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Do NSAIDS stop or just slow bone growth...

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:26 AM in Back Surgery and Neck Surgery
7 months postfusion and having either piriformis issues or inflammed SI joint. My OS has taken a two month trip to help in Afghanistan. He has a fellow but that's it. He is Canadian and apparently this is from way back in college and they pulled him for 2 months.
The MA told me it was fine to take Motrin now and I feel I could really benefit from it. Does it just slow the bone growth or if I take it do I risk totally stopping bone growth??


  • Not sure exactly, but was told that I could not take Advil, Motrin, Aleve, etc. because they were NAISD's and that drug interfers with the fusion process. I'm only 2 weeks post op and wasn't told how long this was in effect.

    Hope you find some answers.

  • I was told that I could take them. My Dr and surgeon both had no idea what other dr's are talking about. I started taking them a month after surgery and I have no problems with my fusion.
  • thanks, that's a big relief! I've been doing pretty well and advancing but the last 5 days I'm feeling it along the sacral border and I'm not sure if it's SI or if it's the butt muscle firing up. I hope a few days of Motrin will settle it down. Working without a net with my OS gone...the one question I didn't grill him with presurgery was "Will you be leaving for military service?" thought of everything else to ask him but that. lol
  • NSAIDS are proven in studies to inhibit fusion. Obviously, some people will take them and still fuse and some people will not take them and still not fuse.(example-I think Bruce took some postop and fused if I remember correctly and I didn't take them for the first year and still not fused at 18 months. Go figure!)

    Most articles I've read and docs I've talked to say the minimum is 3 months post fusion though some are more conservative and say 6 months post fusion no NSAIDS.

    This isn't just a spine issue-some ortho docs have fits if a fresh arm/leg/whatever fracture patient is told to take NSAIDS.

  • I was told to stay away from Nsaids completely. My doctor had a fit when I took Ibuprofen for inflammation and asked him afterward. I haven't asked him if that prohibition is over by this time at 3 months.
  • All of my paperwork has bold writing that states no ibuprfen, advil, motrin etc. This is bad for me as I suffer from migraines and my pills contain these.

    Also my doctor has a firm policy to have all of his patients removed from their pain meds by the sixth week. I this common too? I am not too worried about this as I dont really like taking them but at this point I need them still at least every four hours. Does anyone else have a dr with this guideline?

    Oh my sugery was 12.9

  • This is a tough question. There are studies showing that NSAID's inhibit bone growth and thus fusion, but other studies show no affect. Tylenol is not an NSAID and is fine to take.

    I was told before my surgery no NSAID's for a year. However, at my 3 month appointment, the surgeon said I could start taking small amounts of Advil to help deal with inflammation that has probably been the main source of my recent discomfort. Prescription Advil is 600mg and he said I could do 2 over-the-counter (400mg) up to 3 times a day. I do it once/day to help, but not overdo it.

    Each doctor has their own way of doing things. It is not good to do something against your doctor's orders just because some non-medical professionals on an internet forum say it is okay. The best thing to do is follow your doctor's instructions.
  • I was told I can take Excedrin for headaches--just not a lot. Also, I was put on a 6 day Prednisone pack just 4 weeks after surgery. I questioned my doc on both these issues and he said it was fine. I think every doc is different. My doc is very liberal.

  • PJAK-

    Are you sure your doc means you need to be off pain meds by 6 weeks or does he mean he won't write them himself after 6 weeks? I've seen docs who believe that if you need pain meds after that time you should have your primary doc or pain management doc write them after a certain time postop op. I assume it's just because they don't want to be in the long term pain control business????

    If I had a perfect fusion and no complications, I could have not taken narcs most of the time by 8 weeks. Before things went sour for me, I was mostly taking Tylenol and every couple of days a Vicodin at night. That changed becuz of complications I've had.
  • I'm pretty sure I've got inflammation in either the hip or the SI joint and with the doc gone to Afghanistan, I have to make a choice as to whether to trust his MA or not...I'm going to try twice a day for a week and see if it works. Sleeping is so difficult and it's to the point where its starting to interfere with my walks a bit....say a prayer the fusion continues. I'm 2/3 fused as of last month. I'd hate to ruin it. I just can't believe he left without having another OS available to his patients...I'm really upsest about that. I know his fellow has been there but he's only there on Tues. and still, he's only a fellow. I'll call Tues to pick his brain as well. Thanks everyone!
  • I was told to stop before surgery, and I had read that it was discouraged after surgery. Sure enough, though, my written discharge papers indicated that the surgeon said to resume Mobic when I got home.
  • I'm having a single level PLIF in Jan, and my NS told me that NSAIDS would be okay after 3 months..it seems that there are as many opinions as there are surgeons
  • I would be really worried, frightened, and pissed if my doctor told me they had no idea why other docs were telling patients not to take NSAIDs. It's a proven fact that they affect fusion... NOT an opinion. The way bone grows is from inflammation in the area... If you are taking something that reduces inflammation, you are basically working against the process. Nearly all surgeons are well aware of this, thank GOD. What they vary on is the amount of time in which they recommend patients wait before taking them. I have never heard of a doctor that says it's okay right off the bat. That's ridiculously ignorant of that doctor and they should probably go back to school. It doesn't take a phd to know that anti inflammatories inhibit bone growth. Anyone who has ever broken a bone should even know that, when you go to the E.R. and they tell you that you can take Tylenol or the other prescription meds they can give you... And NOT to take Ibuprofen, Motrin, etc... Since it interferes with the healing process, even though it's not a bone graft or a healing from surgery.

    I don't think it's a matter of whether it slows the process down or stops it. I think that will vary by person, just like the it will vary by person whether the NSAIDs actually affect them a bit, or not at all. I wouldn't chance it, however, unless you have already started fusing. At 7 months post op, there's a good chance you have started fusion. Generally those that will fuse have signs of fusion, or partial fusion by 7 months. (Not ALWAYS, no. It's not a general rule, but it's the statistical majority.)

    If your doctor has previously told you that you have fused or have signs of fusion, and has given you the okay, then I wouldn't worry too much. It's still up to you, and you should do whatever makes you more comfortable.

    As for discharge info... Unless a surgeon tells you directly, I wouldn't base a decision like that on discharge papers (immediately post op, that is... when it's absolutely insane to be taking NSAIDs) because most of the time those papers are drawn up by nurses, and are usually uniform, mass produced information that they just personalize with your name and vitals.
  • Yikes. That sucks. My doctor never gave me any guidelines regarding pain meds aside from telling me not to take more than 12 a day. I've been on them since April, and had my MicroD in May, then my Fusion at the end of Sept... And I'm still on them now. She hasn't said anything to me about getting off them at any point or even weaning down. In the hospital I was taking Dilaudid, Valium, and Percocet, and when I was discharged I was on Dilaudid for 2 weeks after my Fusion and they told me beforehand after the initial 2 weeks I'd be switched back to my Percocet... And my last appt Nov 24 she told me I'd probably need the pain meds MORE now since I'm going to start physical therapy... But I had to be taken off the Valium since that is counterproductive to P.T.

    I think it's not uncommon for docs to have guidelines regarding pain meds. I've heard a lot of people on this site talk about their doctors guidelines regarding meds. Some of them are totally unreasonable, and not fair, in my opinion, but what can ya do? Every doctor has their own ways of running things, so, what can ya do?

    Thanks for the reply, maybe that is the case. I went through my paperwork and it states the same thing about the six week thing but I bet you are right.

    Thank you.
  • love your signature at the bottom of your post... =D>
  • Carol I have read so much about NSAIDS. There are no firm studies either way and some Drs are very conservitative and say absolutely not, while others see the benefit.
    I was given then from Day 1 as I also have lupus and other problems. My Dr said that the benefits far outweigh the risk as without the NSAIDS I would have been unable to walk.
    At 12 weeks I had an X-ray that showed I was fusing really really well. (and had been taking Celebrex) at 24 weeks my fusion had slowed to barely more then at 12 weeks. So who can tell. :??
    I asked my Dr if the NSAIDS would have affected the slowing down of fusion and he said NO it would only make a difference if it was in the first 6 weeks and we have seen that the fusion was growing well at that stage.
    So really it is up to each Dr but you are at 7 months and that should be plently along to take them without fear.
    Have you had any scans etc to see how the fusion is growing?

    Blessings Sara O:)
  • There are lots of studies that lead to the conclusion that NSAIDS can adversely affect bone fusion, but the evidence is largely anecdotal. There are apparently not conclusive studies that categorically prove one way or the other. Consequently most doctors will not want to take the risk and will say no NSAIDS.

    As ernurse pointed out my surgeon prescribed my strong NSAIDS (Arcoxia which is a new COX 2 inhibitor) 3 times a day for my first month following fusion. I fused so well that I was able to have my hardware removed after only 7 months. His belief was that the possible risk of slowing down bone fusion was offset by the considerable benefit of taking a good anti-inflammatory straight after surgery.

    I am not advocating others take NSAIDS after fusion by any means, after all why take the risk? However, bottom line is go with your surgeon's recommendations in this regard, rather than our individual stories here.

    Keep positive!


    ...an old timer here and ex-moderator

  • I am 2/3 of the way fused. My doc is a Canadian citizen. I don't understand the dynamics but apparently he volunteered to help in war while in college and though it's been 20 yrs., he got called to go over to Afghanistan for 2 months. He said it was a very strict 2 month stint and he would be back in mid Jan. Until then, I am a bit leery to trust his fellow but given everything I've read, I am going to try Motrin twice a day for a week and see if this butt thing settles down. If it's hip tendonitis or SI inflammation then it should settle it down, if not I'll think about that then. My walking is great and it may just be a flare up of the butt muscles themselves...who knows?
  • Hi

    My kidney doctor said to avoid NSAIDS and pain meds as they are nephrotoxic and can worsen my kidney function.

  • NO pain meds..you're my hero!! :O
  • No pain meds? I'd be one useless blob of flesh. Or I would just turn into like the second thing from the left on the evolutionary chart. Can't freakin' stand up straight without them. I'm amazed by those who can function without them. I would really cry. Lol.
  • NSAID's are prostaglandin inhibitors, more specifically, Cox-2 inhibitors and Cox-2 is critically involved in fracture healing for the first 3 weeks after the fracture. So they don't stop or slow bone growth, they just impair the healing process. :)
  • I am 9 wks post op of L4 S1 with hardware front and back. I have the opposite problem. Although I still hurt I want to stop taking meds. My Pain Mgt guy keeps upping the scripts. I am slowly cutting the pills out. Withdrawal is real and no fun at all. In fact it's less fun than surgery. But I don't think I would make it through the week with out meds. I am taking 1 less pill a day this week than last week. Next week I will take one less again until I'm down to nothing. ( 4 weeks to go )
    I think common sense is your best guideline.
  • I was told none for 3 months and nothing with steroids in it for 1 year. I'm now 3 months, but I haven't taken any because I just don't want to risk it.
  • I'm wondering if 3 months is much better than 2 months. I had the same surgery a month later than you...what I really want to know is can you put on your socks?
  • so... I am 4 months out.. surgery was april 1. my surgeon said a LITTLE bit of advil for a while would be ok to see if it helped (it did) but not more than a month and or not permanently- so why bother? They also DID prescribe around of 6 pak steroids for all the nerve inflammation... didn't do a damn thing... i'm on fire 88% of the time. still on muscle relaxers and percs at night. some days still really worse than others. I am now trying an enzyme called serapeptase, read that it helps with all... and it's a natural anti inflammatory... then again, will that affect fusion? 3 months passed, xrays looked good.. but have 6 month apt in November.. definitely better than the 3rd WEEK home from surgery but.. still feel like my butt bone (it's the muscles) are overworking, all the time... everyone says the 6th month is the turning point.. hope that is true.. i'm so done with pain... convinced that Tylenol is killing me, that cannot be good for your liver either! I am getting stronger (true) no where near where I used to be.... and continuously being told a year or MORE is normal...
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