Low back pain and neck pain often involve a substantial amount of muscle pain,22 and muscle pain is not particularly inflammatory by nature. Muscle knots (trigger points) are more like poisoned muscle than injured muscle. Although there’s some anecdotal evidence that taking an anti-inflammatory medication reduces muscle pain, mostly it doesn’t seem to work very well. One of the classic signs of low back pain powered by muscle, for instance, is that ibuprofen doesn’t have much effect!
I’m not saying NSAIDs are useless. They have their place. If you’re recovering from surgery or a major injury, traditional over-the-counter pain relievers are good for controlling inflammation, swelling, and pain, but NSAIDs are far too powerful for over-the-counter, everyday use. Unlike a lot of natural pain relievers, NSAIDs also don’t address the cause of inflammation or pain; they just mask the symptoms.