Taking aspirin and ibuprofen as pain relievers may be completely useless, a study suggests.
Experts have now warned that cheap drugs may actually leave patients in agony for longer.
The findings challenge the conventional practice of treating pain with anti-inflammatory drugs, which are taken by millions of people around the world.
The researchers today praised the “excellent” study, which was based on laboratory tests in human cells and mice.
However, they have urged people not to go off painkillers overnight because the drugs have been shown to be effective in the short term.
Taking aspirin and ibuprofen as pain relievers may be completely useless, a study suggests. Experts have now warned that cheap drugs may actually leave patients in agony for longer.
The study by researchers in Canada and Italy suggests that inflammation may not be the nemesis after all.
Instead, it could be protective in the long run. One researcher said “it can be dangerous to interfere with it.”
Popular anti-inflammatories include diclofenac, naproxen, and piroxicam.
The investigation, in it The journal Science Translational Medicine also looked at steroids like dexamethasone, which work in a similar way.
Anti-inflammatory medications work by blocking neutrophils, the white blood cells that help the body begin the healing process.
The experts analyzed blood samples, taken three times, from 98 people struggling with low back pain.
The patients whose pain eventually disappeared had significantly more neutrophils in their blood, compared to those who were still affected.
This inspired the researchers to test neutrophil blockade in mice injured with the anti-inflammatory drugs dexamethasone and diclofenac.
Scientists have found that blocking neutrophils, a type of white blood cell that causes inflammation as part of tissue healing, actually prolonged the duration of pain in mouse studies. The experts were inspired to conduct the experiment after finding differences in genetic samples taken from people who suffered from ongoing low back pain.
Most of the control mice stopped feeling pain within two months.
But the rodents given the anti-inflammatory drugs experienced pain for twice as long on average, with some experiencing pain for 10 times longer than the control group.
Replicating the experiment with pain relievers that don’t target inflammation, such as paracetamol (acetaminophen), did not produce the same extended response to pain.
This suggested that inflammation played a role in injury healing and pain resolution, the authors said.
The findings were supported by a separate analysis of 500,000 people that showed those taking anti-inflammatory drugs to treat pain were more likely to have pain two to 10 years later.
Professor Jeffrey Mogil, an author of the study from McGill University in Canada, said that by interfering with this painful early period, doctors could be doing more harm than good.
“Neutrophils dominate the early stages of inflammation and set the stage for tissue damage repair,” he said.
‘Inflammation happens for a reason, and it seems dangerous to interfere with it.
“For many decades it has been standard medical practice to treat pain with anti-inflammatory medications.
“But we found that this short-term fix could lead to longer-term problems.”
He added that while ibuprofen was not explicitly studied in the experiments, it would have been reflected in the analysis of 500,000 Britons.
“It is very likely that a large percentage of people in the UK Biobank who reported taking NSAIDs were actually taking ibuprofen,” he said.
Co-author Dr. Massimo Allegri, from Monza Hospital in Italy, argued that the findings could mean that doctors should treat painful injuries differently.
“Our findings suggest that it may be time to reconsider how we treat acute pain,” he said.
“Fortunately, pain can be killed in other ways that don’t involve interfering with inflammation.”
The experts called for more evidence comparing anti-inflammatory drugs with other pain relievers that don’t alter inflammation.
Chronic pain and the prescription drugs to counter it are one of the driving factors of the prescription painkiller addiction crisis in both the US and Britain.
Dr. Franziska Denk, a chronic pain expert at King’s College London, called the study a “wonderful start.”
But he said more research was needed before changing the way doctors treated patients.
“It would definitely be premature to make recommendations regarding people’s medication until we have the results of a prospectively designed clinical trial,” he said.
“In my opinion, this study should not spark a debate about the use of NSAIDs in low back pain; much more research is needed first to confirm these findings.”
Professor Blair Smith, a pain expert at the University of Dundee, said the latest study was “excellent” research, but people should continue to take their medicines as recommended until further scientific work is completed.
“It’s also important to note that anti-inflammatory medications are effective in treating pain in the short term,” he said.
“There is good quality evidence to support this and it should not be hidden unnecessarily.”
Ongoing chronic pain has been blamed for fueling a painkiller addiction crisis in both the UK and the US that has ruined thousands of lives.
AN London A School of Economics study published in February found hospitalizations for opioid overdoses in England have soared by 50 percent in a decade.
Experts also warned that prescription painkiller use is likely to rise as millions of patients suffer agony while stuck on record-breaking waiting lists for surgeries such as hip replacements on the NHS.
In the US, the opioid addiction crisis has led to 600,000 overdose deaths since 1999.
About 5 million people a year in England receive prescription opioids, and more than half a million take them for at least three years, according to a 2019 government report.
