MEDICINE AND HEALTH

Taking anti-inflammatory drugs back pain is more severe


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A recent study published in Science-Translational Medicine suggests that two anti-inflammatory drugs commonly used to treat back pain may inadvertently worsen the condition.

Lower back pain is one of the most common diseases worldwide, with about 4 in 5 people experiencing lower back pain at some point, but the causes are often unclear.

Scans show that some patients have an outward bulge of the buffered vertebrae, known as a herniated disc, but many people without back pain also have such a bulge.

Because opioid painkillers can be addictive, doctors may prescribe anti-inflammatory drugs. This is because inflammation is a low-level immune cell activation that exacerbates pain.

Luda Diatchenko and colleagues at McGill University in Canada surveyed 98 people who had recently developed low back pain. The researchers regularly take blood samples and analyze them to determine which immune cells are active in the blood circulation.

Over the next 3 months, a type of inflammatory immune cell (neutrophil) in the body of a person with reduced pain showed a more active level than a person with persistent pain. This suggests that some cells can help people overcome pain, but the process can be disrupted by anti-inflammatory drugs.

Diatchenko’s team also found that treating mice with back injuries with anti-inflammatory drugs such as dexamethasone and diclofenac could relieve pain in the short term but cause greater pain in the long term. In the absence of anti-inflammatory drug treatment, if antibodies are injected to kill neutrophils, they also experience long-term pain.

“Inflammation is painful, but our bodies need inflammation to relieve pain. Pain relief is a process that requires neutrophil activation. Diatchenko said.

Subsequently, as part of a long-term medical study by the UK Biobank, the team looked at people who filled out questionnaires. Patients who reported new back pain were more likely to see the persistence of the problem when taking NSAIDs such as diclofenac than those who took other painkillers, such as paracetamol.

One problem with this part of the study is that people with more severe pain are more likely to be prescribed anti-inflammatory drugs by doctors. In addition, since the UK Biobank study did not ask people how much pain they were, the team needed to consider how much pain each person had in different parts to adjust the results.

Earlier studies have also shown that drugs called dexamethasone and diclofenac may interfere with the normal processes of damaged tissue in the body. But this idea has not yet been validated in randomized trials.

And to really understand whether anti-inflammatories persist back pain, the researchers needed a randomized trial comparing different types of painkillers. (Source: China Science Daily Wang Fang)

Related paper information:https://doi.org/10.1126/scitranslmed.abj9954



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