Remedies for broken bones?
Replies
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EvgeniZyntx wrote: »@tomateoy
You are partially right but shouldn't be recommending someone stop their pain treatment.
1) Yes, anti-inflammatories had a negative effect on tissue recovery. However, this doesn't mean that they are BAD for recovery and should be stopped. Used when needed (versus constantly used) doesn't reduce healing significantly - since chronic inflammation ALSO has a negative effect on recovery. It's a balancing act - and as non-health care professional you should not be recommending changes in treatment - feel free to provide info that a person can THEN discuss with their doctor.
2) "Your body heals better on its own" is bad advice. Just stop.
I'm sharing information on a board, people are welcome to consider it or throw it out. I'm not a medical professional giving medical advice. (Are you?? If so, that's a problem.) I'll say what I like.
Re your reply to 1) - can you provide evidence to support the idea that anti-inflammatories are good for (as in promote) recovery (as in tissue healing)? Outside of rheumatological illnesses, does chronic inflammation happen, that often? Pain can get out of control and lead to chronic problems, that's another question and there are alternatives to NSAIDs for that (with different costs and benefits). Evidence from animal studies is converging on NSAIDs being pretty bad (for animals); studies with humans have been inconclusive. Personally, I'm no longer willing to expose myself to that risk, others can make their determinations for themselves.
Can you expand on why 2) is "bad advice"? "Your body heals on its own" wasn't referring to surgical treatment, physiotherapy, or lifestyle and movement modifications. Just pain meds & their interference with the normal and usually healing inflammatory response.0 -
EvgeniZyntx wrote: »
3) The "piezoelectric fields" explanation is mostly correct - except that those micro fields are never eliminated nor are they "sensed by your body" - they influence osteoblast and osteoclast balance via calcium channel signaling in bone remodelling. It does hold that weight bearing exercise may (not *will*) improve healing and bone growth. But guess what - the OP isn't fully immobilised and that effect is taking place.
That article was written for a lay audience. "Sensed by your body" was obviously referring to more complicated actual processes, not some kind of crazy aura.
Re weight bearing exercise - I believe that was in relation to allowing pain to be the natural limiter for movement, vs numbing yourself to it and continuing to reinjure, or total immobilization. Obviously, that was a point made in the blog post and not specifically directed to the OP.0 -
EvgeniZyntx wrote: »@tomateoy
You are partially right but shouldn't be recommending someone stop their pain treatment.
1) Yes, anti-inflammatories had a negative effect on tissue recovery. However, this doesn't mean that they are BAD for recovery and should be stopped. Used when needed (versus constantly used) doesn't reduce healing significantly - since chronic inflammation ALSO has a negative effect on recovery. It's a balancing act - and as non-health care professional you should not be recommending changes in treatment - feel free to provide info that a person can THEN discuss with their doctor.
2) "Your body heals better on its own" is bad advice. Just stop.
I'm sharing information on a board, people are welcome to consider it or throw it out. I'm not a medical professional giving medical advice. I'll say what I like.
Re your reply to 1) - can you provide evidence to support the idea that anti-inflammatories are good for, promote recovery? Outside of rheumatological illnesses, does chronic inflammation happen, that often? Pain can get out of control and lead to chronic problems, that's another question and there are alternatives to NSAIDs for that (with different costs and benefits). Evidence from animal studies is converging on it being pretty bad (for animals); studies with humans have been inconclusive. Personally, I'm no longer willing to expose myself to that risk, others can make their determinations for themselves.
Can you expand on why 2) is "bad advice"?
I) Yes, I can. a) on the reduction of pain may lead to improved mobility (which you already pointed out improves healing and remodeling) b) pain influences the feedback mechanisms of parathyroid hormone which in turn influence calcium homeostasis. These are basic physiological function found in any first year med book. But to provide a specific reference - those same articles that recommend the avoidance of NSAIDS during healing (always read the original article) are shown to only have a negative influence in the early stages of bone damage and not beyond the first 2 weeks (i.e. for someone who has been in pain for long term.) (http://www.ncbi.nlm.nih.gov/pubmed/17332098)
II) chronic inflammation occurs all the time outside of rheumatological illness. It's an immune or tissue damage or neurological or hormonal response. Even over-exercise will lead to chronic inflammatory response. Ever heard of things like diabetes, IBS or stress which each can result in induced inflammation?
Why is 2) bad advice? Because it is a blatant spacious lie. It's such a large generalisation that can be proven false by the history of medicine. If we take it as true and should stop vaccines, surgery and in general, medicine - because the "body heals better on its own". It's easy to discredit. Sometimes doing nothing is the best medicine BUT you don't know that in the specific. (Nor do I.) So it is, at best, an empty phrase pandering to "all those drugs are bad for you" mentality.
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EvgeniZyntx wrote: »
3) The "piezoelectric fields" explanation is mostly correct - except that those micro fields are never eliminated nor are they "sensed by your body" - they influence osteoblast and osteoclast balance via calcium channel signaling in bone remodelling. It does hold that weight bearing exercise may (not *will*) improve healing and bone growth. But guess what - the OP isn't fully immobilised and that effect is taking place.
That article was written for a lay audience. "Sensed by your body" was obviously referring to more complicated actual processes, not some kind of crazy aura.
We can still expect that "dumbing down" for a lay audience isn't going to lead people down short-cuts with terminology borrowed from Mesmerism (see here), etc...
It would have been just as easy to write "tiny electrical currents produced by movement influence proper bone modelling".
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EvgeniZyntx wrote: »EvgeniZyntx wrote: »@tomateoy
You are partially right but shouldn't be recommending someone stop their pain treatment.
1) Yes, anti-inflammatories had a negative effect on tissue recovery. However, this doesn't mean that they are BAD for recovery and should be stopped. Used when needed (versus constantly used) doesn't reduce healing significantly - since chronic inflammation ALSO has a negative effect on recovery. It's a balancing act - and as non-health care professional you should not be recommending changes in treatment - feel free to provide info that a person can THEN discuss with their doctor.
2) "Your body heals better on its own" is bad advice. Just stop.
I'm sharing information on a board, people are welcome to consider it or throw it out. I'm not a medical professional giving medical advice. I'll say what I like.
Re your reply to 1) - can you provide evidence to support the idea that anti-inflammatories are good for, promote recovery? Outside of rheumatological illnesses, does chronic inflammation happen, that often? Pain can get out of control and lead to chronic problems, that's another question and there are alternatives to NSAIDs for that (with different costs and benefits). Evidence from animal studies is converging on it being pretty bad (for animals); studies with humans have been inconclusive. Personally, I'm no longer willing to expose myself to that risk, others can make their determinations for themselves.
Can you expand on why 2) is "bad advice"?
I) Yes, I can. a) on the reduction of pain may lead to improved mobility (which you already pointed out improves healing and remodeling) b) pain influences the feedback mechanisms of parathyroid hormone which in turn influence calcium homeostasis. These are basic physiological function found in any first year med book. But to provide a specific reference - those same articles that recommend the avoidance of NSAIDS during healing (always read the original article) are shown to only have a negative influence in the early stages of bone damage and not beyond the first 2 weeks (i.e. for someone who has been in pain for long term.) (http://www.ncbi.nlm.nih.gov/pubmed/17332098)
If other treatment (casting, relative rest, etc) is taken up and pain is controlled by not doing painful movements or by alternative medications that do NOT interfere with healing, NSAIDs are unnecessary.
Bolded is a, let's say, confident statement that few researchers looking at NSAIDs and healing in humans today feel able to make. The impact of NSAIDs on bone and soft tissue healing in humans, in the short and long term, is unclear.
See this review (note that I don't agree with their conclusion): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259713/
Also: http://www.ingentaconnect.com/content/ben/rrct/2013/00000008/00000001/art00008
Bad for many after dental implants:
http://onlinelibrary.wiley.com/doi/10.1111/clr.12493/full
http://www.joionline.org/doi/abs/10.1563/AAID-JOI-D-13-00125
It's an open question. You should be more curious than confident.0 -
EvgeniZyntx wrote: »
Why is 2) bad advice? Because it is a blatant spacious lie. It's such a large generalisation that can be proven false by the history of medicine. If we take it as true and should stop vaccines, surgery and in general, medicine - because the "body heals better on its own". It's easy to discredit. Sometimes doing nothing is the best medicine BUT you don't know that in the specific. (Nor do I.) So it is, at best, an empty phrase pandering to "all those drugs are bad for you" mentality.
This is really distorting and blowing way out of proportion the very limited argument made earlier, which was in relation to pain medication. Other than that, it's a non-answer.0 -
EvgeniZyntx wrote: »EvgeniZyntx wrote: »
3) The "piezoelectric fields" explanation is mostly correct - except that those micro fields are never eliminated nor are they "sensed by your body" - they influence osteoblast and osteoclast balance via calcium channel signaling in bone remodelling. It does hold that weight bearing exercise may (not *will*) improve healing and bone growth. But guess what - the OP isn't fully immobilised and that effect is taking place.
That article was written for a lay audience. "Sensed by your body" was obviously referring to more complicated actual processes, not some kind of crazy aura.
We can still expect that "dumbing down" for a lay audience isn't going to lead people down short-cuts with terminology borrowed from Mesmerism (see here), etc...
It would have been just as easy to write "tiny electrical currents produced by movement influence proper bone modelling".
How is "sensed by your body" inaccurate? Sensation is mesmerism? Ridiculous.0 -
EvgeniZyntx wrote: »EvgeniZyntx wrote: »@tomateoy
You are partially right but shouldn't be recommending someone stop their pain treatment.
1) Yes, anti-inflammatories had a negative effect on tissue recovery. However, this doesn't mean that they are BAD for recovery and should be stopped. Used when needed (versus constantly used) doesn't reduce healing significantly - since chronic inflammation ALSO has a negative effect on recovery. It's a balancing act - and as non-health care professional you should not be recommending changes in treatment - feel free to provide info that a person can THEN discuss with their doctor.
2) "Your body heals better on its own" is bad advice. Just stop.
I'm sharing information on a board, people are welcome to consider it or throw it out. I'm not a medical professional giving medical advice. I'll say what I like.
Re your reply to 1) - can you provide evidence to support the idea that anti-inflammatories are good for, promote recovery? Outside of rheumatological illnesses, does chronic inflammation happen, that often? Pain can get out of control and lead to chronic problems, that's another question and there are alternatives to NSAIDs for that (with different costs and benefits). Evidence from animal studies is converging on it being pretty bad (for animals); studies with humans have been inconclusive. Personally, I'm no longer willing to expose myself to that risk, others can make their determinations for themselves.
Can you expand on why 2) is "bad advice"?
I) Yes, I can. a) on the reduction of pain may lead to improved mobility (which you already pointed out improves healing and remodeling) b) pain influences the feedback mechanisms of parathyroid hormone which in turn influence calcium homeostasis. These are basic physiological function found in any first year med book. But to provide a specific reference - those same articles that recommend the avoidance of NSAIDS during healing (always read the original article) are shown to only have a negative influence in the early stages of bone damage and not beyond the first 2 weeks (i.e. for someone who has been in pain for long term.) (http://www.ncbi.nlm.nih.gov/pubmed/17332098)
If other treatment (casting, relative rest, etc) is taken up and pain is controlled by not doing painful movements or by alternative medications that do NOT interfere with healing, NSAIDs are unnecessary.
Bolded is a, let's say, confident statement that few researchers looking at NSAIDs and healing in humans today feel able to make. The impact of NSAIDs on bone and soft tissue healing in humans, in the short and long term, is unclear.
See this review (note that I don't agree with their conclusion): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259713/
Also: http://www.ingentaconnect.com/content/ben/rrct/2013/00000008/00000001/art00008
Bad for many after dental implants:
http://onlinelibrary.wiley.com/doi/10.1111/clr.12493/full
http://www.joionline.org/doi/abs/10.1563/AAID-JOI-D-13-00125
It's an open question. You should be more curious than confident.
Wait - you actually use a reference that has as a conclusion that NSAIDS should be used. Really?
There is no robust clinical and/or scientific evidence to discard the use of NSAIDs in patients suffering from a fracture, but equal lack of evidence does not constitute proof of the absence of an effect. The majority of the available evidence is based on animal findings and these results should be interpreted with caution due to the differences in physiological mechanisms between humans and animals. The need of basic science research defining the exact mechanism that NSAIDs could interfere with bone cells and the conduction of well-randomised prospective clinical trial are warranted. Till then, clinician should treat NSAIDs as a risk factor for bone healing impairment and should be avoided in high-risk patients.
In other words, during the early acute healing period.
As to the dental stuff - not relevant.
It is an open question - which means that the treatment of inflammation and pain should be case by case and NOT be resolved by a blank statement of "don't use them" and "your body heals better".
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EvgeniZyntx wrote: »II) chronic inflammation occurs all the time outside of rheumatological illness. It's an immune or tissue damage or neurological or hormonal response. Even over-exercise will lead to chronic inflammatory response. Ever heard of things like diabetes, IBS or stress which each can result in induced inflammation?
Chronic inflammation does occur in those instances but I'd like to meet the doctor who treats IBS or diabetes or stress with ibuprofen.0 -
EvgeniZyntx wrote: »EvgeniZyntx wrote: »EvgeniZyntx wrote: »@tomateoy
You are partially right but shouldn't be recommending someone stop their pain treatment.
1) Yes, anti-inflammatories had a negative effect on tissue recovery. However, this doesn't mean that they are BAD for recovery and should be stopped. Used when needed (versus constantly used) doesn't reduce healing significantly - since chronic inflammation ALSO has a negative effect on recovery. It's a balancing act - and as non-health care professional you should not be recommending changes in treatment - feel free to provide info that a person can THEN discuss with their doctor.
2) "Your body heals better on its own" is bad advice. Just stop.
I'm sharing information on a board, people are welcome to consider it or throw it out. I'm not a medical professional giving medical advice. I'll say what I like.
Re your reply to 1) - can you provide evidence to support the idea that anti-inflammatories are good for, promote recovery? Outside of rheumatological illnesses, does chronic inflammation happen, that often? Pain can get out of control and lead to chronic problems, that's another question and there are alternatives to NSAIDs for that (with different costs and benefits). Evidence from animal studies is converging on it being pretty bad (for animals); studies with humans have been inconclusive. Personally, I'm no longer willing to expose myself to that risk, others can make their determinations for themselves.
Can you expand on why 2) is "bad advice"?
I) Yes, I can. a) on the reduction of pain may lead to improved mobility (which you already pointed out improves healing and remodeling) b) pain influences the feedback mechanisms of parathyroid hormone which in turn influence calcium homeostasis. These are basic physiological function found in any first year med book. But to provide a specific reference - those same articles that recommend the avoidance of NSAIDS during healing (always read the original article) are shown to only have a negative influence in the early stages of bone damage and not beyond the first 2 weeks (i.e. for someone who has been in pain for long term.) (http://www.ncbi.nlm.nih.gov/pubmed/17332098)
If other treatment (casting, relative rest, etc) is taken up and pain is controlled by not doing painful movements or by alternative medications that do NOT interfere with healing, NSAIDs are unnecessary.
Bolded is a, let's say, confident statement that few researchers looking at NSAIDs and healing in humans today feel able to make. The impact of NSAIDs on bone and soft tissue healing in humans, in the short and long term, is unclear.
See this review (note that I don't agree with their conclusion): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259713/
Also: http://www.ingentaconnect.com/content/ben/rrct/2013/00000008/00000001/art00008
Bad for many after dental implants:
http://onlinelibrary.wiley.com/doi/10.1111/clr.12493/full
http://www.joionline.org/doi/abs/10.1563/AAID-JOI-D-13-00125
It's an open question. You should be more curious than confident.
Wait - you actually use a reference that has as a conclusion that NSAIDS should be used. Really?
There is no robust clinical and/or scientific evidence to discard the use of NSAIDs in patients suffering from a fracture, but equal lack of evidence does not constitute proof of the absence of an effect. The majority of the available evidence is based on animal findings and these results should be interpreted with caution due to the differences in physiological mechanisms between humans and animals. The need of basic science research defining the exact mechanism that NSAIDs could interfere with bone cells and the conduction of well-randomised prospective clinical trial are warranted. Till then, clinician should treat NSAIDs as a risk factor for bone healing impairment and should be avoided in high-risk patients.
In other words, during the early acute healing period.
As to the dental stuff - not relevant.
It is an open question - which means that the treatment of inflammation and pain should be case by case and NOT be resolved by a blank statement of "don't use them" and "your body heals better".
What? Dental stuff is "not relevant" why, because you've decided that? Lol. It's absolutely relevant.
I used the reference because the literature review was good. I disagree with the conclusion and recommendation. Yes, that's possible!
NSAIDs are problematic for chronic issues as well. Find your own references if you don't like the ones I brought in.
It's been lovely chatting with you (oh wait nope not at all).0 -
EvgeniZyntx wrote: »II) chronic inflammation occurs all the time outside of rheumatological illness. It's an immune or tissue damage or neurological or hormonal response. Even over-exercise will lead to chronic inflammatory response. Ever heard of things like diabetes, IBS or stress which each can result in induced inflammation?
Chronic inflammation does occur in those instances but I'd like to meet the doctor who treats IBS or diabetes or stress with ibuprofen.
Moving goal posts. You asked about when does inflammation occur outside of rheumatology. I answered.
Let's take that example though - you want a disease where ibuprofen is used long term to treat inflammatory aspects of disease successfully? Cystic fibrosis and impaired lung disease comes to mind. I'm sure I could find a dozen others...
0 -
EvgeniZyntx wrote: »EvgeniZyntx wrote: »EvgeniZyntx wrote: »@tomateoy
You are partially right but shouldn't be recommending someone stop their pain treatment.
1) Yes, anti-inflammatories had a negative effect on tissue recovery. However, this doesn't mean that they are BAD for recovery and should be stopped. Used when needed (versus constantly used) doesn't reduce healing significantly - since chronic inflammation ALSO has a negative effect on recovery. It's a balancing act - and as non-health care professional you should not be recommending changes in treatment - feel free to provide info that a person can THEN discuss with their doctor.
2) "Your body heals better on its own" is bad advice. Just stop.
I'm sharing information on a board, people are welcome to consider it or throw it out. I'm not a medical professional giving medical advice. I'll say what I like.
Re your reply to 1) - can you provide evidence to support the idea that anti-inflammatories are good for, promote recovery? Outside of rheumatological illnesses, does chronic inflammation happen, that often? Pain can get out of control and lead to chronic problems, that's another question and there are alternatives to NSAIDs for that (with different costs and benefits). Evidence from animal studies is converging on it being pretty bad (for animals); studies with humans have been inconclusive. Personally, I'm no longer willing to expose myself to that risk, others can make their determinations for themselves.
Can you expand on why 2) is "bad advice"?
I) Yes, I can. a) on the reduction of pain may lead to improved mobility (which you already pointed out improves healing and remodeling) b) pain influences the feedback mechanisms of parathyroid hormone which in turn influence calcium homeostasis. These are basic physiological function found in any first year med book. But to provide a specific reference - those same articles that recommend the avoidance of NSAIDS during healing (always read the original article) are shown to only have a negative influence in the early stages of bone damage and not beyond the first 2 weeks (i.e. for someone who has been in pain for long term.) (http://www.ncbi.nlm.nih.gov/pubmed/17332098)
If other treatment (casting, relative rest, etc) is taken up and pain is controlled by not doing painful movements or by alternative medications that do NOT interfere with healing, NSAIDs are unnecessary.
Bolded is a, let's say, confident statement that few researchers looking at NSAIDs and healing in humans today feel able to make. The impact of NSAIDs on bone and soft tissue healing in humans, in the short and long term, is unclear.
See this review (note that I don't agree with their conclusion): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259713/
Also: http://www.ingentaconnect.com/content/ben/rrct/2013/00000008/00000001/art00008
Bad for many after dental implants:
http://onlinelibrary.wiley.com/doi/10.1111/clr.12493/full
http://www.joionline.org/doi/abs/10.1563/AAID-JOI-D-13-00125
It's an open question. You should be more curious than confident.
Wait - you actually use a reference that has as a conclusion that NSAIDS should be used. Really?
There is no robust clinical and/or scientific evidence to discard the use of NSAIDs in patients suffering from a fracture, but equal lack of evidence does not constitute proof of the absence of an effect. The majority of the available evidence is based on animal findings and these results should be interpreted with caution due to the differences in physiological mechanisms between humans and animals. The need of basic science research defining the exact mechanism that NSAIDs could interfere with bone cells and the conduction of well-randomised prospective clinical trial are warranted. Till then, clinician should treat NSAIDs as a risk factor for bone healing impairment and should be avoided in high-risk patients.
In other words, during the early acute healing period.
As to the dental stuff - not relevant.
It is an open question - which means that the treatment of inflammation and pain should be case by case and NOT be resolved by a blank statement of "don't use them" and "your body heals better".
What? Dental stuff is "not relevant" why, because you've decided that? Lol. It's absolutely relevant.
I used the reference because the literature review was good. I disagree with the conclusion and recommendation. Yes, that's possible!
NSAIDs are problematic for chronic issues as well. Find your own references if you don't like the ones I brought in.
It's been lovely chatting with you (oh wait nope not at all).
How is your quote mining for references and stumbling on dental implants stuff relevant to MKEgals punctual use of anti-inflammatory for a chronic period...
MKEgal wrote "Anti-inflammatories, immobilise as much as possible, gentle exercise (wish I could swim), and lots of patience.
This has been going on for more than a year, and my foot still hurts from time to time."
It's a long term healing process where the person is probably using them on and off to manage inflammation. And you are all "but NSAIDS are all the debil" - I'm not sure how you want to link acute issues in dental recovery with a chronic evolving healing issue? But go ahead, please explain how you think this is relevant to MKEgal's post.
Or are you just ranting about NSAIDS in general? (Next you'll be telling me that I shouldn't take my piroxicam when I have a gout attack because of dental implants?)0 -
What does the pain feel like? Is it prickly?
The pain varies. Sometimes it is prickly, most of the time its shooting pain with minor aches and throbs. Everything makes the pain vary, the weather, how I slept, what I ate. If its hot out my foot throbs. If its cold it feels like a million icicles are bursting through my bone. If I eat too many processed foods, it swells, if I swim too much it aches with the blood flow.
Unfortunately because of how tough my feet are, icing is nearly unrealistic as a pain reliever anymore. And you all are right about the dangers of anti-inflammatory/pain meds. It only encourages me to not care so much about using my foot and ends up doing more damage than good.
Honestly though, the pain day to day is really manageable, and not the driving force behind me trying to get it healed. So if certain drugs really are starting to be disproved for certain things I don't mind not using them. Interestingly, the only other thing my doctor said to do in addition to wearing the boot or using crutches was to kick off the healing with one week of ibuprofen 3x a day.
I'm for sure going to check out or try those teas and other remedies. I must be honest though, acupuncture scares the snot out of me. My mother did it all the time and I never could bring myself around to trying it.0 -
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@hannahcall2 - that doc, more than likely, gave you standard advice. The boot & (relative) time off is probably what will help
If there's a particular treatment that differs from that, that your review of evidence suggests might help (although, it's iffy by the sounds of it), it's just more research to find a doc who'll consider it.Not sure what your insurance or finances are like, but if you can, find an ortho who specializes in rehabilitating ballet dancers (women on pointe) or runners. Can't dance with a big toe injury like this, someone who treats athletes will likely be more familiar with rehabilitation and physical therapy exercises than other docs who don't.
If you're relying on insurance, the squeaky wheel gets the oil. Be assertive about your care and let people know the healing time of 6 weeks to 6 years is a little too vague and more than a little unacceptable. Find a specialist and get them to fund you. Get it in writing. I did this years ago and my insurance sent me to the Baylor Scoliosis Center which was not part of my plan's coverage. I was VERY persistent (and right) and they got tired of me and wanted me to stop bugging them.
^^ This the only way it happens (in the US, I gather - but in general, it takes knocking on doors). +1 for finding a doc who deals primarily with getting athletes prone to this problem back to work.0 -
EvgeniZyntx wrote: »EvgeniZyntx wrote: »II) chronic inflammation occurs all the time outside of rheumatological illness. It's an immune or tissue damage or neurological or hormonal response. Even over-exercise will lead to chronic inflammatory response. Ever heard of things like diabetes, IBS or stress which each can result in induced inflammation?
Chronic inflammation does occur in those instances but I'd like to meet the doctor who treats IBS or diabetes or stress with ibuprofen.
Moving goal posts. You asked about when does inflammation occur outside of rheumatology. I answered.
Let's take that example though - you want a disease where ibuprofen is used long term to treat inflammatory aspects of disease successfully? Cystic fibrosis and impaired lung disease comes to mind. I'm sure I could find a dozen others...
I wasn't moving the goalposts, you shot them out of orbit - the context of the discussion was evidently orthopaedic or MSK injury and pain.EvgeniZyntx wrote: »EvgeniZyntx wrote: »EvgeniZyntx wrote: »EvgeniZyntx wrote: »@tomateoy
You are partially right but shouldn't be recommending someone stop their pain treatment.
1) Yes, anti-inflammatories had a negative effect on tissue recovery. However, this doesn't mean that they are BAD for recovery and should be stopped. Used when needed (versus constantly used) doesn't reduce healing significantly - since chronic inflammation ALSO has a negative effect on recovery. It's a balancing act - and as non-health care professional you should not be recommending changes in treatment - feel free to provide info that a person can THEN discuss with their doctor.
2) "Your body heals better on its own" is bad advice. Just stop.
I'm sharing information on a board, people are welcome to consider it or throw it out. I'm not a medical professional giving medical advice. I'll say what I like.
Re your reply to 1) - can you provide evidence to support the idea that anti-inflammatories are good for, promote recovery? Outside of rheumatological illnesses, does chronic inflammation happen, that often? Pain can get out of control and lead to chronic problems, that's another question and there are alternatives to NSAIDs for that (with different costs and benefits). Evidence from animal studies is converging on it being pretty bad (for animals); studies with humans have been inconclusive. Personally, I'm no longer willing to expose myself to that risk, others can make their determinations for themselves.
Can you expand on why 2) is "bad advice"?
I) Yes, I can. a) on the reduction of pain may lead to improved mobility (which you already pointed out improves healing and remodeling) b) pain influences the feedback mechanisms of parathyroid hormone which in turn influence calcium homeostasis. These are basic physiological function found in any first year med book. But to provide a specific reference - those same articles that recommend the avoidance of NSAIDS during healing (always read the original article) are shown to only have a negative influence in the early stages of bone damage and not beyond the first 2 weeks (i.e. for someone who has been in pain for long term.) (http://www.ncbi.nlm.nih.gov/pubmed/17332098)
If other treatment (casting, relative rest, etc) is taken up and pain is controlled by not doing painful movements or by alternative medications that do NOT interfere with healing, NSAIDs are unnecessary.
Bolded is a, let's say, confident statement that few researchers looking at NSAIDs and healing in humans today feel able to make. The impact of NSAIDs on bone and soft tissue healing in humans, in the short and long term, is unclear.
See this review (note that I don't agree with their conclusion): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259713/
Also: http://www.ingentaconnect.com/content/ben/rrct/2013/00000008/00000001/art00008
Bad for many after dental implants:
http://onlinelibrary.wiley.com/doi/10.1111/clr.12493/full
http://www.joionline.org/doi/abs/10.1563/AAID-JOI-D-13-00125
It's an open question. You should be more curious than confident.
Wait - you actually use a reference that has as a conclusion that NSAIDS should be used. Really?
There is no robust clinical and/or scientific evidence to discard the use of NSAIDs in patients suffering from a fracture, but equal lack of evidence does not constitute proof of the absence of an effect. The majority of the available evidence is based on animal findings and these results should be interpreted with caution due to the differences in physiological mechanisms between humans and animals. The need of basic science research defining the exact mechanism that NSAIDs could interfere with bone cells and the conduction of well-randomised prospective clinical trial are warranted. Till then, clinician should treat NSAIDs as a risk factor for bone healing impairment and should be avoided in high-risk patients.
In other words, during the early acute healing period.
As to the dental stuff - not relevant.
It is an open question - which means that the treatment of inflammation and pain should be case by case and NOT be resolved by a blank statement of "don't use them" and "your body heals better".
What? Dental stuff is "not relevant" why, because you've decided that? Lol. It's absolutely relevant.
I used the reference because the literature review was good. I disagree with the conclusion and recommendation. Yes, that's possible!
NSAIDs are problematic for chronic issues as well. Find your own references if you don't like the ones I brought in.
It's been lovely chatting with you (oh wait nope not at all).
How is your quote mining for references and stumbling on dental implants stuff relevant to MKEgals punctual use of anti-inflammatory for a chronic period...
MKEgal wrote "Anti-inflammatories, immobilise as much as possible, gentle exercise (wish I could swim), and lots of patience.
This has been going on for more than a year, and my foot still hurts from time to time."
It's a long term healing process where the person is probably using them on and off to manage inflammation. And you are all "but NSAIDS are all the debil" - I'm not sure how you want to link acute issues in dental recovery with a chronic evolving healing issue? But go ahead, please explain how you think this is relevant to MKEgal's post.
Or are you just ranting about NSAIDS in general? (Next you'll be telling me that I shouldn't take my piroxicam when I have a gout attack because of dental implants?)
We'd moved on past MKEgals' post. The dental stuff was pointing to implications re healing.
My bottom line is that there's reason to believe NSAIDs shouldn't be taken for granted as promoting healing in all cases.
Yes, people should look to the research, and evidence from their own bodies, and the informed, up to date medical opinions of professionals experienced with that particular injury & phase of healing & that particular population.
(Personally, NSAIDs have done a lot to manage all manner of pain for *me* in the short term - for years, most of my life - but it's at least possible they might have done more harm than good over time. People pop them like candy, and they're told to. Not sure it helps in every case. And it *is* advised in every case.)
The old paradigms are changing, all this is shifting under our feet as we walk. People should do what they feel is right for them, in their judgement.0 -
I would recommend incorporating gelatin in your diet. Google it for what it can do for bones. I add 1/4th of a teaspoon of it to anything that I drink that's hot. It's an easy add.
Edger Cayce would recommend wraps of apple cider vinegar and salt for broken bones and fractures. Weird, but might be worth a shot.....0 -
EvgeniZyntx wrote: »EvgeniZyntx wrote: »II) chronic inflammation occurs all the time outside of rheumatological illness. It's an immune or tissue damage or neurological or hormonal response. Even over-exercise will lead to chronic inflammatory response. Ever heard of things like diabetes, IBS or stress which each can result in induced inflammation?
Chronic inflammation does occur in those instances but I'd like to meet the doctor who treats IBS or diabetes or stress with ibuprofen.
Moving goal posts. You asked about when does inflammation occur outside of rheumatology. I answered.
Let's take that example though - you want a disease where ibuprofen is used long term to treat inflammatory aspects of disease successfully? Cystic fibrosis and impaired lung disease comes to mind. I'm sure I could find a dozen others...
I wasn't moving the goalposts, you shot them out of orbit - the context of the discussion was evidently orthopaedic or MSK injury and pain.EvgeniZyntx wrote: »EvgeniZyntx wrote: »EvgeniZyntx wrote: »EvgeniZyntx wrote: »@tomateoy
You are partially right but shouldn't be recommending someone stop their pain treatment.
1) Yes, anti-inflammatories had a negative effect on tissue recovery. However, this doesn't mean that they are BAD for recovery and should be stopped. Used when needed (versus constantly used) doesn't reduce healing significantly - since chronic inflammation ALSO has a negative effect on recovery. It's a balancing act - and as non-health care professional you should not be recommending changes in treatment - feel free to provide info that a person can THEN discuss with their doctor.
2) "Your body heals better on its own" is bad advice. Just stop.
I'm sharing information on a board, people are welcome to consider it or throw it out. I'm not a medical professional giving medical advice. I'll say what I like.
Re your reply to 1) - can you provide evidence to support the idea that anti-inflammatories are good for, promote recovery? Outside of rheumatological illnesses, does chronic inflammation happen, that often? Pain can get out of control and lead to chronic problems, that's another question and there are alternatives to NSAIDs for that (with different costs and benefits). Evidence from animal studies is converging on it being pretty bad (for animals); studies with humans have been inconclusive. Personally, I'm no longer willing to expose myself to that risk, others can make their determinations for themselves.
Can you expand on why 2) is "bad advice"?
I) Yes, I can. a) on the reduction of pain may lead to improved mobility (which you already pointed out improves healing and remodeling) b) pain influences the feedback mechanisms of parathyroid hormone which in turn influence calcium homeostasis. These are basic physiological function found in any first year med book. But to provide a specific reference - those same articles that recommend the avoidance of NSAIDS during healing (always read the original article) are shown to only have a negative influence in the early stages of bone damage and not beyond the first 2 weeks (i.e. for someone who has been in pain for long term.) (http://www.ncbi.nlm.nih.gov/pubmed/17332098)
If other treatment (casting, relative rest, etc) is taken up and pain is controlled by not doing painful movements or by alternative medications that do NOT interfere with healing, NSAIDs are unnecessary.
Bolded is a, let's say, confident statement that few researchers looking at NSAIDs and healing in humans today feel able to make. The impact of NSAIDs on bone and soft tissue healing in humans, in the short and long term, is unclear.
See this review (note that I don't agree with their conclusion): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259713/
Also: http://www.ingentaconnect.com/content/ben/rrct/2013/00000008/00000001/art00008
Bad for many after dental implants:
http://onlinelibrary.wiley.com/doi/10.1111/clr.12493/full
http://www.joionline.org/doi/abs/10.1563/AAID-JOI-D-13-00125
It's an open question. You should be more curious than confident.
Wait - you actually use a reference that has as a conclusion that NSAIDS should be used. Really?
There is no robust clinical and/or scientific evidence to discard the use of NSAIDs in patients suffering from a fracture, but equal lack of evidence does not constitute proof of the absence of an effect. The majority of the available evidence is based on animal findings and these results should be interpreted with caution due to the differences in physiological mechanisms between humans and animals. The need of basic science research defining the exact mechanism that NSAIDs could interfere with bone cells and the conduction of well-randomised prospective clinical trial are warranted. Till then, clinician should treat NSAIDs as a risk factor for bone healing impairment and should be avoided in high-risk patients.
In other words, during the early acute healing period.
As to the dental stuff - not relevant.
It is an open question - which means that the treatment of inflammation and pain should be case by case and NOT be resolved by a blank statement of "don't use them" and "your body heals better".
What? Dental stuff is "not relevant" why, because you've decided that? Lol. It's absolutely relevant.
I used the reference because the literature review was good. I disagree with the conclusion and recommendation. Yes, that's possible!
NSAIDs are problematic for chronic issues as well. Find your own references if you don't like the ones I brought in.
It's been lovely chatting with you (oh wait nope not at all).
How is your quote mining for references and stumbling on dental implants stuff relevant to MKEgals punctual use of anti-inflammatory for a chronic period...
MKEgal wrote "Anti-inflammatories, immobilise as much as possible, gentle exercise (wish I could swim), and lots of patience.
This has been going on for more than a year, and my foot still hurts from time to time."
It's a long term healing process where the person is probably using them on and off to manage inflammation. And you are all "but NSAIDS are all the debil" - I'm not sure how you want to link acute issues in dental recovery with a chronic evolving healing issue? But go ahead, please explain how you think this is relevant to MKEgal's post.
Or are you just ranting about NSAIDS in general? (Next you'll be telling me that I shouldn't take my piroxicam when I have a gout attack because of dental implants?)
We'd moved on past MKEgals' post. The dental stuff was pointing to implications re healing.
My bottom line is that there's reason to believe NSAIDs shouldn't be taken for granted as promoting healing in all cases.
Yes, people should look to the research, and evidence from their own bodies, and the informed, up to date medical opinions of professionals experienced with that particular injury & phase of healing & that particular population.
(Personally, NSAIDs have done a lot to manage all manner of pain for *me* in the short term - for years, most of my life - but it's at least possible they might have done more harm than good over time. People pop them like candy, and they're told to. Not sure it helps in every case. And it *is* advised in every case.)
The old paradigms are changing, all this is shifting under our feet as we walk. People should do what they feel is right for them, in their judgement.
I don't want to jump in to this "discussion" but...
When I broke my wrist a couple of months ago I was told by the emergency room, my GP, the hospital where I had the surgery done and two orthopedic surgeons to not take NSAIDs. I was told they would thin my blood. I had assumed it was only applicable pre-surgery but my surgeon and now my physical therapist still are telling me no NSAIDs as it interferes with healing.
0 -
EvgeniZyntx wrote: »EvgeniZyntx wrote: »II) chronic inflammation occurs all the time outside of rheumatological illness. It's an immune or tissue damage or neurological or hormonal response. Even over-exercise will lead to chronic inflammatory response. Ever heard of things like diabetes, IBS or stress which each can result in induced inflammation?
Chronic inflammation does occur in those instances but I'd like to meet the doctor who treats IBS or diabetes or stress with ibuprofen.
Moving goal posts. You asked about when does inflammation occur outside of rheumatology. I answered.
Let's take that example though - you want a disease where ibuprofen is used long term to treat inflammatory aspects of disease successfully? Cystic fibrosis and impaired lung disease comes to mind. I'm sure I could find a dozen others...
I wasn't moving the goalposts, you shot them out of orbit - the context of the discussion was evidently orthopaedic or MSK injury and pain.EvgeniZyntx wrote: »EvgeniZyntx wrote: »EvgeniZyntx wrote: »EvgeniZyntx wrote: »@tomateoy
You are partially right but shouldn't be recommending someone stop their pain treatment.
1) Yes, anti-inflammatories had a negative effect on tissue recovery. However, this doesn't mean that they are BAD for recovery and should be stopped. Used when needed (versus constantly used) doesn't reduce healing significantly - since chronic inflammation ALSO has a negative effect on recovery. It's a balancing act - and as non-health care professional you should not be recommending changes in treatment - feel free to provide info that a person can THEN discuss with their doctor.
2) "Your body heals better on its own" is bad advice. Just stop.
I'm sharing information on a board, people are welcome to consider it or throw it out. I'm not a medical professional giving medical advice. I'll say what I like.
Re your reply to 1) - can you provide evidence to support the idea that anti-inflammatories are good for, promote recovery? Outside of rheumatological illnesses, does chronic inflammation happen, that often? Pain can get out of control and lead to chronic problems, that's another question and there are alternatives to NSAIDs for that (with different costs and benefits). Evidence from animal studies is converging on it being pretty bad (for animals); studies with humans have been inconclusive. Personally, I'm no longer willing to expose myself to that risk, others can make their determinations for themselves.
Can you expand on why 2) is "bad advice"?
I) Yes, I can. a) on the reduction of pain may lead to improved mobility (which you already pointed out improves healing and remodeling) b) pain influences the feedback mechanisms of parathyroid hormone which in turn influence calcium homeostasis. These are basic physiological function found in any first year med book. But to provide a specific reference - those same articles that recommend the avoidance of NSAIDS during healing (always read the original article) are shown to only have a negative influence in the early stages of bone damage and not beyond the first 2 weeks (i.e. for someone who has been in pain for long term.) (http://www.ncbi.nlm.nih.gov/pubmed/17332098)
If other treatment (casting, relative rest, etc) is taken up and pain is controlled by not doing painful movements or by alternative medications that do NOT interfere with healing, NSAIDs are unnecessary.
Bolded is a, let's say, confident statement that few researchers looking at NSAIDs and healing in humans today feel able to make. The impact of NSAIDs on bone and soft tissue healing in humans, in the short and long term, is unclear.
See this review (note that I don't agree with their conclusion): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259713/
Also: http://www.ingentaconnect.com/content/ben/rrct/2013/00000008/00000001/art00008
Bad for many after dental implants:
http://onlinelibrary.wiley.com/doi/10.1111/clr.12493/full
http://www.joionline.org/doi/abs/10.1563/AAID-JOI-D-13-00125
It's an open question. You should be more curious than confident.
Wait - you actually use a reference that has as a conclusion that NSAIDS should be used. Really?
There is no robust clinical and/or scientific evidence to discard the use of NSAIDs in patients suffering from a fracture, but equal lack of evidence does not constitute proof of the absence of an effect. The majority of the available evidence is based on animal findings and these results should be interpreted with caution due to the differences in physiological mechanisms between humans and animals. The need of basic science research defining the exact mechanism that NSAIDs could interfere with bone cells and the conduction of well-randomised prospective clinical trial are warranted. Till then, clinician should treat NSAIDs as a risk factor for bone healing impairment and should be avoided in high-risk patients.
In other words, during the early acute healing period.
As to the dental stuff - not relevant.
It is an open question - which means that the treatment of inflammation and pain should be case by case and NOT be resolved by a blank statement of "don't use them" and "your body heals better".
What? Dental stuff is "not relevant" why, because you've decided that? Lol. It's absolutely relevant.
I used the reference because the literature review was good. I disagree with the conclusion and recommendation. Yes, that's possible!
NSAIDs are problematic for chronic issues as well. Find your own references if you don't like the ones I brought in.
It's been lovely chatting with you (oh wait nope not at all).
How is your quote mining for references and stumbling on dental implants stuff relevant to MKEgals punctual use of anti-inflammatory for a chronic period...
MKEgal wrote "Anti-inflammatories, immobilise as much as possible, gentle exercise (wish I could swim), and lots of patience.
This has been going on for more than a year, and my foot still hurts from time to time."
It's a long term healing process where the person is probably using them on and off to manage inflammation. And you are all "but NSAIDS are all the debil" - I'm not sure how you want to link acute issues in dental recovery with a chronic evolving healing issue? But go ahead, please explain how you think this is relevant to MKEgal's post.
Or are you just ranting about NSAIDS in general? (Next you'll be telling me that I shouldn't take my piroxicam when I have a gout attack because of dental implants?)
We'd moved on past MKEgals' post. The dental stuff was pointing to implications re healing.
My bottom line is that there's reason to believe NSAIDs shouldn't be taken for granted as promoting healing in all cases.
Yes, people should look to the research, and evidence from their own bodies, and the informed, up to date medical opinions of professionals experienced with that particular injury & phase of healing & that particular population.
(Personally, NSAIDs have done a lot to manage all manner of pain for *me* in the short term - for years, most of my life - but it's at least possible they might have done more harm than good over time. People pop them like candy, and they're told to. Not sure it helps in every case. And it *is* advised in every case.)
The old paradigms are changing, all this is shifting under our feet as we walk. People should do what they feel is right for them, in their judgement.
I don't want to jump in to this "discussion" but...
When I broke my wrist a couple of months ago I was told by the emergency room, my GP, the hospital where I had the surgery done and two orthopedic surgeons to not take NSAIDs. I was told they would thin my blood. I had assumed it was only applicable pre-surgery but my surgeon and now my physical therapist still are telling me no NSAIDs as it interferes with healing.
Thank you for sharing your experience, Annie.
(No imposition at all, I think it's good to move on from there.)0
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