Anti-Inflammatory Drug Might Lead to Chronic Pain, While Inflammation Could Heal: Experts
Anti-Inflammatory Drug Might Lead to Chronic Pain, While Inflammation Could Heal: Experts

By Cara Michelle Miller

Doctors have recommended nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to relieve acute inflammation for decades. But does short-term relief—and interfering with the body’s natural healing process—come at the cost of chronic pain?

Pain from a minor injury, like a sprained ankle or thrown-out back, often resolves on its own. But for some, acute pain lingers, becoming chronic. The “standard medical care for this type of pain is probably making matters worse, is what the research suggests,” Jeffrey Mogil, a neuroscientist at McGill University, told The Epoch Times.

Early-Stage Inflammation Prevents Chronic Pain

Injuries trigger inflammation for a reason, and researchers are working to understand it better.

One study, published in Science Translational Medicine, focused on 98 lower-back pain patients over a three-month period. During that time, half of the volunteers fully recovered, while the other half developed chronic low-back pain. Using RNA sequencing, the researchers compared the activity levels of immune cells between both groups.

They discovered that neutrophils, immune cells that feature prominently at the onset of the inflammation sequence, play a role in remaining pain-free. Neutrophils help the body fight infection and repair tissue damage.

According to the researchers, the chronic pain group started with less inflammatory neutrophil activity and later had little to no activity in the cells that create inflammation. Contrastingly, the genes of the recovered patients were very active with inflammation-related cells.

“Neutrophils rush in pretty early after some sort of injury, causing a process that ends up preventing chronic pain,” said Mr. Mogil, a senior author of the paper, “and you probably shouldn’t block it.”

Scientists have known that anti-inflammatory drugs inhibit neutrophil activity in people and animals. However, the link to chronic pain had been missed because prior studies did not follow patients long enough beyond immediate pain reduction.

“NSAIDs definitely interfere with the process,” Eugene Aiello, a chiropractic physician and neurologic researcher, told The Epoch Times. “But not everybody in the chronic pain group was taking NSAIDs. More studies are needed to identify what else is preventing the neutrophils from completing the repair process.”

Recognizing Whether Inflammation Is Good or Bad

There are generally two types of inflammation: acute and chronic. To determine whether inflammation is good or bad, we must understand how these differ.

Chronic inflammation is long-lasting and spreads throughout the body. It becomes the problem rather than the solution to infection or injury. It can lead to more serious conditions such as heart disease or even cancer.

In contrast, acute inflammation is beneficial—provided it is robust, short-lived, and site-specific. When a ligament or tendon is strained or torn, it triggers an influx of blood, fluids, and immune cells to the area.

“Swelling is the body’s innate wisdom to increase the surface area so that healing mediators can then come into that area,” Brandon LaGreca, a licensed acupuncturist nationally certified in Oriental medicine, told The Epoch Times.

Neutrophils are part of these first responders. Their presence is key to removing damage and debris through lymphatic drainage, setting the stage for damaged tissue to be repaired.

Pain and swelling are a clear message that the “paramedics” are at work. Decreasing pain without shutting down the “highway” is critical for supporting the healing process.

“If you’re injured, one Advil for discomfort or to get sleep is different than taking 800 milligrams of Advil three times a day for three weeks,” said Mr. Aiello. “That’s when you’re likely to have a problem.”

“There are ways to block pain without blocking inflammation, and the most well-known of those is Tylenol,” said Mr. Mogil. But the overuse of Tylenol, or acetaminophen, comes with risks like liver injury.

Reconsidering the Standard Treatment for Acute Pain

Based on their initial study, Mr. Mogil and the other researchers hypothesized that inhibiting the body’s initial inflammatory response leads to chronic pain. They expanded on the research with a study in which mice with an injured paw were given either an over-the-counter (OTC) anti-inflammatory drug or saline.

Although the mice in the OTC group initially showed fewer pain symptoms because their inflammation response was dulled, the pain eventually returned and became chronic. For mice that received saline, the pain subsided in half that time, and they remained pain-free.

To see if their hypothesis might apply to humans, the researchers did a separate analysis of patients in the United Kingdom. Those with acute back pain who reported taking anti-inflammatories were around 70 percent more likely to have pain two to six years later, an effect not seen in people taking acetaminophen or antidepressants.

While the researchers linked blocking early-stage inflammation to the development of chronic pain, decades of medical orthodoxy will not be overturned by a single study. Clinical trials are needed for that, but funding has proven difficult for the researchers to get.

Mr. Mogil noted that the findings shouldn’t be confused with using NSAIDs for chronic conditions, where reducing inflammation is essential.

Working With the Body’s Natural Inflammatory Response

How can you enhance the body’s natural healing process, ensuring a full recovery? Traditional Chinese medicine (TCM) stands out in answering this question, as it has treated acute injuries for thousands of years.

Mr. LaGreca explained that TCM focuses on stimulating circulation to the area of injury, restoring movement and function, and enhancing the body’s natural healing process. “We encourage the healing process so that inflammation resolves on its own, as opposed to suppressing it,” he added.

Here is a combination of approaches that use TCM principles to work with—not against—acute inflammation.

Practice Gentle Movement

Following an injury, pain, heat, redness, and swelling can last one to three days. While rest is important, too much weakens the body, delaying healing. Rest should be balanced with gentle movement within pain tolerance.

“It’s injury dependent, but you can cautiously explore range of motion, stretching, and movement immediately,” advised Mr. Aiello.

Gentle range-of-motion movements, including walking and slowly rotating the joints, help maintain the health of ligaments and tendons by preventing stiffness and promoting circulation. This also helps to move fluid through the lymphatic system.

“For example, with an ankle injury, you may not want to walk on it with a lot of pressure,” added Mr. LaGreca, “but you can start with gentle ankle rotations.”

As pain and swelling decrease, careful movement can increase until there is a regular exercise routine. “Putting a small amount of load on the ligament helps new tissue grow back in the right way,” Mr. Aiello added. Ideally, this is done with a physical therapist or sports trainer.

Studies have shown that exercise and other physical therapies are effective for people with musculoskeletal pain, such as low back pain.

Try Drug-Free Remedies

Nutrition can help provide relief from acute pain. “Your immune response needs fuel from nutrients and lots of antioxidants because the key to overcoming the pain is for neutrophils to help clear the damaged tissues,” explained Mr. Aiello. “That debris is what’s eliciting the pain.”

Ginger, turmeric, capsaicin, and valerian root have all been shown to be effective natural pain relievers.

Many Chinese herbs can also be applied topically to help with pain, noted Mr. LaGreca. Additionally, acupuncture or acupressure on specific points is one of the most direct methods for immediate pain relief that also promotes circulation, increasing lymphatic drainage.

Multiple studies have shown that acupuncture effectively treats sports injuries like strains, sprains, and swollen muscles. One randomized controlled trial published in the American Journal of Emergency Medicine demonstrated that acupuncture is more effective, faster in relieving pain, and has fewer adverse effects than intravenous morphine.

Studies on acupressure have shown that applying pressure to stimulate specific points can also reduce acute pain. Acupressure is easily self-administered.

Opt for Heat Over Ice

From the TCM perspective, heat increases circulation. Mr. LaGreca recommended a warm bath with Epsom salts “to stimulate circulation and help the process along.”

Cold does the opposite, slowing down movement and impairing the circulation of blood and fluids. “Ice might make you feel better by reducing swelling, but that swelling is there for a reason,” cautioned Mr. LaGreca. Ice may even delay healing.

Dr. Gabe Mirkin, who introduced R.I.C.E.—rest, ice, compression, elevation—to the sports medicine world in 1978, revised his recommendation in 2015. He wrote, “Both ice and complete rest may delay healing, instead of helping.”

Get Deep Sleep

While resting for hours on end isn’t recommended, deep sleep is crucial for injury recovery.

When the body enters its deep sleep stage, the pituitary gland releases growth hormones that stimulate muscle repair and growth. Growth hormones must be released in greater amounts when the body is healing from an injury.

Healing takes time and requires trust in the body’s natural process. “We need to do things that encourage that healing process,” said Mr. LaGreca.

“Inflammation isn’t always bad,” added Mr. Aiello. “Knowing how to use it to fully heal can prevent longer-term problems.”

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