Strains and sprains

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The Pharmaceutical Journal
Vol 277 No 7411 p133
29 July 2006

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· Strains and sprains
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Letters to the Editor

Strains and sprains

Can an apparent contradiction be reconciled?

From Mr P. Melnick, MRPharmS

A recent article (PJ, 3 June, p655 PDF (40K)), suggested that ibuprofen should be avoided in the treatment of strains and sprains because the inflammation experienced in the first few days was an important part of the healing process. I seem to recall advice, current just a few years ago, which held that ibuprofen and other non-steroidal anti-inflammatory drugs exert an immediate analgesic effect, but take some two to three weeks before they manifest their anti-inflammatory properties. Can this apparent contradiction be reconciled?

Perry Melnick
Ilford, Essex

RHIANNON BRAUND, author of the article, replies:

Unfortunately I am not sure what reference is being cited for the comment that non-steroidal anti-inflammatory drugs take two to three weeks before an anti-inflammatory effect is seen. I wonder if it was in regards to chronic inflammatory conditions. Many of the references cited in the article published on 3 June have shown a reduction in inflammation in the acute inflammatory phase (24–48 hours) when treated with NSAIDs and it is this reduction in acute inflammation that causes concern. Recent evidence is accumulating that by inhibiting the acute inflammatory phase we are doing more harm than good. As Mr Melnick will be aware, new research often challenges previous practice.

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