function

...NSAID use appears to be a contributing factor in developing clinically diagnosed hyponatremia based on blood sampling post-race

...study concluded that ibuprofen use compared to nonuse by athletes did not alter muscle damage or soreness and was related to elevated indicators of inflammation-the exact opposite reason that athletes take NSAIDs in the first place!

So, although a lot of athletes are currently taking NSAIDs, there is a definite down side.

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Taking Ibuprofen longterm is a very bad idea as it can lead to some big gastrointestinal issues like stomach bleeding. It can even increase the risk of hearing loss.

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Please give references for the gastrointestinal issues. –  michael Sep 12 '11 at 13:11
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