Using anti-inflammatory drugs and steroids to relieve pain may increase the chances of developing chronic pain, according to researchers at McGill University and colleagues in Italy. Their research calls into question conventional practices used to relieve pain. Normal recovery from a painful injury involves inflammation, and blocking this inflammation with medication can lead to more difficult pain to treat.
“It has been a standard medical practice for many decades to treat pain with anti-inflammatory drugs. But we’ve found that this short-term solution can lead to long-term problems, “said Jeffrey Mogil, a professor in the Department of Psychology at McGill University and EP’s Taylor Department of Pain Research.
The difference between people who improve and not
In the study published in Science Translational Medicine, the researchers studied the mechanisms of pain in both humans and mice. They found that neutrophils – a type of white blood cell that helps the body fight infection – play a key role in resolving pain.
“When analyzing the genes of people suffering from lower back pain, we observed active changes in the genes over time in people whose pain has disappeared. “Changes in blood cells and their activity seemed to be the most important factor, especially in cells called neutrophils,” said Luda Dyatchenko, a professor at the School of Medicine, the School of Dental Medicine and the Canadian Department of Research in Pain Genetics.
Inflammation plays a key role in resolving pain
“Neutrophils dominate the early stages of inflammation and lay the foundation for repairing tissue damage. Inflammation occurs for some reason and it seems dangerous to interfere with it, “said Professor Mogil, who is also a member of the Alan Edwards Center for Pain Research with Professor Diatchenko.
Experimental neutrophil blockade in mice prolongs pain up to ten times longer than normal. Treatment of pain with anti-inflammatory drugs and steroids such as dexamethasone and diclofenac also led to the same result, although they were effective against pain in the beginning.
These The findings are also supported by a separate analysis of 500,000 people in the UK, which shows that those taking anti-inflammatory drugs to treat their pain are more likely to have pain two to ten years later, an effect that does not observed in people taking acetaminophen or an antibiotic. -depressants.
Revision of standard medical treatment for acute pain
“Our findings suggest that it may be time to rethink the way we treat acute pain. Fortunately, pain can be eradicated in other ways that do not involve inflammation, ”said Massimo Allegri, a doctor at the Monza Hospital in Italy and the Ensemble Hospitalier de la Cote in Switzerland.
“We found that resolving pain is actually an active biological process,” said Professor Diatchenko. These findings should be followed by clinical trials directly comparing anti-inflammatory drugs with other painkillers that relieve pain but do not impair inflammation.
reference: Parisien M, Lima LV, Dagostino C et al. The acute inflammatory response by activating neutrophils prevents the development of chronic pain. Sci Transl. Honey. 2022. doi: 10.1126 / scitranslmed.abj9954
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