A commonly underrated hazard is the use of pain medication, including over-the-counter favorites like acetaminophen (Tylenol and others). Patients often take them for fairly minor pain, sometimes with the idea that the “anti-inflammatory” or some other effect will improve healing. However, a new study  in the Annals of the Rheumatic Diseases (ARD) warns that even standard doses of acetaminophen (or paracetamol, as it’s known in the UK) taken regularly can damage kidney function, especially with higher dose levels. This doesn’t mean we shouldn’t take any pain medicine for an injury, or that acetaminophen is especially harmful compared to other pain relievers; it does remind us to be respectful of harmful side effects from these medications, and to only use them when necessary. (Although this 2015 study only looked at acetaminophen, most pain relievers have been found to have comparable risks.) Some steps to consider are applying heat, ice, massage, physical therapy, supplements, or activity modification – for example, if something hurts when you move, rest it as much as possible. Any persistent pain needs appropriate medical evaluation, but talk to your physician about other alternatives to over-the-counter pain medications.
Miles Hassell MD
 Roberts, E. et al. Ann Rheum Dis 2015;0:1–8. doi:10.1136/annrheumdis-2014-206914