Volume 29, Issue 163, September 2025

Non-steroidal anti-inflammatory drugs and their role in soft tissue and bone healing after sports injuries: a literature review

Brzyska Agata^1♦, Kucharski Tomasz², Steć Greta¹, Pawlak Magdalena¹, Prolejko Sandra³, Gajęcki Błażej¹, Kopala Justyna⁴, Wiśniewski Mikołaj⁵, Siemianowski Jan¹, Kotnis Weronika³

¹Central Clinical Hospital of Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
²Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
³Medical University of Lodz, Kościuszki 4, 90-419 Lodz, Poland
⁴University Clinical Hospital No.2 of the Medical University of Lodz, Żeromskiego 113, 90-549 Łódź, Poland
⁵Pope John Paul II Independent Public Regional Hospital in Zamość, ul. Aleje Jana Pawła II 10, 22-400 Zamosc, Poland

^♦Corresponding author
Brzyska Agata, Central Clinical Hospital of Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland

ABSTRACT

Purpose: Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used drugs in healing musculoskeletal injuries in sports medicine. However, this approach is controversial because NSAIDs inhibit the inflammatory response, which is necessary for proper tissue healing. The purpose of this article was to present the current state of knowledge on the effects of NSAIDs on soft tissue and bone healing and to assess whether there are grounds for changing clinical management in sports medicine. Methods: A systematic search of MEDLINE (PubMed and Ovid) identified 35 relevant publications, including clinical trials, preclinical studies, systematic reviews, and meta-analyses. We analyzed the studies assessing the impact of NSAIDs on soft tissue and bone healing qualitatively with attention to clinical significance. Results: Animal studies indicate the adverse effects of some NSAIDs on bone healing, especially indomethacin and celecoxib. Deteriorated healing results were observed in soft tissues, especially after rotator cuff reconstruction, following the use of celecoxib. Non-selective NSAIDs, such as ibuprofen, showed a neutral or beneficial effect in most studies. However, clinical data remain limited and inconsistent, with some meta-analyses showing a relationship with patient age while others show no significant differences. Conclusions: Some NSAIDs, especially selective COX-2 inhibitors, may slow down the healing of soft tissue, and indomethacin may also slow down the healing of bones. Because there are no clear, high-quality clinical trials, medical professionals should be careful when giving NSAIDs and only give the lowest dose for the shortest amount of time that works.

Keywords: non-steroidal anti-inflammatory drugs (NSAID); cyclooxygenase (COX); bone healing; soft tissue healing; sports medicine

Medical Science, 2025, 29, e176ms3652

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DOI: https://doi.org/10.54905/disssi.v29i163.e176ms3652

Published: 25 September 2025