Use of NSAID's like ibuprofen and steroids tied to increased risk of chronic pain

Canada: Using anti-inflammatory drugs is associated with increased risk of persistent pain, indicating that anti-inflammatory treatments might have negative effects on pain duration, says a recent study. However, the researchers say that more research will be needed into a possible link between anti-inflammatory drugs and longer-term problems such as back pain.

"Using drugs such as steroids and ibuprofen to relieve short-term health problems could increase the likelihood of developing chronic pain," Marc Parisien, McGill University, Montreal, Quebec, Canada and colleagues wrote in their study published in the journal Science Translational Medicine.

Based on the findings, it becomes important to reconsider as to how the pain is treated. Inflammation is a body's natural reaction to injury and infection that helps in normal recovery from a painful injury. The new research suggests that blocking inflammation with drugs could lead to harder-to-treat issues.

Inflamamtion has a protective effect, such as preventing acute pain from becoming chronic, and overtly reducing the inflammation may be harmful, the researchers note.

Acute pain state can lead to chronic pain. The mechanisms mediating the transition from acute to chronic pain remain to be explained. Thereby, in the study, Parisien et al. focused on the immune system using samples from patients and animal models.

In subjects with resolved pain, transcriptomic analysis in immune cells from subjects with low back pain showed that neutrophil activation–dependent inflammatory genes were up-regulated, whereseas in patients with persistent pain no changes were seen. In rodents, anti-inflammatory treatments prolonged pain duration and the effect was abolished by neutrophil administration.

"Our data suggest that active biological processes protect from transitioning to chronic pain after an acute pain episode," they wrote. "Thus, despite analgesic efficacy at early time points, the management of acute inflammation may be counterproductive for long-term outcomes of LBP sufferers."

To conclude, the use of anti-inflammatory drugs was related to an increased risk of persistent pain, suggesting that anti-inflammatory treatments might have negative effects on pain duration.

Reference:

Parisien M, Lima LV, Dagostino C, El-Hachem N, Drury GL, Grant AV, Huising J, Verma V, Meloto CB, Silva JR, Dutra GGS, Markova T, Dang H, Tessier PA, Slade GD, Nackley AG, Ghasemlou N, Mogil JS, Allegri M, Diatchenko L. Acute inflammatory response via neutrophil activation protects against the development of chronic pain. Sci Transl Med. 2022 May 11;14(644):eabj9954. doi: 10.1126/scitranslmed.abj9954. Epub 2022 May 11. PMID: 35544595.