Do you take painkillers, ibuprofen, etc. when hiking?

Nothing. If it hurts enough to slow me down, nothing over-the-counter will make any difference, and anything that works will prevent me thinking clearly enough to hike out. On long enough expeditions I might carry a strong painkiller in case I have the need to sleep while injured, but I haven't used an analgesic since the last time I had surgery. (Not counting small amounts of alcohol consumed for other purposes.)

I've been carrying the same bottle of Advil and Tylenol (a few of each) with me for a few years now. I think I'm missing a couple that have turned to powder from bouncing around in there but otherwise haven't needed anything since I started with the glucosamine 10 years ago for knee pain.

Never anything during the hike. After the hike I used to pop a couple asperin or a single ibuprofen, but I was recently diagnosed with erosive gastritis so I'm off NSAIDs entirely. Now just a Tylenol if I really feel I need it.

I used to take Advil early on in the week when I was doing one week sections on the AT. I switched over to glucosamine after hearing from several retired AT thruhiking couples that they attributed their ability to hike the AT to glucosamine. At least two of the couples had tried thru hikes the prior year and had to drop off trail early due to joint issues. I ran into them with over 1000 miles for the season and they were still going strong and attributed the glucosamine.

It takes a couple of months to kick in so, its hard to prove it works, but I have gone off of it once of twice and regretted it. DO note there are several combinations of glucosamine with MSM and chronditin. The combinations are triple the cost for the glucosamine and the research studies I had seen were with strictly glucosamine, so I stick with straight glucosamine.

I stll do take Advil in advance of a hike when its going to be a long run.

Never during the hike. I find that it affects my muscles, not like a relaxant but still enough to throw off my balance and a bit of coordination.

I think that glucosamine has been shown to help some people who have knee pain; it has not been proven to improve hip pain. It's hard to calculate the placebo effect of any drug, of course. Tylenol (acetaminophen) and NSAIDS (e.g., Advil, Motrin) are not risk-free. High doses over an extended period can have effects on the liver and kidneys, respectively. I don't take them prophylactically, "just in case." There's no free lunch. Ice is great.

i never leave for a hike without some form of oxycodone, if i cant find a doctor to right a script for that i will find some hydrocodone. be it from the streets or someones medicine cabinet. best technique for either of these is via. hypodermic needle.

or if im lying i sometimes take ibu's before and after a hike and always carry a prescription migraine medication with me (for real) as i get migraines every now and again.
have had knee problems for years now so pretty much learn to expect and deal with pain.

"Just the usual cautions:
High does of acetaminophen (Tylenol, Panadol) can cause liver damage. Combining it with alcohol can increase the chance of damage. Drug-induced liver damage is a major cause of liver replacements.
The NSAIDs (aspirin (Bayer, Bufferin), ibuprofen (Advil, Motrin), naproxen (Aleve)) can cause stomach irritation and bleeding and/or other side effects.
(Excedrin, mentioned earlier, contains both acetaminophen and aspirin.)"

Sound advice from Doug Paul. I used to be pretty free with the use of Tylenol, Ibuprofen, Advil, etc until some of the results of a recent annual physical. Some elevated liver enzymes. My internist advised no alcohol or OTC medication for 3 weeks before taking another blood test.
He traced elevated levels to pain killers. I had a lengthy flu and used medication to take down a fever and combined with others, was overdosing.
This is far different than taking 2-3 pills on the trail, but his opinion was that many of us take way too much OTC pain relievers and that over the years it can lead to liver and other organ damage.
He feels that coated aspirin is probably the safest in small dosages and when needed.

I guess I am an anomaly, and should stop hiking, climbing and skiing.
I take Aleve, before, and after a hike. I carry with me aspirin and tylenol and also carry a narcotic pain med. When I blew out my ankle 3 years ago I wished I had the narcotic. I haven't used it yet, but I have it as a security blanket.
I have Rheumatoid Arthritis, so anti-inflamatories are part of my day to day life. I use ice as a pain/swelling remedy. Agree with Glucosamine. It has been clinically proven to help joints when take consistantly.

I don't take any pain relievers when I hike and generally don't need to take them after a hike either. As others have said, pain is the body's way of saying something's going wrong and I want to be able to hear it so that I can be hiking well into my years.

I'm strongly in the ibuprofen camp - don't take too many, maybe a couple before and a couple after. When I was in college, my doc's prescribed 8x600mg per day of ibu so I could 'play thru the pain'. Ended up with two knee surgeries and three shoulder repairs by doing that. So I understand the masking the pain issue, but since my shoulder has been in pain for nearly thirty years now a little masking isn't such a bad thing. On top of all that, I broke my hip two years ago, and that still aches on longer hikes...for that I still keep some of the prescription painkillers on hand, but rarely use them any more.

I used to take a lot of "vitamin I" when I hiked as I had/have problems with my knees (some arthritis going on in the old joints as I have gotten older). A couple before driving to the trailhead; then another couple at the summit; maybe some more once I was back at the car; and another dose before I went to bed. I also took glucosamine and had some good results with it, although I was still taking the "vitamin I". Then about 3 years ago I started taking a whole food nutritional supplement (it's labeled as food - not as a drug or other supplement). After about 3 or 4 months, I stopped taking both multi vitamins and glucosamine (I finished up what I had in the medicine cabinet and never bought more), because I was getting all of the phyto nutrients necessary for my body to use with this supplement. I can't remember when I took "vitamin I" last - maybe several months ago when I had a lowgrade fever. I never take it any more when I hike!

Anyone interested in hearing more about this product - PM me.

peakbagger said:

I switched over to glucosamine after hearing from several retired AT thruhiking couples that they attributed their ability to hike the AT to glucosamine. At least two of the couples had tried thru hikes the prior year and had to drop off trail early due to joint issues. I ran into them with over 1000 miles for the season and they were still going strong and attributed the glucosamine.

It takes a couple of months to kick in so, its hard to prove it works, but I have gone off of it once of twice and regretted it. DO note there are several combinations of glucosamine with MSM and chronditin. The combinations are triple the cost for the glucosamine and the research studies I had seen were with strictly glucosamine, so I stick with straight glucosamine.

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The reports (eg Consumer Reports) that I have seen are for glucosaimine and chrondroitin. After a doc told me that he saw some evidence for arthritis in a hip joint X-ray I started taking G+C prophylactically. The hip joint has always been asymptomatic, but the incidence of the earlier-mentioned sudden ankle pain has diminished. (The sudden ankle pain also responded to ibuprofen, so it could have involved inflammation. G+C appears to be a slow-acting joint anti-inflammatory agent.)

Some web reports:
http://orthopedics.about.com/cs/supplements/a/glucosamine.htm
http://arthritis.webmd.com/tc/glucosamine-and-chondroitin-topic-overview

Doug

I never take anything before or during a hike. Lately I've been taking 4 x 200mg Ibuprofen after most hikes right before I go to bed, and again in the morning. It isn't for the usual muscle aches and pains after vigorous exercise (I can usually ignore that), but for previous injuries that have started flaring up more often (knee surgery x3 [same knee], and shoulder surgery).

I gear up for pain on more challenging hikes with three Advil. If it has been damp (when hasn't it?) or when the leaves have fallen (I love shuffling through them) I switch to Advil Cold and Sinus, the kind I have to show my license for.

DougPaul said:

* Pure water ice is ok, but frozen water + anything else (eg veggies) can be dangerous. Whenever you add anything to water, its freezing temp is lowered and if lowered below that of tissue it can potentially freeze the tissue. Since tissue is bathed in salt water, its freezing point is a little below that of pure water and thus cannot be frozen by pure water ice.
Doug

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I recently had surgery for skin cancer, and my doctor recommended using frozen peas rather than ice packs to reduce swelling. She said peas were not only much cheaper, but in bags contoured to the face better than ice packs.

Furthermore, when my wife broke her ankle this spring, both the emergency room physician and her doctor recommended bags of frozen peas rather than ice packs. Again this was primarily because the bags would contour around her leg.

While it's true that frozen objects can harm tissue, I don't believe vegetables kept in a home freezer or a cooler reach dangerous temperatures. They also tend to thaw quickly.

Daniel Eagan said:

I recently had surgery for skin cancer, and my doctor recommended using frozen peas rather than ice packs to reduce swelling. She said peas were not only much cheaper, but in bags contoured to the face better than ice packs.

Furthermore, when my wife broke her ankle this spring, both the emergency room physician and her doctor recommended bags of frozen peas rather than ice packs. Again this was primarily because the bags would contour around her leg.

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OK, as long as you don't eat the peas.

While it's true that frozen objects can harm tissue, I don't believe vegetables kept in a home freezer or a cooler reach dangerous temperatures. They also tend to thaw quickly.

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Actually anything that has been in the freezer long enough (eg peas or ice) will initially be at the temp of the freezer-- ~0F in my freezer. So if it can suck the heat out of tissue fast enough, it can freeze tissue. Thus initially there is a race until the peas/ice begin to melt.

A mixture of ice and water or a mixture of frozen peas and water/unfrozen peas will tend to stay at their respective melting/freezing temps until totally thawed.

Once the peas/ice have warmed to their melting/freezing point (slightly below 32F for peas, 32F for pure ice) then there is steady-state condition. Since flesh also freezes at slightly below 32F, the risk depends on the freezing temp of the peas vs the freezing point of flesh. (The freezing point of ice is always higher than the freezing point of flesh.) It is possible that the freezing temp of the peas is higher than the freezing point of flesh--I don't know the exact numbers.

So maybe there is a problem with peas (or other frozen objects), maybe not. I prefer not to take the risk. Pure water ice or commercial ice packs (once they have begun to melt) are known to be safe.

BTW1, my commercial ice packs soften up after a few minutes and will then conform to the shape of the body quite well.

BTW2, if you thaw peas and then refreeze them, you will have a solid block. Not reusable--you probably have to eat them... ( )

BTW3, yes you can actually eat the peas...


Any thing that significantly cools the flesh without damaging it (or causing hypothermia) will do. Simple cold water (eg a mountain stream) will do quite well.

Doug

TEO said:

You will not experience Ibuprofen's anti-inflammatory benefits from taking a couple of pills after a hike. To get the anti-inflammatory effect, you need to build up a minimum level of ibuprofen in your blood stream, which means taking it regularly several times a day for one week before the anti-inflammatory effects kick in.

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I got the same explanation from my doc when I told her the pain in my hands (now thought to be tendonitits, x-rays negative for arthritis) didn't go away with a dose or two of Ibuprofen. She told me to take it religiously for 4-6 weeks and report back. It did work, but I don't take it constantly anymore, just when I over-do something and feel it coming back.

TEO said:

You will not experience Ibuprofen's anti-inflammatory benefits from taking a couple of pills after a hike. To get the anti-inflammatory effect, you need to build up a minimum level of ibuprofen in your blood stream, which means taking it regularly several times a day for one week before the anti-inflammatory effects kick in.

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I've heard a slightly different version: start taking it a few days before the hike for maximum effects.

Inflammation can continue for a while after the insult, so taking it after the hike may still help to reduce the inflammation, but not as much as if you start taking it before the hike.


It would be nice if there were OTC short-term non-analgesic anti-inflammatories available... (While I'm wishing it would be nice if they had minimal side effects, too.)

OTC=over the counter

Doug

I am a long-term user of moderate to high doses of an NSAID. I don't drink (much) and I get my liver checked yearly. I also cut back as much as possible on the dosing, until the on-going levels in my body wane to the point of the re-emergence of symptoms. In my case, being on this drug on a continuing basis has solved problems, but it's not so great for the liver, requires an acid-reducer side-car, and who wants to rely daily on drugs?

That said, my doctor (a rheumatologist with mostly arthritis patients) informed me that my dosage (equivalent to about 2000 milligrams [eight total regular pills] of ibuprofen a day) pales in comparison to what some of his patients ingest. Doesn't make it okay; just helps to know the spectrum.

I wish I could go with those who say they use nothing; higher fitness levels will relieve much of what NSAIDs do in the short-term.

$0.02,

--M.