NSAIDsNatural Anti-inflammatoryCytolyseSuper AntioxidantTendinitis & BursitisStress ReliefFind a DoctorDrugs MedicationsLinksNSAIDs Case AnalysisNew Approaches to Soft Tissue InjuriesNon-steroidial anti-inflammatory drugs (NSAIDs) are typically used to reduceinflammation in soft tissue injuries. The past 50 years represent an era of prodigiousgrowth for sport and fitness related activities. Unfortunately, increased participationhas contributed to a rise in the number of sports-related injuries and the use of NSAIDs.The majority of these injuries involve soft tissue structures such as muscle, tendon andligaments. Practitioners in the field of sports medicine have a variety of drugs and otherforms of therapy at their disposal for the treatment of acute inflammation secondary tosoft tissue injury. These include the non-steroidial anti-inflammatory drugs, cortisol andmuscle relaxants.NSAIDs are administered with the intent to control acute inflammation and relieve pain.This is achieved by inhibiting the production of prostaglandin, a product of arachidonicacid via the cyclo-oxygenase pathway within the cell membrane. Following the acuteinflammatory response, a number of prostaglandins are produced of which prostaglandin E2(PGE2) is particularly catabolic to muscle and the net result is the loss of muscleprotein and atrophy. On the other hand, another prostaglandin, E1, reduces inflammatoryresponse and promotes muscle relaxation. In addition, yet another prostaglandin called F2promotes the growth of muscle when this compound acts synergistically with the hormoneinsulin. When athletes take these NSAIDs, they inhibit all prostaglandin synthesis. As aresult, NSAIDs control inflammation and decrease pain but the muscle is left in anon-regenerative phase.The glucocorticoids (steroids) are another group of drugs used to treat soft tissueinjury. These hormones are very effective in controlling mediators of inflammation and arecapable of influencing muscle mass. However, a condition known as Cushing's Syndrome iscaused by excessive amounts of corticosteroids, resulting in muscle weakness, atrophy anddeath of the muscle fibre. Some authors have referred to glucocorticoids as being thehormone targeting soft tissue. This happens by converting proteins to amino acids and thento carbohydrates. This process appears to involve three mechanisms: (1) an increasedrelease of amino acids by the muscle, (2) a decrease of DNA and protein synthesis at thetranslation level, and (3) a reduction of amino acid uptake in the muscle. To date thesedrugs are routinely given when the injury persists and the athlete does not respond to acommon first line of treatment with NSAIDs.Ice, compression and elevation are the standard treatments when dealing with acute softtissue injuries. However, these modalities are only effective at providing anesthesia andpreserving cell integrity during the first 24 hours following an injury, and are of littlebenefit during the recovery phase. Furth