Using drugs such as ibuprofen and steroids to relieve short-term pain may increase the chances of developing chronic pain, new research shows.
The results of a small study challenge common methods of dealing with pain and suggest that it may be time to reconsider how pain is treated.
Normal recovery from a painful injury includes inflammation – the body’s natural response to injury and infection – and new research shows that blocking inflammation with drugs can lead to more difficult pain to treat.
Inflammation can have a protective effect, and excessive reduction can be harmful.
In other words, inflammation can prevent acute pain from becoming chronic.
Jeffrey Mogil, a professor of pain research at McGill University in Canada, said: “While ibuprofen has not been explicitly studied in humans or mice. [in the mouse we used diclofenac]Because ibuprofen is so common in the United Kingdom, it is very likely that a large percentage of those in the UK Biobank who report taking NSAIDs [non-steroidal anti-inflammatory drugs] they were actually taking ibuprofen. “
Researchers said lower back pain is the most commonly reported form of chronic pain – pain that lasts longer than would be expected after an injury – and leads to huge economic and medical costs each year.
Most patients receive standard treatments such as nonsteroidal anti-inflammatory drugs such as ibuprofen and corticosteroids.
But these drugs are only somewhat effective, and little is known about why acute pain – which begins suddenly in response to something specific, such as an injury – is resolved in some patients but continues as chronic pain in others.
To understand the transition from acute to chronic lower back pain, the researchers followed 98 patients with acute low back pain for three months.
They also studied the mechanisms of pain in both humans and mice and found that neutrophils – a type of white blood cell that helps the body fight infection – play a key role in resolving pain.
Blocking these cells in mice prolongs pain up to 10 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.
The researchers said the findings were supported by a separate analysis of 500,000 people in a study by Biobank in the United Kingdom, which showed that those taking anti-inflammatory drugs to treat pain were more likely to experience pain for two to 10 years. -Late.
This effect has not been observed and is not observed in people taking paracetamol or antidepressants.
Dr Francisca Denk, a senior lecturer at King’s College London, said: “It would be premature to make any recommendations about people’s medicines until we get results from a prospectively designed clinical trial.
Professor Blair Smith of the University of Dundee said: “The theory is that inflammation can have a protective effect in the long run and that over-reducing inflammation can be harmful.
“It is important to note, however, that this is only one study and more research is needed to confirm and investigate further.
“It is also important to note that anti-inflammatory drugs are effective in short-term pain management.
“There is good evidence to support this and it should not be delayed unnecessarily.
“Anti-inflammatory drugs have a number of other potentially dangerous side effects, and their long-term use is usually not recommended except with caution.”
The results are published in Science Translational Medicine. – BCP
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