Injuries And Injury-related Pain Relationships To NSAID Use And Abuse In Collegiate Athletes

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used by athletes to treat musculoskeletal pain and injuries. The relationship between NSAID use and current pain and injuries in collegiate athletes in unknown. Understanding this relationship is important due to the potential for athletes to improperly obtain and abuse NSAIDs. PURPOSE: To investigate how pain and injury effects current collegiate athlete NSAID use during both in and out of season. METHODS: Athletes from all 3 NCAA Divisions self-reported data on in and out of season NSAID use, purchase, and dosage. The Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC) was used to evaluate current level of participation and pain. Logistic regressions were used to assess the relationship between current NSAID use and OSTRC total score. Models were adjusted for age, gender, NCAA division, history of orthopaedic surgery, and history of major injury, with unadjusted and adjusted Odds Ratios (OR) with 95% confidence intervals (95% CI). χ2 and Kruskall Wallis tests assessed the relationship between NSAID use and OSTRC overuse and substantial overuse injuries in and out of season. RESULTS: 252 athletes (age of 19.43 ± 1.2 years; Male: 28%; D1: 101, D2: 74, D3: 77) completed the survey. 33% currently used NSAIDs, 48% self-purchased, and 53% took two pills per dose. 36% did not answer where NSAIDs were obtained and 34% did not answer what dosage was taken. The OSTRC median score was 0 (IQR: 0-22). 53% had overuse injuries, while 20% had substantial overuse injuries. Current NSAID users had greater odds of having increased OSTRC scores (1.03 (95% CI: 1.02, 1.04), p<0.001). OSTRC overuse and substantial overuse injured athletes were more likely to use NSAIDs (over use: χ2 = 34.0, p<0.001; substantial overuse: χ2 = 28.2, p<0.001) and use them out of season (over use: χ2 =24.4, p<0.001; substantial overuse: χ2 = 21.4, p<0.001) as compared to non-overuse and non-substantial overuse injured athletes. CONCLUSION: NSAID use is high and the majority of athletes purchase their own NSAIDs, instead of receiving them from a medical professional. Injured athletes are more likely to use NSAIDs both in and out of season. Sports medicine professionals needs to monitor NSAID use and abuse in order to mitigate potential NSAID-related negative health impacts.