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Anti-inflammatories, paradoxically, although effective against acute pain, can trigger chronic pain. That is how.
It may sound silly, but the anti-inflammatories we commonly use to fight pain can increase the risk of chronic pain. In other words, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) that are short-term pain relievers can have a negative effect on long-term pain. The reason is that they interfere with the inflammatory process that occurs naturally when you feel pain for any reason (like an injury); blocking it would only produce pain that lasts longer and is harder to manage. For this reason, scientists suggest rethinking the way we treat pain, switching to pain relievers but not anti-inflammatories.
To discover that anti-inflammatories may increase the risk of chronic pain, an international research team led by Canadian scientists from the Alan Edwards Center for Pain Research at McGill University in Montreal, who collaborated with colleagues from the Department of Medicine and Surgery of the University of Parma, the Department of Anesthesiology, Pain and Palliative Medicine of the Radboud University of Nijmegen (The Netherlands), the University of North Carolina, the Monza Polyclinic and other institutes. The scientists, coordinated by Professor Luda Diatchenko, a professor at the Canadian University School of Dentistry and Oral Health Sciences, reached their conclusions after analyzing in depth the mechanisms of pain in patients and in murine models (mice).
First, Professor Diatchenko and colleagues focused on neutrophil granulocytes, a type of white blood cell that specializes in protecting the body against infection but also plays a key role in pain. Analyzing gene activity in people who used anti-inflammatories for low back pain, they found that genes related to neutrophils were upregulated in those who had recovered from pain, while they were not in those with persistent pain at the end of treatment. (three months). The same situation has been seen in people with temporomandibular disorders, which cause pain in the muscles associated with the jaw and ears. “Neutrophils dominate the early stages of inflammation and set the stage for tissue damage repair. Inflammation happens for a reason, and it seems dangerous to intervene in it,” study co-author Professor Jeffrey S. Mogil said in a news release.
In the next phase of the research, the scientists involved the mice and subjected them to various experiments. In those with blocked neutrophils, for example, chronic pain lasted up to ten times, while those treated with anti-inflammatory drugs lasted more than twice as long as those not treated. On the other hand, the peripheral injection of neutrophils and S100A8/A9 proteins that are normally produced by neutrophils, meanwhile, prevented the prolongation of pain by the use of an anti-inflammatory. In addition, analyzing data from more than 500,000 UK Biobank patients, the scientists found that people who treated acute pain with anti-inflammatories were more likely to have chronic pain for 2 to 10 years than those who treated acute pain with anti-inflammatories. anti-inflammatories .who used other pain relievers. In summary, all these results show that interfering with the natural inflammatory process triggered by neutrophils through the use of anti-inflammatories (such as NSAIDs) can have a short-term positive effect on pain, but there is a risk of triggering it. chronic.
“Our results suggest that it may be time to reconsider how we treat acute pain. Fortunately, the pain can be stopped by other means that do not involve interference with inflammation,” said Professor Massimo Allegri of the Monza Polyclinic. “These results should be followed by clinical trials directly comparing anti-inflammatories with other pain relievers that relieve pain but do not stop inflammation,” Professor Diatchenko repeated. Details of the research “Acute inflammatory response through neutrophil activation protects against the development of chronic pain” have been published in the scientific journal Science Translational Medicine.