2022 – The way we treat acute pain may be wrong

June 17, 2022 — In a surprising finding that goes against conventional medicine, researchers at McGill University report that treating pain with anti-inflammatory drugs such as ibuprofen or aspirin may enhance pain in the long term.

The paper published in Translational Medicine Sciences, notes that inflammation, a normal part of recovering from an injury, helps resolve acute pain and prevent it from becoming chronic. Preventing this inflammation can disrupt this process and lead to more and more difficult-to-treat pain.

“What we’ve been doing for decades not only seems wrong, it appears to be 180 degrees wrong,” says lead study author Jeffrey Mogill, PhD, professor in the Department of Psychology at McGill University. “You don’t have to prevent inflammation. You have to allow inflammation. That’s what stops chronic pain.”

Inflammation: a natural pain reliever

To find out why pain subsides in some and persists (and persists) in others, the researchers looked at the mechanisms of pain in both humans and mice. They found that a type of white blood cell known as a neutrophil appeared to play a major role.

“By analyzing the genes of people who have experienced back pain, we observed active changes in genes over time in people whose pain was gone,” says Luda Diatschenko, PhD, professor at McGill College of Medicine and Canada Excellence Research Chair in Human Pain Genetics. “It appears that changes in blood cells and their activity are the most important factor, particularly in cells called neutrophils.”

To test this compound, the researchers blocked neutrophils in mice and found that the pain lasted 2 to 10 times longer than normal. The anti-inflammatory drugs had the same prolonged effect on pain despite the short-term relief – although injecting neutrophils into mice seemed to prevent this.

The findings are supported by a separate analysis of 500,000 people in the UK, which showed that those who took anti-inflammatory drugs to treat their pain were more likely to experience pain 2 to 10 years later.

“Inflammation occurs for a reason, and it seems dangerous to interfere with it,” Mogill says.

Rethink how we deal with pain

Neutrophils arrive early in the inflammation, early in the infection — just when many of us are turning to analgesics. This research suggests it could be even better no To prevent inflammation and let the neutrophils “do their job” instead. Mogill says that taking a pain reliever without blocking the neutrophils, such as acetaminophen, may be better than taking an anti-inflammatory drug or steroid.

The researchers said that although the results are convincing, clinical trials are necessary to directly compare anti-inflammatory drugs with other pain relievers. This research could also pave the way for the development of new drugs for people with chronic pain, Mogill says.

“Our data strongly suggest that neutrophils themselves act as analgesics, which may be useful in the design of analgesics,” Mogil says. “And of course we need new painkillers.”

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