Key Points:
- Over-the-counter pain relievers such as Tylenol or ibuprofen are commonly used to reduce pain and soreness from mild sports injuries.
- It?s okay for young athletes to occasionally use these medications for sports related aches and soreness
- If you ever find yourself in a situation where you must have the medication in order to be able to play, you should seek medical care
- Never use a narcotic pain medication in order to help you take the field
Several factors cause athletes of all levels to continue to play through pain: the warrior 
mentality, shame from showing weakness and letting others down, pressure from teammates and coaches, and the threat, imagined or real, of lost playing time.
For young athletes is it okay to take pain medicine in order to allow you to continue playing?
This is a very tricky question without simple answers, but there are some general guidelines that we can look to.
Types of pain medicines
For most young athletes when we talk about ?painkillers? or ?pain medicine? we are referring to commonly available over-the-counter medications such as Tylenol, or anti-inflammatory painkillers such as aspirin, ibuprofen, or naproxen.
Additionally there are prescription injectable pain medications and prescription narcotics, which would need to be carefully supervised by a doctor. Those would typically be used only during the recovery phase from a serious injury or from surgery.
Generally okay: occasional use for soreness
Let?s say that your team is starting off some pretty intense preseason training. It?s very common in this scenario to have aching muscles especially during the early days of training. At the end of the training session you should do a proper cooldown, you may want to apply ice, and when you get home in the evening it?s generally okay to take some anti-inflammatory medication such as ibuprofen to help you feel better.
Similarly, it?s common during the course of the season to have soreness or achiness in your muscles from continued play. As long as there?s been no real injury and as long as you would describe it as soreness, then that is another scenario where I would generally say it?s okay to take some pain medicine to help you feel better and continue playing.
Warning: if you can?t play without pain medicine then don?t play
If you find yourself in a situation where you absolutely have to have some type of ibuprofen, naproxen or other over-the-counter medication each time that you go out and train or play, then you are in a dangerous situation where you really need to seek medical help for this condition. There are real risks in continuing to play by relying upon usage of pain medication in this scenario. You may be masking the pain enough that you risk serious or permanent injury to an area, and there are risks to your stomach, liver, and kidneys from prolonged usage of many of these medications.
Ideally I would want you to seek qualified medical help in this case. At the very least you need to take some time off from play, get yourself comfortable enough so that you don?t need the medication in order to return to play.
Never: narcotic pain medication
In our orthopedic sports medicine group at Stanford we see a lot of athletes of all levels of play, and in my 23 year career I cannot recall a single time where I prescribed a narcotic in order to allow a young athlete to take the field. The same is true for every single one of my partners, as well as all other responsible physicians that we know.
The problem though is that it is all too easy for a young athlete to obtain narcotic medications illegally. And the consequences can be disastrous.
Consider this true story: a star soccer player in Southern California collided with another player and injured her already hyperextended knee. A doctor prescribed the opioid
Norco. She soon obtained another opioid called OxyContin from a friend, and ultimately started using and even dealing heroin. She introduced her brother to the drug, leading to his death from an overdose.
What?s the connection? According to the National Institute on Drug Abuse, opioids are a close cousin to heroin, to which the brain responds in the same way. Plus, heroin is cheaper than opioids; an 80 mg OxyContin can cost up to $100 a pill on the street, but according to USA Today, a multiple-dose supply of heroin goes for $45 to $60. This is really scary stuff.
Fortunately most of our young athletes will only have to deal with the ?occasional use for soreness? scenario. But if you ever find yourself in a situation where you absolutely need the medication otherwise you won?t be able to play, get yourself to qualified medical help quickly.
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