What’s the difference between non-steroidal anti-inflammatory drugs and steroids?

Both non-steroidal anti-inflammatory drugs (NSAIDs) and steroids are used to treat, and reduce, inflammation, however they work in totally different ways and are used to treat very different conditions says physiotherapist Alex Howarth.

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Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of drugs that are used commonly to reduce pain and swelling. The most recognisable of these are Ibuprofen, Naproxen and Diclofenac.


Ibuprofen and Naproxen are everyday pain killers that can be purchased over the counter in any pharmacy. They can dampen down and help to alleviate the symptoms experienced during short-term bouts of pain, such as muscle strains, joint sprains, back or headaches or general discomfort sustained after an injury.

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Immediately after an injury prostaglandins are released as part of the body’s defence mechanism. They cause damaged areas of the body to swell whilst also enhancing the pain signals. This is a vital part of the healing process, but too much swelling causes pain and muscle inhibition. NSAID’s work by depressing the release of these prostaglandins, which thereby reduce the swelling and pain.

Whilst all three drugs have a similar effect, it is best not to mix them as that can result in an increased risk of side effects. Long term use of NSAID’s can cause abdominal discomfort, constipation and nausea. Ibuprofen should not be taken on an empty stomach.

Steroids on the other hand are far more powerful drugs, they are more effective at reducing inflammation, but they also have many more serious side effects. As a result, they must be prescribed and monitored by a doctor. They are synthetic hormones that are used primarily to reduce inflammation in long term conditions such as asthma, bronchitis, colitis and systemic arthritis.

Common examples of steroids include; Prednisone, cortisone and hydrocortisone. They work by suppressing the immune system, which has the effect of reducing the amount of inflammation produced by the body in response to illness or injury. The side effect of this though, is that with the suppression of the immune system, comes an increased risk of infection if taken for a prolonged period. For those with chronic inflammatory conditions, steroids are a highly effective treatment.

In summary, if you’ve sustained a minor ache or twinge, then taking a short course of NSAID’s can help to reduce the pain and get you back training again in no time. They should not be used to help you train through the pain though, and if you need to be taking painkillers to be able to train then it is advised that you go and see your local physio or GP to assess the cause of your pain.

If you are in any doubt about whether you should be taking anti-inflammatories, your pharmacist or GP will be able to guide you.

If you have any concerns at all, like with any health issue, seek medical advice from a qualified medical practitioner, whether that’s a doctor or physiotherapist.    

Alex Howarth is a senior physiotherapist with Capitalphysio.com



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