Analgesic practices and predictors of use in South Africa-based runners

The use of analgesics is prevalent in runners, with an associated potential for serious harm. More information is needed regarding runners' practices and the factors that may influence their use of analgesics, to identify potential sources of misuse or abuse.

To describe South Africa (SA)-based runners' practices regarding use of analgesics, focusing on the types used, sources of information, and factors predicting use.

This study had a descriptive, cross-sectional design. SA-based runners aged ≥18 years, who had run at least one race during the year preceding the study, were included. Participants were recruited via social media and SA running clubs. They completed an online survey that included demographic information, training and competition history, and analgesic usage practices.

Data from 332 participants (196 females, 136 males) were analysed. There was a high rate of analgesic use (64%), with 17% of users reporting concomitant use of more than one type of analgesic. The highest rate of analgesic use was after a run (80%). Non-steroidal anti-inflammatory drugs (NSAIDs) were the most frequently used analgesics before (71%), during (50%) and after a run (74%). Importantly, NSAIDs and a combination NSAID-containing analgesic were the most common analgesics used concomitantly (19%). Most participants (90%) used over-the-counter analgesics, 41% of them receiving no input from any health professional. Sustaining a running-related injury increased the likelihood of analgesic use almost three-fold (Exp(B)=2.6; 95% confidence interval 1.59 - 2.41; p=0.0001).

A large percentage of runners in our study displayed unsafe practices regarding analgesic use during training and competition, predominantly for perceived injury management. Importantly, the lack of education and recommendations regarding analgesics from health professionals is very concerning, as there is a risk of potentially life-threatening analgesic-induced adverse effects, especially as a high percentage were using two NSAIDs concomitantly. Knowledge of these practices, gained through this study, could allow for the development and implementation of corrective strategies to promote education and safe practice of analgesic use in runners.