Table 3b. Symptoms and diseases of the musculoskeletal system associated with analgesic use in sport.

Organ system	Symptoms/diseases	Sources	Remarks
Ligaments	Poorer healing, increased elasticity	18, 19, 25, e17, e22, e23	Risk of premature return to training with inadequate mechanical load capacity, limited mobility, limited collagen synthesis
Joints	Cartilage injuries, arthritis	19, 21, 33	Risk of overuse/misuse due to decreased pain perception; faster progression of hip and knee osteoarthritis with NSAIDs has been described in the literature
Bones	Delayed healing	9, 18–20, 25, 35, e4, e7, e9, e12, e15, e17–e19, e23	NSAIDs have proven useful to prevent ossification after joint replacement; delayed bone healing after fracture has been discussed in the literature
	Risk of stress fractures	19, e7, e12	NSAIDs affecting collagen and matrix synthesis may lead to decreased bone remodeling
Muscles	Delayed healing/ recovery	9, 10, 18, 19, 23, 33, 39, e9, e15–e18, e22, e23
	Rhabdomyolysis	24, 32, e5, e12
Tendons	Delayed healing	25, 35, e6, e9, e19, e22, e23	Limited collagen synthesis

NSAIDs, nonsteroidal anti-inflammatory drugs