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The Dangers of Pain Killers
by Dave Bintz

You have just started your training program for your next race, and you might be experiencing some aches and pains.  Use of “pain killers,” or NSAIDs (non-steroidal anti-inflammatory drugs) to help with those aches and reduce inflammation is frequently discussed in running publications.  Not often enough do they talk about the following.

A significant danger is kidney failure (renal failure).  It happened to me and if I can save one runner from the trauma, my role as a “Mileage Missionary” will be complete.  I am not a doctor so I cannot and will not give you medical advice.  What I can do is recount what happened to me and what the medical professionals, the ones who saved my life, told me.

It happened at the 2002 Boston Marathon.  I went into the race injured.  Pride took over and rather than defer my race to the following year, I decided to run it anyway.  I had been using ibuprofen (brands such as MotrinÔ) to reduce the pain and swelling, just like all the publications tell you to do.  Before the race I took 800 mg; not an uncommon dosage for serious pain relief.  It was a relative hot day for a Boston Marathon – 70° F at the start.

I knew something was seriously wrong even before I reached the sixth mile, but I pushed on - the second very stupid mistake.  At the half way mark I took another 200 mg of ibuprofen, the last of the big three mistakes.

To summarize the journey from there:  Boston Marathons are on Mondays (Patriot’s Day).  I was seriously ill with flu-like symptoms to the following Friday, being treated by my doctor for dehydration.  On Friday, a new doctor stepped in, called for blood tests, and diagnosed acute kidney failure.  I was rushed to the hospital where they could not get my kidneys “jump-started.”  To avoid stroke or heart failure I was put on dialysis and discussions about transplants started.

Then the miracles came.  After a week on dialysis, for no known reason, my kidneys started functioning.  I ran the Chicago Marathon six months later.  Today I have full kidney function and run at least two marathons a year. 

The specific condition I experienced was “ATN” (Acute Tubular Necrosis), induced by too much ibuprofen coupled with dehydration.  Mine was an extreme situation, but one that you as a runner, must keep in mind.  According to the doctors, you can induce the same condition with naproxen (Aleve™).  Ibuprofen and naproxen are metabolized in the kidneys; another thing they told me.  And if you are wondering about aspirin and acetaminophen (Tylenol™), they can create problems too, but they are metabolized in the liver. 

I know you have heard it before but I will say it again:  Consult your doctor when considering the use of NSAIDs in conjunction with training.  They are important and useful, but they can be dangerous in our sport.

And let me pass along what a good friend and doctor who is also a marathoner, says repeatedly to novice runners. “If you have to take pain killers to run, you shouldn’t be running.”

Oh, I forgot to mention:  I did finish that 2002 Boston Marathon with a time of 4:15:42.

Disclaimer: We are not doctors, we are just runners like you. This article should never substitute for a doctor's advice. Talk to your doctor if you have any questions.

Last revised June 27, 2007

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