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Blocking Inflammation After An Injury Can Result In Persistent Pain

The usual medical advice to take non-prescription anti-inflammatory drugs (e.g., Advil, Aleve, aspirin) or steroids for pain and inflammation from an injury may actually backfire down the line. A recent study found that blocking inflammation from an injury actually causes an increase in pain and inflammation 3 months later (may become chronic pain), and which is harder to treat.

The McGill University researchers found that drugs that inhibit inflammation interfere with the natural recovery process, thus increasing the odds for chronic pain.  They found that neutrophils (a type of white blood cell that helps the body fight infection) play a key role in resolving pain.

"Neutrophils dominate the early stages of inflammation and set the stage for repair of tissue damage. Inflammation occurs for a reason, and it looks like it's dangerous to interfere with it," said Professor Mogil, one of the researchers.

The researchers looked at lower back pain and temporomandibular disorder (TMD) and found that the results appeared to hold for both mice and humans.

Bottom line: After an injury such as lower back pain, non-prescription medicines that only block pain are OK to take, for example, Tylenol (Acetaminophen) . It's the anti-inflammatory medicines that could lead to persistent (chronic) pain three months later. View inflammation as part of the healing process - don't want to interfere with that.

Excerpts from Medical Xpress: Discovery reveals blocking inflammation may lead to chronic pain

Using anti-inflammatory drugs and steroids to relieve pain could increase the chances of developing chronic pain, according to researchers from McGill University and colleagues in Italy. Their research puts into question conventional practices used to alleviate pain. Normal recovery from a painful injury involves inflammation and blocking that inflammation with drugs could lead to harder-to-treat pain.

"For many decades it's been standard medical practice to treat pain with anti-inflammatory drugs. But we found that this short-term fix could lead to longer-term problems," says Jeffrey Mogil, a Professor in the Department of Psychology at McGill University and E. P. Taylor Chair in Pain Studies.

Inflammation plays a key role in resolving pain

Experimentally blocking neutrophils in mice prolonged the pain up to ten times the normal duration. Treating the pain with anti-inflammatory drugs and steroids like dexamethasone and diclofenac also produced the same result, although they were effective against pain early on.

These findings are also supported by a separate analysis of 500,000 people in the United Kingdom that showed that those taking anti-inflammatory drugs to treat their pain were more likely to have pain two to ten years later, an effect not seen in people taking acetaminophen or anti-depressants.

"Our findings suggest it may be time to reconsider the way we treat acute pain. Luckily pain can be killed in other ways that don't involve interfering with inflammation," says Massimo Allegri, a Physician at the Policlinico of Monza Hospital in Italy and Ensemble Hospitalier de la Cote in Switzerland.

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