Indication. Analgesic drugs (painkillers) can be used to a limited extent to reduce the pain with minor injuries where there are no risks of aggravating the injury through continued sports activity (i.e. bleeding under the nail, skin abrasions etc.). All forms of painkillers can naturally be taken if the sports activity ceases. Paracetamol is recommended due to the very modest side effects associated with its use.
Mechanism of action. Paracetamol provides both painkilling (analgesic) and temperature lowering (antipyretic) effects. The mechanism is partly unknown. 90% is absorbed from the intestines after ingestion of a tablet, with maximum concentration of paracetamol being achieved after ½-1 hour after ingestion. The duration of the effect is 4-6 hours. It should be noted that only approx. 60% is absorbed from suppositories.
Side effects. Paracetamol in normal doses has by and large no side effects, as opposed to weak morphine type drugs containing acetyl salicylic acid. Long term treatment with maximum dosage appears, however, to increase the risk of ulcers, especially if the treatment is combined with rheumatic pills (NSAID), (article).
Contraindications. Painkillers should never be used to enable the athlete to continue an activity which bears a risk of aggravating the injury. Paracetamol and other painkilling drugs with antipyretic effects must never be used to lower the body temperature of an athlete before starting sports activity. Serious virus infections can invade the (cardiac) muscle of the heart and cause myocarditis. The risk of myocarditis is increased under great physical exertion during virus infections, and some cases have been reported of fatalities amongst young, otherwise healthy athletes, under these circumstances. Increased body temperature indicates an infection, and all athletes should stop sports activity until the body temperature has returned to normal.
Conclusion. Paracetamol can be recommended when needed as painkillers for conditions where pain is experienced without any suspicions of inflammation.