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@Alice Please resolve

I routinely take NSAIDs when doing sustained (i.e. all-day) high-intensity activities, such as mountaineering or hiking over off-trail mountain passes. I’ll typically take 400-600mg ibuprofen q3-6 hrs, along with 30-50mg caffeine q2-4 hrs and 100+ kcal high-carb snacks q1-2 hrs.

I’m (genuinely) curious why you wouldn’t do this? What’s your concern?

(IMO, it’s simply better living through chemistry. I haven’t experienced any drawbacks nor am I aware of any theoretical risks from this. Moreover, I find it to be a huge boon to my endurance and general capacity to continue performing in the field.)

@snazzlePop Yeah, they really do make for better, or at least less painful, living. I refrained from using painkillers this year other than the two times I mentioned mostly because I didn’t feel the need to. Or I just enjoy sufferfests now?

@Alice Speaking as someone who recently started doing exercise it’s probably the latter.

Last week I took an Advil, because I was in too much pain (from an unrelated issue) to get out of bed, much less hike and carry a pack. It was just an easy hike, but the Advil worked so well. A couple days ago I took three, because I'd been climbing and scrambling for 18 hours straight, a vole had chewed through half my food supply, and I just wanted to go home and eat a pizza.

Other than these two instances, I've gone on about ten hikes I'd consider hard without taking painkillers.

How old are you? Sounds like a 50s something misguided strategy at reclaiming youth. I can see it being a good idea for emergency situations only. Yes doctors may do it but some doctors have Iamverysmart syndrome. I have had doctor friends recommended taking Ambien. Some Doctors used to recommend smoking certain cigarettes. Some Doctors are anti vaxers, yet they are optomotrists or whatever specialties. Do not take people's advice simply because they have a piece of paper, on the other hand if they are highly specialized in this form of medicine maybe they are on to something.

since you're not talking about daily use and specifically about intermittent instances where you expect reasonably large amounts of residual pain, I'm betting / voting / advising YES.

NSAIDs like ibuprofen are particularly effective at precluding pain before it kicks in (the whole "take some before bed to reduce the hangover the next day" thing). while pain is a good signal that something is wrong, it's also very good at getting you to compensate when you need to just get off the damn mountain, and compensating for pain leads to significantly higher risk of real injury.

moderate, intermittent uses of painkillers are absolutely a blessing of the modern era that can make you more effective. and since you've said in /Alice/now-that-ive-reached-my-goal-will-i, "appearance and weight are irrelevant", I expect you're most concerned about performance while reducing health risks rather than muscle production.

you can get overdose issues and bad side effects from long-term use of significant doses, such as malaise, digestion tract complications, and so forth. however, manufacturer dosage recommendations are well below this threshold for even frequent use. anecdotally: I'm someone who is generally sensitive to medications and only started having noticeable side effects after taking 4,000 mg of ibuprofen + 1,000-2,000 acetaminophen/ paracetamol daily for two months (800mg ibu every 4 hours, 4-6x times per day, a prescription level dose, plus "normal" acetaminophen), which I took because of a major injury.

my nurse and doctor friends would be the first to down a couple pills before doing a hard hike or something where they expected pain. you'll be fiiiiine

@Stralor most importantly, how did you feel after those hikes you took painkillers? my expectation: slightly reduced speed or endurance but much improved recovery, and probably fewer rolled ankles and blown-out knees (though the sample size is too small for that).

(I should note I'm betting against you in the maintaining fitness market, so I believe my bet and advice here are counterproductive to my chance of profit there, and in fairness this might as well be considered a hedge.)

@Stralor Yeah, I know doctors who do this every time they ski. I wouldn't take them often, and not at high doses.

@Stralor Both times I took painkillers, I'll admit, I didn't really need to. I just wanted to be off the mountain before the pizza place closed. The recovery afterward was great, maybe too good. After summiting Grand Teton, I felt like I'd never walk again. But when I woke up and realized my knees worked, I talked my friend into a "chill" hike that turned into 12 miles up into the canyons. So these same friends that are offering me ibuprofen would probably prefer I recover slowly and chill, for once.

In addition to what's posted below, NSAIDs are associated with worse exercise-induced hyponatremia (low sodium), which can be unpleasant and bad for you. If mild you will just feel generally unwell. They're bad for your kidneys if you get dehydrated.

@WXTJ Good to know! Do they make you more susceptible to hyponatremia or do they make the symptoms worse once you already have hyponatremia?

@Alice They're associated with worse hyponatremia after intense exercise (eg marathons). How/if they make you more susceptible wasn't addressed by the evidence I saw I'm afraid! (It was a while ago as well.) If it did make it worse, it would be likely via the kidneys. I think it's less likely they would worsen hyponatremia symptoms (eg dizziness, fatigue, nausea, generalised weakness, oedema) but that is just a general impression of the physiology, not based on evidence I have seen. Over-hydration can contribute to this as well.

@WXTJ I'm getting beyond what I know so I'll stop there!

@WXTJ Thanks!

@KatjaGrace I'm curious if there's a reason why you bet yes?

@Alice I was reading it as 'will you..' not 'should you..', and if your friends do it and you are thinking about it enough to make a market, and you call your reluctance 'for no reason', I just thought you were more likely to do it than 11%. My guess is that it's a bad idea, but I don't hate pain that much and am paranoid about drugs.

@KatjaGrace Got it. I'm in the same camp about toughing out pain and being cautious about drugs. I'd taken painkillers only a couple times in my life before last fall, so two in one hiking season was unusual for me. But my friends asked, "Why suffer?" and that was enough to convince me, haha.

I guess the other vague reason I had for avoiding painkillers was about the aesthetics of climbing. I'm not good enough yet to worry about climbing the cleanest line up a mountain (I'll take the easiest route, whatever I can get), but I would like to do it on my own power. It makes a difference to me whether I free climb or need the rope, so I think I'd feel the same way about relying on painkillers to carry me through a hike.

Also, one comment regarding the resolution criterion: Title and description have a mismatch. The title suggests that it is about the community's opinion if you should use pain killers (clear NO I assume)whereas the description states that the market will actually resolve to what you will be doing (you could ignore the advice and warnings).

I suggest you change either the title or the resolution criterion.

@howtodowtle Good point. I figure advice is useful only if I take it. I'll resolve the market based on my behavior this hiking season, not the community's advice.

Painkillers reduce muscle creation. Short version, they tested muscle gain on left vs right arms when one arm got exercised and got painkillers where the other didn’t. I could probably find the study when I have more time and if I remember.

@JohnSmithb9be Fascinating, I'd love to read that study if you find it. That'd be a solid reason not to take painkillers.

@JohnSmithb9be I’m curious about seeing that study. Those results sound surprising, if their methodology is sound.