Anti-inflammatory drugs and steroids are commonly used to relieve the acute pain caused by certain injuries, however, the natural process of recovery from a painful injury involves inflammation, so preventing it with the help of drugs of this type could trigger pain that is persistent and more difficult to treat, researchers at McGill University and colleagues in Italy have found.
“For many decades it has been standard medical practice to treat pain with anti-inflammatory medications. But we found that this short-term fix could lead to longer-term problems,” said Jeffrey Mogil, Professor in the Department of Psychology at McGill University and the EP Taylor Chair in Pain Studies.
The authors of the research that led to this conclusion examined 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 pain resolution.
“By analyzing the genes of people with low back pain, we saw active changes in the genes over time in people whose pain disappeared. Changes in blood cells and their activity seemed to be the most important factor, especially in cells called neutrophils,” said Luda Diatchenko, Professor in the Faculty of Medicine, Faculty of Dentistry and Canada Excellence Research Chair in Genetics at the Human pain.
The role of inflammation in pain resolution
“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 interfere with it,” warns Professor Mogil, who is also a Fellow at the Alan Edwards Center for Pain Research along with Professor Diatchenko. In fact, when doing an experiment with mice in which the neutrophils were blocked, they found that the pain lasted up to 10 times longer than its normal duration. Using anti-inflammatory drugs and steroids such as dexamethasone and diclofenac for pain treatment had the same result, although these drugs were effective against pain from the start.
“It may be time to reconsider how we treat acute pain. Fortunately, pain can be eliminated in other ways that don’t involve interfering with inflammation.”
The study results, which have been published in Science Translational Medicine, are also supported by another analysis of 500,000 people in the UK that showed those taking anti-inflammatory drugs to treat pain were more likely to experience pain over two to 10 years. later, and that this effect was not seen in those taking paracetamol or antidepressants.
“Our findings suggest that it may be time to reconsider how we treat acute pain. Fortunately, pain can be eliminated in other ways that do not involve interfering with inflammation,” says Massimo Allegri, a physician at the Monza Hospital Polyclinic in Italy and the Ensemble Hospitalier de la Cote in Switzerland.
“We found that pain resolution is actually an active biological process,” says Professor Diatchenko, “these findings should be followed up by clinical trials that directly compare anti-inflammatory drugs with other pain relievers that relieve aches and pains, but they don’t interrupt inflammation.”
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