NSAIDs in the News

[redir]

I figure this might apply to many of us here. Cycling being a low impact perhaps doesn't require the use of NSAIDs as much as some others, but if you are like me, you like to run too. And frankly without NSAIDs I could not run. I also could not play the guitar. I take about 4 ALieve a week and it's just enough to maintain a pain free environment for what I do...

And then I read the studies that I'M GONNA DIE!!!!!!!!!!!

100% INCREASED RISK OF HEART ATTACK!!!!!!!!!!!!!!

As a scientist (in a former life) myself these 'studies' piss me off.

But anyway just in case you got all scared about it too, here's an article that puts these studies in their place.

https://www.healthnewsreview.org/2017/05/dial-a-headline-on-nsaids-myocardial-infarction-gives-us-a-heart-attack/

I think maybe there are some medical docs on this forum? What do you think?

[JAGI410]

Once I read the study that 2 beers is a better pain reliever than aspirin, I stopped reading about other forms of pain relief.

[MattTuck]

Once I read the study that 2 beers is a better pain reliever than aspirin, I stopped reading about other forms of pain relief.

Who sponsored that study, AB-InBev?

[benb]

Well.. how old are you, how much are you running, how much are you playing guitar. In the linked article it mentions if you've already got a heart issue and have elevated risk the NSAIDS can represent a "substantial" risk.

I know this is common with running, but something sounds really wrong if you are needing them to play guitar.

[Lewis Moon]

As an aquatic toxicologist who does risk assessments for fish consumption (just one of my hats) I absolutely HATE it when, say, a one in a billion to a five in a billion increase in risk is characterized as being a 500% increase. Of course that's actually true, but I also think it's intentionally deceptive. Both risks are infinitesimally small. News organizations and advocacy groups do this all the time.
I have the book "How to lie with statistics" prominently displayed on my bookshelf.

[benb]

As an aquatic toxicologist who does risk assessments for fish consumption (just one of my hats) I absolutely HATE it when, say, a one in a billion to a five in a billion increase in risk is characterized as being a 500% increase. Of course that's actually true, but I also think it's intentionally deceptive. News organizations and advocacy groups do this all the time.
I have the book "How to lie with statistics" prominently displayed on my bookshelf.

Seeing how ignorant most people are about this makes me wonder if the folks in the news are just completely ignorant and can't understand the math at all. I'm not sure they are necessarily being intentionally malicious in how the report this stuff. The press also seems to have an inflated ego about their own intelligence a lot of the time which isn't going to help. They probably don't want to admit it when they don't really understand a scientific study they're reporting on, and don't want to have to ask for additional clarification. It seems like they always want to feel like they are every bit as smart as the people they are reporting on/interviewing, regardless of what field they are reporting on.

I've seen this with folks I know who are engineers and can't understand the math behind relative risks. (like e.x. getting Measles vs the chances of getting a Vaccine side effect) These are people who had to study significantly more math than a journalist, and they still don't understand/trust science.

[parallelfish]

Check out "Relief Factor". It has worked remarkably well for me.

[redir]

Well.. how old are you, how much are you running, how much are you playing guitar. In the linked article it mentions if you've already got a heart issue and have elevated risk the NSAIDS can represent a "substantial" risk.

I know this is common with running, but something sounds really wrong if you are needing them to play guitar.

I've done 47 trips around the sun. Guitar is pretty hard on the wrist. I have psoriatic arthritis and I broke the wrist when I was a kid. I play at least 1 hour a day sometimes much more then that. Running, not much only about 10k per week but I feel that particularly in the right hip. I didn't think taking 4 or 5 200mg tabs a week was a lot but maybe I'm wrong.

[54ny77]

redir: if your wrist complications are related to joints & tendons in your forearms, take a look at this. it's been a minor miracle worker for me.

https://www.armaid.com/store/products/44/armaid



I figure this might apply to many of us here. Cycling being a low impact perhaps doesn't require the use of NSAIDs as much as some others, but if you are like me, you like to run too. And frankly without NSAIDs I could not run. I also could not play the guitar. I take about 4 ALieve a week and it's just enough to maintain a pain free environment for what I do...

And then I read the studies that I'M GONNA DIE!!!!!!!!!!!

100% INCREASED RISK OF HEART ATTACK!!!!!!!!!!!!!!

As a scientist (in a former life) myself these 'studies' piss me off.

But anyway just in case you got all scared about it too, here's an article that puts these studies in their place.

https://www.healthnewsreview.org/2017/05/dial-a-headline-on-nsaids-myocardial-infarction-gives-us-a-heart-attack/

I think maybe there are some medical docs on this forum? What do you think?

[fuzzalow]

As an aquatic toxicologist who does risk assessments for fish consumption (just one of my hats) I absolutely HATE it when, say, a one in a billion to a five in a billion increase in risk is characterized as being a 500% increase. Of course that's actually true, but I also think it's intentionally deceptive. Both risks are infinitesimally small. News organizations and advocacy groups do this all the time.
I have the book "How to lie with statistics" prominently displayed on my bookshelf.

Sure, percent increase hyperbole is meaningless without considering the base number. But even being cognizant of the base number is meaningless without context. Infinitesimally small might mean little in raw number terms but in areas like toxicology, finance etc it might well mean alot.

Unless we're talkin' about specific, specialized documentation, I'm not sure the background precision for a more general readership matters all that much. You and me might want more precision but, depending on the article & periodical, they ain't talkin' to us.

[saf-t]

As an aquatic toxicologist who does risk assessments for fish consumption (just one of my hats) I absolutely HATE it when, say, a one in a billion to a five in a billion increase in risk is characterized as being a 500% increase. Of course that's actually true, but I also think it's intentionally deceptive. Both risks are infinitesimally small. News organizations and advocacy groups do this all the time.
I have the book "How to lie with statistics" prominently displayed on my bookshelf.

Science guy here too. I frequently find myself explaining the difference between relative risk and absolute risk.

[redir]

Thanks for the suggestions I definitely will check those out.

[benb]

I've done 47 trips around the sun. Guitar is pretty hard on the wrist. I have psoriatic arthritis and I broke the wrist when I was a kid. I play at least 1 hour a day sometimes much more then that. Running, not much only about 10k per week but I feel that particularly in the right hip. I didn't think taking 4 or 5 200mg tabs a week was a lot but maybe I'm wrong.

Probably all you needed to say was arthritis. I play at least an hour every day too.. my acoustic will occasionally make my left arm sore.. my electric basically never. I almost always chalk it up to doing something wrong.

I don't own that armaid thing that 54ny77 mentioned.. but I have tried it in the store.. it's freakin great, I want one.

I roll out my forearms every morning and night with a foam roller.. I injured my wrist back in 2014.. I didn't catch onto the foam roller till last fall, the PT never clued me in on it. It's made a huge difference, and if I do either do something stupid on my bike or playing my guitar the foam roller clears it up really well. Say I do something dumb on the guitar at night.. if I hit my arm with the foam roller before bed my arm will be fine in the morning. If I don't I'll wake up with a sore arm and possibly some pain at the elbow or in the wrist. I've been doing this 6 months.. it's helped almost enough I don't need to do it every day anymore. Similar improvement/time frame as when I had a knee injury and was told to use the roller on my legs.

I mostly blame cycling.. I think the muscles in my forearms were a giant mess of scar tissue/adhesions/trigger points from years of holding that same posture on the road handlebars.

[redir]

Interesting I never even thought of using a foam roller for wrist pain. I love it on my It band for running though!

And yes for sure Mountain Biking puts a big hit on my wrists for sure.

[benb]

Yah.. MTB can be bad. Doesn't necessarily seem like it always worse than road for me though.

When I hurt my wrist hurt half the stuff the PT had me to just made it worse.. the foam roller definitely makes it better. I'm kind of mad in retrospect... I could have gotten a lot better a lot faster if I'd gotten a different protocol from the PT.

[thwart]

Yeah, appropriately communicating 'risk' is a tricky business.

Many folks take a fair amount of NSAID's and figure since they're OTC that they are pretty harmless. So there's that group to factor in as well... they would benefit from information that they're more dangerous than taking a vitamin (for example).

If you have multiple risk factors for heart disease, or high blood pressure, or kidney function problems, or previous stomach ulcers... then NSAID's should be used very sparingly and probably best only after consultation with your doc.

However Paceline members are more active and healthier than the average, so the way this information is presented in the media as mentioned above, is overkill.

FWIW, naproxen (Aleve) seems to be the least risky NSAID to use from a cardiovascular standpoint... although that could change next week as new studies come out. I think most docs would consider 4 tablets a week to be pretty low dose and low risk (assuming you've got none of the conditions outlined above).

Of course anything you can do to alter the activities that cause pain, perform stretching, use icing after activities, massage, foam rollers, etc. to minimize use of any meds would be wise.

[jumphigher]

Seeing how ignorant most people are about this makes me wonder if the folks in the news are just completely ignorant and can't understand the math at all. I'm not sure they are necessarily being intentionally malicious in how the report this stuff. The press also seems to have an inflated ego about their own intelligence a lot of the time which isn't going to help. They probably don't want to admit it when they don't really understand a scientific study they're reporting on, and don't want to have to ask for additional clarification. It seems like they always want to feel like they are every bit as smart as the people they are reporting on/interviewing, regardless of what field they are reporting on.

I've seen this with folks I know who are engineers and can't understand the math behind relative risks. (like e.x. getting Measles vs the chances of getting a Vaccine side effect) These are people who had to study significantly more math than a journalist, and they still don't understand/trust science.

^Totally agree with this.

[biker72]

Looks like I should have died 30 years ago....:D