Aggressively Treating Inflammation May Lead To Chronic Pain

December 23, 2022

Summary: Inflammation is a defensive reaction that promotes healing. However, inflammation also causes acute pain. Thus, it is a common practice to use anti-inflammatory drugs to suppress pain and for chronic pain treatment. However, studies show that suppressing inflammation reduces the activity of neutrophils and thus increases the risk of chronic pain. Hence, experts recommend changing the approach towards joint inflammation treatment.

Inflammation is a defensive reaction that is essential for tissue regeneration. However, uncontrolled inflammation may cause more damage than good. Inflammation causes local redness and, more importantly, severe pain. Thus, doctors are quick to prescribe anti-inflammatory drugs for chronic pain treatment, forgetting that pain is also a sign of undergoing repair processes. Hence, medications like non-steroidal anti-inflammatory drugs (NSAIDs) are among the most used drugs.

As more and more people are nowadays experiencing chronic pain, researchers are becoming increasingly interested in why some people are more likely to experience such health issues. It appears that one of the reasons could be aggressive joint inflammation treatment.

It does not mean that one should not treat inflammation, but one uncontrolled inflammation. However, aggressive medication for inflammation must be avoided, as doing so would also suppress healing processes and thus make the conditions chronic.

Of course, these findings put into question some usual ways of treating pain. It means doctors and people should be careful during chronic pain treatment and joint inflammation treatment. But, of course, not all painkillers suppress inflammation. Thus, opioids or acetaminophen would not suppress inflammation. But, drugs like ibuprofen and diclofenac would suppress inflammation and make the conditions chronic.

The new study was published in Science Translational Medicine. In the study, researchers explored the pain mechanism in both mice and humans. In addition, they found that white blood cells called neutrophils play an important role in fighting infections, tissue regeneration, and healing.

The study found that those living with chronic pain were individuals who had developed specific changes in genes, which altered the activity of white blood cells in their bodies. In addition, these changes seem to alter the activity of neutrophils, thus putting these individuals at a greater risk of chronic pain.

It is essential to understand that neutrophils dominate the early stages of inflammation and set the stage for tissue repair. However, if these early processes are disturbed through aggressive anti-inflammatory therapy, the condition is more likely to become chronic.

In the study, when researchers blocked neutrophils in mice, they found that it prolonged the pain by as much as ten times. In addition, they found that treating pain and inflammation with dexamethasone or diclofenac produced similar results. Though both drugs were quite effective in suppressing pain in the early stages, they ultimately increased the risk of chronic pain1.

This is not the first study with such findings. Earlier, a study was done on half a million people in the UK. It found that those who took medication for inflammation more commonly and treated inflammation aggressively were more likely to experience pain two to ten years later. Such an effect was not seen in those who chose acetaminophen or anti-depressants.

There are several implications of this study. Particularly considering that NSAIDs are often the treatment of choice in different inflammatory and painful conditions. Moreover, some NSAIDs are even available as over-the-counter drugs. It means that doctors must reconsider how they treat pain, and patients must be aware of the risks of aggressive anti-inflammatory therapy.

Of course, such treatments feel good in their early stages as they provide quick relief. But as the studies show that such a treatment approach may considerably increase the risk of chronic pain.

Understanding that suppressing all kinds of inflammation is not a good idea is vital. After all, it is part of the healing process. It is crucial to tolerate some pain, let the body heal itself, and wait for pain resolution. If the pain is severe, it is better to use medications that suppress pain sensation but not inflammation.

By Gurpreet Singh Padda, MD, MBA, MHP