Something I experienced about 20 years ago - I threw my back out (just was sitting, and turned my torso - and that was it), major sciatica pain.

Went to the doctor. I was prescribed a certain stretching exercise, plus also 800mg ibuprofen, bed rest, etc.

I was popping the ibuprofen "on schedule" - 3x a day. At first, it helped some, and so did the exercise. But then, the pain came back, and nothing was cutting it. Not the stretching exercises, not the ibuprofen; this was after a few weeks of doing all of this.

So I decided that since the ibuprofen wasn't helping, to just drop it. And I continued with the exercise.

...and the pain went away. I haven't had a major problem with my lower back since then (knock on wood).

My anecdotal theory is that somehow, the anti-inflammatory drug was preventing healing at high doses, and I had to quit it to get better.

I don't know if that is really true or not, all I know is that was what seemed to do the trick for me.

Inflammation can be a signal to the body to heal an area specifically expressing the inflammation. Many treatments involve causing additional damage to the wounded area to promote inflamation. This is good!

Its chronic inflammation that's not good.

Isn't this the concept behind dry needling?

I do believe so.

Similar experience here. I had residual pain from a neck fusion and doc put me on those 800mg ibuprofen horse pills + PT. It seemed to help at first but then plateaued and didn't seem to help much. After I had been on ibuprofen for months I noticed that small cuts on my hands (typical for my line of work) were slow to heal.

One day I went to a lecture on brain research by some top neurologist at Stanford. As an aside about the difficulty of maintaining double-blind standard in actual experiments, she mentioned that she once worked on research involving NSAIDs. To mark the mice for tracking they punched coded holes in their ears but found they could tell which mice were getting NSAIDs because the holes would not heal for the treated mice whereas in untreated mice the holes would heal. I tossed the horse pills that night when I got back from the lecture and the cuts on my hands started healing normally again.

I can’t find the citation right now, but as I recall, a lot of connective tissue has very little blood flow. Inflammation increases blood flow, which can help with healing.

Achilles tendinosis is a good example of this. The achilles tendon replaces cells at a very slow rate. If there is chronic damage, it can take decades to heal on its own. But if you intentionally damage the area with eccentric heel drops, it can heal fairly quickly.

Doing a similar protocol with my patella tendon

Anecdotally, my own experience with chronic back issues is the reverse, and jives with the explanation I was given. My lowest 3 disks are degenerating, with the bottom disk almost gone. About 8 years ago I had to have a laminectomy due to a disk bulge pushing against a nerve, and no amount of NSAIDs nor physical therapy would fix it.

I had herniated disks before and after, but only one required surgery. For as long as I can remember, I'll get severe back pain once or twice a year, which eventually goes away. The explanation I received for these events is that it is likely that the outer sheath of a disk is getting torn, stretched, or some other type of trauma. This hurts in and of itself, however, additionally the disk material may begin to bulge. Once bulging, that part of the disk loses access to nutrients and moisture and eventually dries up, with the bulge receding and the damage scarring over. The doctor described this like a grape to a raisin, though I'm sure it looks nothing like the analogy.

Summary, with time, the disk sheathing trauma scars and the bulge dessicates, possibly about the same time NSAIDs are declared of no help.

For me, I definitely notice much less pressure in my back when on an NSAID, and I sleep much better as well.

I've read that taking NSAIDs for exercise-induced muscle soreness is counterproductive, as they can inhibit new muscle growth. Seems like this could be related.

I had something similar, woke up one morning and had this crazy pain in my upper spine which went into my right arm.

The pain was so insane nothing helped (didn't try oxy though). I went to a million different doctors of all types and nothing really helped.

It wasn't until a met a chiropractor who told me that it was some upper disc fracture which resulted in some liquid pushing on my nerve and that the only thing I could do was to make some neck exercise to pump blood through the area which would make it heal.

That helped within 3 weeks.

Ibuprofen interferes with absorption of one of the B vitamins. Long term use promotes a B vitamin deficiency.

Yup, and anti-oxidants actually prevent aerobic conditioning in athletes.[1]. Presumably oxidative stress is a signal to the body to become more aerobically efficient.

Yet at the same time, oxidative stress is linked to numerous diseases.

Biology is hard.

[1] Derek Lowe’s blog (don’t have exact link)

It's almost as-if our cells depend on some sort of chemical equilibrium. The old advice of everything in moderation may be the best way to go.

I'm not sure your explanation was any easier to grok for people, how about this:

Inflammation is what the body uses to clean out disease and heal itself.

The individual mechanisms used to do this could be considered analogous (but very different from) a short antibiotics regimen.

In the short term or localised to one area it is beneficial. But at a systemic always on level there are negative side effects where these systems begin to overwhelm/damage healthy functions/cells.

same for NSAIDS (ibuprofen etc) and bone healing

They told my wife to only use Tylenol(acetaminophen, which isn't an NSAID)for pain when she broke her back. Inflammation has important uses, but like auto-immune disorders, too much can cause other problems.