Pain relief and running: the facts

Using pain killers before or during a race is a thorny issue for runners. We examine the facts.

Pain relief and running: the facts

Should you take painkillers during a race? The decision is a toss-up between warding off a niggling injury that you’re worried about, and potentially suffering some unwanted side-effects from popping the pills.

Previous research has indicated the problems taking pain relief medication can bring on for runners. This study reported by the Independent, which used participants in the 2010 Bonn Marathon, found ‘runners who used painkillers had a 13 per cent increased risk of "adverse events" including pain, muscle cramps and intestinal cramps.’

It’s worth adding to this that all three of those problems can occur for various reasons during a long race, such as ingesting too many gels, lack of water intake and general wear and tear that running long distance on tarmac can have on your body.

Proceed with caution

The use of pain relief for runners should definitely be done with a degree of caution.

Dr Colette Coyle, intensive care registrar and four-time London Marathon finisher says:

“I would advise not to take pain-killers on an empty stomach as can they can cause gastric irritation, and you have to consider that most people about to run a long race will have eaten well beforehand and, so taking tablets just before the start could bring this on.

“If you are prone to niggles or already carrying an injury, it is advisable to take them before the start. But if you’re planning on taking them in case you don’t pick up an injury you’ve never had before, it’s just not necessary."

Potential risks

Coyle advises that if runners are worried about developing a pain during the race, carrying a pack with you would be more advisable. “Then, if you start to feel an ache, taking paracetamol in a small dose would be non-harmful with minimal side effects,” she adds.

"But I wouldn’t take anything stronger like codeine or tramadol. Even aspirin would also irritate the stomach, and you would need large doses to have the effect you’re looking for.

“Also, it’s worth remembering that taking too many is not good for the kidneys, and during a long race you are more likely to get dehydrated, whereby this problem would be exacerbated.”

This view is supported by other findings in that same study, in which nine respondents reported temporary hospital admittance: three for temporary kidney failure (post-ibuprofen ingestion), four with bleeds (post-aspirin ingestion) and two heart attacks (post-aspirin ingestion). No runners in the control group of this study reported hospital admittance.

The general message seems to be that the potential risks outweigh the benefits when it comes to taking pain killers during a race, so use sparingly. If you're in acute pain, you'll do yourself more damage than good if you keep running, so we recommend you drop out of the race and seek medical advice for your injury.

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