The researchers also replicated the findings in mice, either by squeezing the animals’ sciatic nerves to produce back and leg pain or by injecting the sciatic nerves with an irritant. 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
Then, the group wondered whether chronic pain resulted from pain suppression or inflammation suppression. So they gave some mice a prescribed anti-inflammatory, diclofenac. Other mice took one of the other three analgesic or pain relieving drugs: gabapentin, morphine, and lidocaine.
Only with diclofenac did the pain persist, becoming chronic.
These findings led them to wonder: were patients taking nonsteroidal anti-inflammatory drugs like ibuprofen or steroids like dexamethasone to relieve back pain also more likely to develop chronic pain?
The researchers turned to data from the British biobank, a repository with information on the medical conditions and drug use of half a million patients. They studied 2,163 people with acute back pain, 461 of whom suffered from chronic pain. Those taking a non-steroidal anti-inflammatory drug were nearly twice as likely to develop chronic back pain than those taking other drugs or taking no drugs, the researchers found.
Dr Diatchenko said she does not believe her findings affect the issue of opioid addiction. In fact, she said, “to avoid opioids, doctors have started prescribing more non-steroidal anti-inflammatory drugs.”
“We need to think further about how to treat our patients,” he said.
The tendency to use non-steroidal anti-inflammatory drugs persists despite their insignificant performance. In Analysis of randomized clinical trials found that these drugs have almost no benefit over placebos in reducing low back pain.
Dr Atlas says short-term use of non-steroidal anti-inflammatories is likely not harmful, but the new study adds, while not showing long-term use to be harmful, “at least provides a biological mechanism that says the short-term use is not the same as long-term use. “