An Anti-inflammatory Story

You know how this one goes kids. Once upon a time there was a foot. One day this foot was injured. Or had surgery. Or developed an infection. And many weeks later the brain that was on the other side of the body from this foot was wondering why it’s taking so long to heal, and if that bottle of Ibuprofen or Naprosyn in the medicine cabinet (between an old box of bandaids and a swig of pepto) is effective in meaningfully reducing the swelling and inflammation, thereby expediting the healing process.

 

As we have discussed in the past, inflammation is a natural consequence of the disruption of the body’s natural processes, and an important part of the healing process. Part of this process, especially in the initial stages, is the transmission of pain signals. As the healing process progresses to the more chronic stages, pain typically decreases, and swelling becomes persistent and slow to resolve. Now some of the more commonly used medications to treat pain from foot injuries or surgery are in the class of drugs known as non-steroidal anti-inflammatory drugs, or NSAIDs, which include ibuprofen, Naprosyn and aspirin. These are called non-steroidals in contrast to corticosteroids, or cortisone, such as prednisone, which we have discussed before.

 

I am often asked if NSAIDs can be used to treat inflammation, and as I tell my dear NYC podiatry patients, while these medicines are great for treating pain, especially in the acute stages, I have not found them to be very effective in treating inflammation in a meaningful way in the clinical setting. In other, less boring words, NSAIDs do reduce inflammation in theory, however inflammation is a slow and quite annoying process that is just part of the body’s way of healing.

 

As I have said in these holy blogs and many times to my even holier NYC podiatry patients: the body wants to heal, we just have to give it the tools to do so. That means reducing pressure on an injured foot, initiating range of motion exercises as early as possible after surgery, and sometimes avoiding medicines that reduce inflammation where inflammation is beneficial. Narcotics are great for acute post operative and post injury pain, NSAID’s are great for the later stages of healing- when used appropriately- and cortisone is a potent anti-inflammatory agent for heel pain, basic tissue damage and generalized persistent inflammation in a slow healing or arthritic foot.

 

So at the risk of really confusing my NYC podiatry audience, NSAIDs are great for pain, and nobody should hesitate to control their pain in a medically sound and appropriate way. Not entirely convinced that they work as well for inflammation,that just needs to resolve on its own, but they do play a role in the healing process. For further information, contact your friendly neighborhood foot doc :-). (Love the smiley face, colon dash parentheses business, I just feel so hip and friendly.)

 

See you in the office.

 

Ernest Isaacson