The researchers also replicated the findings in mice by pinching the animals’ sciatic nerves to create back and leg pain, or by injecting an irritant into their sciatic nerves. When they blocked the animals’ immune response with dexamethasone, a steroid commonly used to treat back pain, the pain became chronic.
Six Tips for Treating Chronic Pain
Next, the group questioned whether chronic pain was caused by pain suppression or by suppression of inflammation. So they gave some mice a prescription anti-inflammatory, diclofenac. Other mice received one of three other analgesic or pain-relieving drugs – gabapentin, morphine, and lidocaine.
With diclofenac alone, the pain persisted and became chronic.
These results led them to ask the question: Were patients who took nonsteroidal anti-inflammatories such as ibuprofen or steroids such as dexamethasone to relieve their back pain also more likely to develop chronic pain?
The researchers consulted data from the UK Biobank, a repository of information on the medical condition and drug use of half a million patients. They studied 2,163 people with acute back pain, 461 of whom had chronic pain. The researchers found that those who took a nonsteroidal anti-inflammatory had almost twice the chance of developing chronic back pain than those who took other medications or did not use them.
Dr. Diatchenko said she doesn’t think her findings are related to the problem of opioid addiction. In fact, “to avoid opioids, clinicians started prescribing more and more nonsteroidal anti-inflammatory drugs,” he said.
“We need to think more about how we treat our patients,” he said.
Despite their unimpressive performance, the trend of using nonsteroidal anti-inflammatories continues. A analysis of randomized clinical trials They found that these drugs had almost no benefit over placebos in reducing low back pain.
Atlas says that short-term use of nonsteroidal anti-inflammatories is probably not harmful, but while the new study doesn’t prove long-term use harmful, “it at least gives a biological mechanism that says short-term use isn’t harmful. same long term.”