Every so often, scientific inquiry comes up with some surprising twists in what we consider settled medical knowledge. A recent study published in the journal Science Translational Medicine appears to do just that. The research looked at the relationship of the body’s inflammatory response with the development of long-term, chronic pain. One of the conclusions appears to be that non-steroidal anti-inflammatory drugs (NSAIDS) and other over-the-counter painkillers may work in the short term, but at the cost of creating long-term pain.
The Pain Conundrum
People in pain understandably want relief now, and are often willing to ignore long-term consequences to get that relief. You need look no further than the opioid crisis—fueled by the over-prescribing of oxycontin and other powerful painkillers. But the only true way to eliminate pain is to address its underlying cause.
This is no small issue. The CDC estimates that are about 50 million adults in the U.S living with chronic pain. Absent a prescription for incredibly powerful drugs, those people often turn to over-the-counter (NSAIDs), like ibuprofen and aspirin. Now, the study results suggest the NSAID use that quells pain-causing inflammation is actually stopping the body’s natural response to trauma and short-circuiting healing. To grasp what those results mean, it’s important to understand the role of inflammation in our bodies.
The Natural Response
Inflammation is a normal response to trauma. The most obvious example is if you got hit by a projectile like a baseball, the skin would swell in an inflammatory response. That inflammation sends pain signals to the brain, alerting you that you have been injured. The greater the inflammation, the stronger the pain signals.
In the case of localized injury swelling, you simply ice the spot, apply compression, elevate the limb, and rest. Time and your body does the rest. The more challenging issue is inflammation in internal organs and tissues. Because it’s harder to deal with the actual cause of that inflammation, we tend to turn to the painkillers in our medicine chests. The study suggest, that may actually be leading to chronic pain.
The researchers followed 98 patients with chronic back pain, looking at both their physical and cellular health. They discovered that a cell type called neutrophils is essential as a pathway for pain signals. NSAIDs block neutrophils, short-circuiting pain, but—as evidenced by the study—prolonging it, sometimes into acute long-term pain. They found that patients with higher levels of neutrophils had less chronic pain.
The study reinforces the results of earlier studies, but further studies need to be done to be conclusive. But what does that mean to someone in pain?
- Careful NSAID use. Ibuprofen for a rare headache? Sure. But in other cases, where you may get in the habit of using NSAIDs on a daily or near-daily basis, consult your physician. It may be wiser to find alternative methods of pain control, including breathwork, meditation, or perhaps trying CBD. The goal is always to allow the body to heal itself, as best it can.
- Alternate treatments. Before you start using painkillers, consider other ways to alleviate the pain. In the case of joint injury, use RICE (rest, ice, compression and elevation). For a nagging back pain, consider a moist-heat heating pad (20 minutes on, 20 minutes off), gentle stretching, a long bath, or physical therapy if indicated.
• Realize NSAIDs are drugs. Just because a painkiller is sold over-the-counter, does not mean it is completely safe to use. Read the label and follow the guidelines for the maximum recommended daily dose, and maximum length of time of use. It’s easy to get in the habit of gulping down a few aspirin or acetaminophen without considering how long it’s been since the last dose. If you find yourself turning to an NSAID for relief for more than a few days, it’s wise to consult a physician.
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