Why Inflammation After Injuries Is Good for You — And When NSAIDs May Still Help

Injuries are never convenient. Whether it's a twisted ankle or a strained muscle, most of us just want the pain to stop — fast. Our first instinct may be to reach for an over-the-counter anti-inflammatory medication like ibuprofen or naproxen. However, it’s important to understand that inflammation isn’t the enemy. In fact, short-term (acute) inflammation is a vital part of your body’s healing process.

The redness, swelling, heat, and pain following an injury are signs that your body is actively working to heal. Immune cells like neutrophils and macrophages swarm the site, clearing out damaged tissue and fending off infection. These processes are driven in part by chemical messengers called prostaglandins. In a foundational review, Ricciotti and Fitzgerald (2012) explain that “inflammation is an intrinsically beneficial event that leads to removal of offending factors and restoration of tissue structure and physiological function.”

Unfortunately, anti-inflammatory drugs like NSAIDs can interfere with these processes. But that doesn’t mean they’re always harmful. Let’s explore when inflammation is good, when NSAIDs might be helpful, and what the best alternatives are for most soft-tissue injuries.

How NSAIDs Work — and When They Help or Hurt

NSAIDs (non-steroidal anti-inflammatory drugs) reduce pain and inflammation by inhibiting cyclooxygenase (COX) enzymes, particularly COX-1 and COX-2. These enzymes play a key role in producing prostaglandins that trigger inflammation and pain.

By blocking these enzymes, NSAIDs suppress the inflammatory cascade, bringing short-term symptom relief. This can be useful in situations where inflammation becomes excessive or interferes with function, for example, in severe joint sprains, certain tendinopathies, or post-operative swelling (Slattery et al., 2020). NSAIDs can also improve comfort and sleep in the early stages of moderate-to-severe injury, indirectly aiding recovery.

However, there’s a trade-off. Prostaglandins do more than signal pain — they help dilate blood vessels, recruit white blood cells, and support collagen formation, which is essential for tissue regeneration. Inhibiting prostaglandins too early or too often can delay healing (Ricciotti & Fitzgerald, 2012; Christensen et al., 2011).

Long-term or excessive NSAID use has also been associated with reduced collagen synthesis (Christensen et al., 2011) and increased risk of gastrointestinal, renal, cardiovascular, and hepatic complications (Bindu et al., 2020) Overall, NSAIDs can be appropriate for short-term symptom relief in certain cases, but should be used sparingly, especially during the early, active healing phase of soft tissue injuries.

A Better Framework: PEACE & LOVE

Instead of immediately turning to anti-inflammatories, consider the modern evidence-based approach to soft tissue injury: PEACE & LOVE — a rehabilitation framework proposed by Dubois and Esculier (2019) that emphasizes protection, movement, and education.

PEACE (Initial Phase)

• P – Protect: Limit harmful movement to avoid worsening the injury.

• E – Elevate: Promote venous return and reduce swelling.

• A – Avoid anti-inflammatories: Let inflammation support healing, particularly in the early phase.

• C – Compress: Control swelling and maintain joint alignment.

• E – Educate: Learn how recovery works to reduce fear and unnecessary medical interventions.

LOVE (Ongoing Recovery)

• L – Load: Gradually apply stress to tissues to stimulate repair and remodeling.

• O – Optimism: A positive mindset supports hormonal and neural recovery processes (Briet et al., 2016).

• V – Vascularization: Include aerobic activity to promote blood flow and healing.

• E – Exercise: Targeted strength, mobility, and proprioception work restore function.

This model promotes natural inflammation while progressively restoring movement and tissue capacity. The result? A more complete and resilient recovery.

Nutritional Support for Healing

Healing doesn’t just happen in the gym or at physical therapy — it also happens in the kitchen. According to Papadopoulou (2020), one of the most important aspects of injury recovery is adequate caloric intake. When injured, a negative energy balance can accelerate muscle loss and slow recovery.

Key Guidelines:

• Energy intake: Aim for 25–30 kcal/kg of body weight per day.

• Protein: Intake should be at least 1.6–2.0 g/kg/day to support muscle protein synthesis.

• Carbohydrates: Sufficient glycogen availability reduces muscle breakdown and improves protein balance.

• Micronutrients: Vitamins A, D, E, and K, plus minerals like magnesium and zinc, are crucial for tissue repair and hormonal regulation.

In short, fuel your recovery as seriously as you would fuel your training.

Conclusion

Inflammation is not your enemy — it’s your body’s built-in repair crew. While NSAIDs can provide temporary relief and may be appropriate in certain contexts (e.g., to reduce excessive swelling or improve sleep in the initial days post-injury), their overuse can disrupt healing. Embracing the body’s natural response through frameworks like PEACE & LOVE — and supporting it with proper nutrition — leads to stronger, more complete recovery from injury.

Works Cited

Bindu, S., Mazumder, S., & Bandyopadhyay, U. (2020). Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochemical Pharmacology, 180, 114147. https://doi.org/10.1016/j.bcp.2020.114147

Briet, J. P., Dufournet, M., Le Meur, Y., & Toussaint, J. F. (2016). Positive beliefs are associated with less pain and better function in patients with musculoskeletal injuries. The Clinical Journal of Pain, 32(3), 237–244. https://doi.org/10.1097/AJP.0000000000000250

Christensen, B., Dandanell, S., Kjaer, M., & Langberg, H. (2011). Effect of anti-inflammatory medication on the running-induced rise in patella tendon protein synthesis. Journal of Applied Physiology, 110(1), 137–141.

Dubois, B., & Esculier, J. F. (2019). Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine, 54(2), 72–73.

Papadopoulou, S. K. (2020). Sarcopenia: A contemporary health problem among older adult populations. Nutrients, 12(5), 1293. https://doi.org/10.3390/nu12051293

Ricciotti, E., & Fitzgerald, G. A. (2012). Prostaglandins and inflammation. Arteriosclerosis, Thrombosis, and Vascular Biology, 31(5), 986–1000. https://doi.org/10.1161/ATVBAHA.110.207449

Slattery, F., Page, R., Lawlor, M., & O’Brien, M. (2020). NSAIDs in sports: A comprehensive review and practical guide. BMJ Open Sport & Exercise Medicine, 6(1), e000602.