From the Guidelines
Ibuprofen is not necessarily superior to aspirin for musculoskeletal injuries, as the evidence suggests that oral NSAIDs, including ibuprofen, are effective in reducing pain and improving physical function, but does not specifically compare ibuprofen to aspirin [ 1 ].
Key Points
- Oral NSAIDs, such as ibuprofen, are recommended for the treatment of acute pain from non-low back, musculoskeletal injuries [ 1 ].
- Topical NSAIDs with or without menthol gel are also recommended as first-line therapy [ 1 ].
- Aspirin is not specifically mentioned in the guidelines as a recommended treatment for musculoskeletal injuries.
- Acetaminophen is suggested as an alternative to oral NSAIDs for reducing pain [ 1 ].
Comparison of NSAIDs
- A study found that diclofenac showed superior results to ibuprofen and piroxicam in reducing pain during motion in patients with acute ankle sprains [ 1 ].
- Another study found that celecoxib was non-inferior to non-selective NSAIDs, including ibuprofen, for reducing pain following an acute ankle sprain injury [ 1 ].
Conclusion is not allowed, so the answer just ends here.
From the FDA Drug Label
In clinical studies in patients with rheumatoid arthritis and osteoarthritis, ibuprofen tablets have been shown to be comparable to aspirin in controlling pain and inflammation and to be associated with a statistically significant reduction in the milder gastrointestinal side effects Although it is not definitely known whether ibuprofen tablets causes less peptic ulceration than aspirin, in one study involving 885 patients with rheumatoid arthritis treated for up to one year, there were no reports of gastric ulceration with ibuprofen tablets whereas frank ulceration was reported in 13 patients in the aspirin group (statistically significant p < 0. 001) Studies using 51Cr-tagged red cells indicate that fecal blood loss associated with ibuprofen tablets in doses up to 2400 mg daily did not exceed the normal range, and was significantly less than that seen in aspirin-treated patients
Ibuprofen is not superior to aspirin for musculoskeletal injuries in terms of efficacy, as they are comparable in controlling pain and inflammation. However, ibuprofen may have a safer gastrointestinal profile compared to aspirin, with a lower incidence of gastrointestinal side effects and less fecal blood loss 2.
From the Research
Comparison of Ibuprofen and Aspirin for Musculoskeletal Injuries
- Ibuprofen was found to be better tolerated than aspirin in patients with musculoskeletal conditions, with a lower rate of significant adverse events (15.0% vs 20.5%) 3.
- Ibuprofen was also associated with fewer digestive system adverse events (4.4%) compared to aspirin (8.6%) and paracetamol (6.5%) 3.
- A systematic review of randomized controlled trials found that ibuprofen was effective in reducing pain scores in children with musculoskeletal injuries, with a favorable combination of effectiveness and safety profile 4.
- However, another study suggested that the use of nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, may be counterproductive in the treatment of musculoskeletal injuries, as inflammation is a necessary component of the healing process 5.
Efficacy of Ibuprofen in Musculoskeletal Pain
- A retrospective cohort study found that the combination of ibuprofen and paracetamol was effective in preventing musculoskeletal pain persistence, with a significantly lower risk of pain persistence compared to other systemic analgesics 6.
- A systematic review and meta-analysis found that NSAID use, including ibuprofen, was associated with a significant decrease in markers of injury, including strength loss, soreness, and blood creatine kinase level, after acute skeletal muscle injury 7.
- However, the study also found that the efficacy of NSAID use may depend on the location of the injury, with higher efficacy found in lower body muscles, and the duration of NSAID administration, with longer durations potentially being detrimental 7.
Safety and Tolerability of Ibuprofen
- Ibuprofen was found to be well tolerated in patients with musculoskeletal conditions, with a lower rate of significant adverse events compared to aspirin 3.
- The combination of ibuprofen and paracetamol was also found to be effective and safe in preventing musculoskeletal pain persistence, with a low risk of adverse events 6.
- However, another study suggested that the use of NSAIDs, including ibuprofen, may be associated with profound side effects, and should not be automatically prescribed as the first choice for treating musculoskeletal injuries 5.