Issue 048

April 2009

Professional fighter Dr Rosi Sexton PhD is a sports therapist and osteopath-in-training based in Manchester, England. She has fought in countries such as Russia, Canada, and the USA, and is ranked as one of the top competitors in her weight class. For more information contact her by email at [email protected] or go to www.rosisexton.wordpress.com/sports-therapy. 

There seem to be lots of different kinds of painkillers you can buy. What are the differences between them?

There are three major types of painkillers that you can buy over the counter without a prescription. They are:

• Paracetamol (acetaminophen in the US). 
• Non-steroidal anti-inflammatories (NSAIDs) e.g. nurofen / ibuprofen, Aleve, aspirin. 
• Medications containing codeine. 

Paracetamol is an effective painkiller, and is often undervalued by fighters. It lacks many of the side effects of other commonly used painkillers and may be used in combination with NSAIDs or codeine (speak to a pharmacist or doctor). 

Non-steroidal anti-inflammatories are commonly used and much misunderstood. They are good for reducing pain. To reduce inflammation however, they need to be taken consistently over a period of several days or more. Popping the occasional tab here and there won’t help the swelling in your sprained ankle, although it may make it feel more comfortable. Taking NSAIDs regularly over a prolonged period can sometimes have nasty side effects. 

Pain medications containing codeine (usually in combination with paracetamol/acetaminophen) are very effective at reducing pain. Drowsiness is a common side effect, so they aren’t good to take before driving, operating heavy machinery, or sparring MMA!  

I’ve been taking ibuprofen for the last six weeks because of a knee injury. Is this a problem?

You should certainly speak to your doctor about whether this is a good idea. Long-term use of NSAIDs may cause stomach pain, digestive problems, and even stomach ulcers. These are powerful drugs, and anyone taking them regularly for longer than a week should be monitored. By always taking ibuprofen with, or after, food you can reduce your chances of having problems. 

I’ve heard that some anti-inflammatories can make you bleed more easily in a fight. Is this true?

Aspirin is certainly one to avoid because it can significantly reduce blood clotting. Other NSAIDs, such as ibuprofen, have also been shown to have an effect (though smaller), which can last for up to 24 hours after taking the drug. It is certainly something to consider if you cut easily.  

My doctor has given me some pills for my back pain. Can I train while taking them?

It depends what the pills are! Always find out from your doctor what you are being prescribed, and what the possible side effects could be. There are some medications commonly prescribed for back pain that you definitely shouldn’t take before training. You also need to consider whether training will aggravate the problem. Fighters often have one of two attitudes towards painkillers: there are those who munch them like sweets, and there are those who won’t take them at all. 

As fighters, we place high demands on our bodies. By taking painkillers on a regular basis to allow you to continue training, you may be doing further damage to an already injured area. First and foremost, it’s important to address the underlying problem. 

On the other hand, there are those who don’t take painkillers at all for fear that they might damage themselves without being able to feel it. This is not usually something to worry about during gentle non-training activities. In many cases taking painkillers helps you to stay moderately active, which can be beneficial. If you have any concerns, speak to your doctor. 

For my next fight, I am told that I may be drugs tested. Are there any painkillers I should avoid taking?

The exact drugs which are prohibited depend on the governing body. If you are taking any prescription medications then you should consult the relevant governing body ahead of time to check whether they are permitted. 

Over-the-counter painkillers containing codeine are banned by some of the athletic commissions in the US. According to Nevada State Athletic Commission, NSAIDs are not prohibited but their use is “discouraged”. 

Where can I get more advice about over-the-counter medications?

Pharmacists are highly trained and will be able to answer any general questions that you have about medications. If you need specific advice about your individual health problems then consult your doctor.