Nonsteroid Anti-Inflammatory Drugs in Sports Medicine: Effectiveness and Risks

At present, in connection with the frequent intensification of the training process, the increase in the volume, intensity and duration of the loads, sportsmen, especially representatives of power and game sports, have got more frequent cases of the pathology of the ligaments and joints. This leads to the removal of the athlete from the training process. Moreover, it is often the reason for the further disability of qualified athletes. This situation requires a sports doctor, pharmacologist, nutritional specialist to use the most modern means of complex treatment and prevention of joint pathology, taking into account the absence of WADA in the forbidden list and features of the sport. Among the three most known and widely used medicines in sports medicine, nonsteroidal anti-inflammatory drugs occupy a special place not only because of the highest frequency of their use. This group of drugs is characterized primarily by a wide range of therapeutic activity. Its range covers all the main manifestations of articular pathology, such as: inflammation, pain, edema, mobility restriction, and a high speed of arresting lesions of the ligament-articular apparatus. However, non-steroidal anti-inflammatory drugs are also characterized by a wide range of side effects from the gastrointestinal tract, cardiovascular system, liver and kidneys, hematopoiesis system. Especially dangerous are these phenomena with the long-term use of non-steroidal anti-inflammatory drugs. That is why, they are recommended for oral administration in short courses and only during an exacerbation to eliminate pain. Today, celecoxib is one of the selective inhibitors of COX-2 widely used in domestic clinics. It is as effective as sodium diclofenac, ibuprofen and naproxen. Factors that predetermined the decision on the feasibility of using celecoxib drugs for the treatment of lesions of the ligaments and joints in athletes may be its quality, effectiveness, as well as a wide range of indications for use, in particular, the relief of pain of various geneses, as shown in numerous clinical studies with evidence level "A". Thus, the judgment on the criteria for choosing non-steroidal anti-inflammatory drugs should be based, firstly, on the tasks facing the sports doctor (short-term pain relief or long-term treatment). Secondly, we should take into account the characteristics of the sport and the specific loads. Thirdly, the doctor should pay attention to the characteristics of the organism of an athlete (initially present problems in the cardiovascular system, hematopoiesis, digestive tract, etc.).