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Can taking less pain medication (i.e. Vicodin, Acetaminophen, Ibuprofen, etc) reduce the amount of time it takes an injury or surgery to heal?

I heard this one a few times now. One was through a roommate when his doctor was surprised at how fast he was healing and asked him if he was taking his pain medication. My roommate said no and the doctor mentioned this.

I also seem to remember where I read that women who do natural childbirths tend to heal more quickly because they do not get Epidurals.

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  • Well the reverse ought to be true, anyway: decreasing healing time reduces pain medication.
    – ChrisW
    Jun 19, 2011 at 17:12
  • Last week I had a major gout attack. Doctor prescribed naproxen for its anti-inflamatory effect as well as to enable me to move around a bit and sleep some which otherwise would have been impossible due to the excruciating pain. Both uses are beneficial to the healing process. Of course in other situations things may be different, as is always the case with broad sweeping statements like yours.
    – jwenting
    Jun 20, 2011 at 8:00
  • Keep in mind that pain has a natural purpose. In injuries like a broken bone, pain reminds the patient to not put pressure or move the injured area. Dulling that pain could result in increased use of the injured limb/joint, which would prolong the healing period.
    – Beofett
    Jun 20, 2011 at 16:40
  • true, but in that case it's not the medication causing the healing to slow but rather the patient's actions. One reason a cast on a broken leg works so well is because it effectively forces inaction on the patient as it's hard to move around in.
    – jwenting
    Jun 21, 2011 at 5:14

1 Answer 1

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Short answers: it depends.

Pain inhibits healing through several mechanisms. According to Nimmo and Duthie as quoted in an article from World Wide Wounds, there are four major problems with severe pain after surgery:

  1. Decreased respiratory movement especially after upper laparotomy or thoractomy. A decreased functional lung capacity, difficulty in breathing deeply and in coughing all contribute to hypoxia after operation.

  2. Decreased mobility because of pain on movement. Early mobilisation is more difficult and the risk of deep venous thrombosis is increased.

  3. Increased sympathetic activity leads to a release of catecholamines which has adverse effects such as hypertension followed by myocardial ischaemia and decreased blood flow to some tissues.

  4. Hormonal and metabolic activity resulting from surgery and made worse by pain increases protein breakdown and mobilisation of free fatty acids.

Reducing pain (through medication or other means) then aids in healing. So taking pain medication would help you heal faster, rather than the other way around.

Having said that, there are questions about the best pain management techniques and methods. Not all medicines are appropriate for all causes of pain. Many people are studying pain management to determine which is the most effective treatment. For example, in a a comparison of three pain medicines/techniques after surgery, researchers found that patient-controlled epidural analgesia was the most effective both in reducing pain and in immune response to the injury. (The other two mechanisms weren't quite as effective in reducing pain, and didn't help the immune system bounce back from the lowered levels after the surgery.)

If some pain medications don't help, it is also possible (although I didn't find human studies to confirm) that a particular pain medication could inhibit healing. Rat studies suggest that Diclofenac inhibits bone healing, as does Celecoxib. (Diclofenac is marketed under the brand names Cataflam and Voltaren. Celecoxib is marketed as Celebrex.)

So the answer to your question would depend on the cause of the pain, the effects of the pain (if it's not inhibiting healing, it's not a problem), and on the effects of the particular pain medication on your condition.

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    @Martha, can I see if I have this straight? The first part is why you SHOULD take your pain medication. Then you link to some discussions about the challenges of choosing the right analgesic. Then the last two links are the keys ones - the ones that suggest (in rats) some analgesics inhibit healing. Is that a fair summary?
    – Oddthinking ♦
    Jun 19, 2011 at 18:20
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    @Oddthinking: The correct answer is: "Ask your doctor about the risks of your particular drug for your particular case."
    – Christian
    Jun 19, 2011 at 18:27
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    @Christian, yes, it's a delicate balance between "Be skeptical of "Dr Google" and the dodgy medical information you get from the Internet, without enough context and understanding. Ask your doctor, who is an expert." and "Be skeptical of your busy doctor who is only human and makes mistakes. Learn about your medications and conditions for yourself so you know how to ask the right questions about your own health and treatment."
    – Oddthinking ♦
    Jun 19, 2011 at 18:37
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    @Oddthinking -- yes, that's correct. As a general rule, pain interferes with healing. Relieving that pain then would help with healing. But it depends on the drug. As far as the particular drugs, I don't know -- I'm not a medical professional. Ask your doctor and if it's not working, seek a second opinion. I actually did some general searches, and in humans I didn't find any drug studies that suggested that a particular medication interfered with healing -- only that some helped more than others.
    – Martha F.
    Jun 19, 2011 at 19:01
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    of course, Martha. Building up a volume of the working substance in your blood and tissue is an important step in getting long term pain medication to work. That's one reason why doses after surgery often start with a few high dosage shots and then continue at a lower rate. It's also why some painkillers are addictive, lowering the level of working substance can cause withdrawal symptoms.
    – jwenting
    Jun 21, 2011 at 5:13

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