Medication NSAIDS for Shoulder Pain

EFFECTIVENESS: 3/5

A large scientific review of a number of studies found that no one NSAID appears more effective than others. Interestingly, they also found that using NSAIDs was no more effective than non-pharmacologic interventions (spinal manipulation, physical therapy, bed rest) when it comes to the treatment of headaches. In general, the same can be said for shoulder injury.

If conservative measures do not produce desired pain relief and functional restoration (getting your range of motion back!), NSAIDs and Acetaminophen are the recommended first medication choice for treatment for both acute sprain/strain and flare-ups of chronic sprain/strains of the shoulder. They were both found to be similar in helping in the recovery of acute pain. But watch out for the stomach and liver side-effects.[i], [ii], [iii], [iv], [v], [vi]

Sources:

[i] Lanas A, Perez-Aisa MA, Feu F, Ponce J, Saperas E, Santolaria S wt al. A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal antiinflammatory drug use. Am J Gastroenterol. 2005 Aug;100(8):1685-93

[ii] http://www.fda.gov/ohrms/dockets/ac/02/briefing/3882B2_02_McNeil-NSAID.htm

[iii] Fine M. Quantifying the impact of NSAID-associated adverse events. The American Journal of Managed Care [01 Nov 2013, 19(14 Suppl):s267-72

[iv] Chou, R. Pharmacological management of low back pain. Drugs. 2010 Mar 5;70(4):387-402.

[v] Wolfe MM, Lichtenstein DR, Singh G. Gastrointestinal toxicity of non-steroidal anti-inflammatory drugs. N Engl J Med. 2007;147(7):478-491.

[vi] Hawk C. The Praeger Handbook of Chiropractic Health Care.Santa Barabara CA: ABC-CLIO; 2017.

SELF CARE: 5/5

While there are prescription NSAIDS available, most commonly used NSAIDS, such as ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve) and aspirin are readily available almost everywhere and over the counter. Generic NSAIDS like these are very inexpensive, and this treatment is widely used in the US.

COST: 4/5

While there are some expensive to very expensive prescription NSAIDS on the market, many are available without a prescription and are very inexpensive. Based on the range of prices, we give it a 4/5.

USEFULNESS: 3/5

TYPES: Non-steroidal anti-inflammatories (NSAIDS); Corticosteroid Injections; Nerve blocks, etc.

As a general concept, before drugs are considered we suggest using other more conservative non-drug therapies as first line intervention for the treatment of shoulder sprain/strain. If conservative measures fail, one should consider the least invasive and dangerous drugs first, followed by other more invasive and risky drugs and procedures. Many times, a multidisciplinary (ex. MDs and DCs, massage therapists and acupuncturists), multimodal approach (ex. joint manipulation/mobilization, NSAIDs, electric stimulation, laser) to injury management is more effective than singular treatment approaches, especially as it relates to Grade II, and III tears/injury.

Non-Steroidal Anti-Inflammatory Mediciation (NSAIDs), Acetaminophen, and Ibuprofen

Overview: NSAIDS are among the most commonly used drugs in the United States and can be found in most people’s medicine cabinets.