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Back Pain Medications: Some medications prescribed to treat symptoms can prolong pain

Back Pain Medications: Some medications prescribed to treat symptoms can prolong pain

 


Two medications, dexamethasone and diclofenac, relieve back pain in the short term, but can interfere with the healing of the injury and can cause worse pain in the long term.


health


May 11, 2022

Woman with back pain

Some medications used to treat back pain can make things worse

Shutterstock / Caban Image-Offset

Two commonly used anti-inflammatory drugs for back pain can inadvertently exacerbate symptoms.

Early studies suggest that drugs called dexamethasone and diclofenac can interfere with the body’s normal process for healing damaged tissue. However, this idea has not yet been tested in a randomized trial, which is the best kind of medical evidence.

lower back pain Is one of the most common conditions in the world, with 4 in 5 people experiencing this condition at some point, but the cause is often unknown.

Some affected people have an outward bulge in one of the discs of the spine, called a herniated disc, but many people without back pain also have such a bulge.

As Opioid analgesics are addictive, The doctor may prescribe an anti-inflammatory drug instead. This is because inflammation, which is a mild activation of immune cells, can exacerbate pain.

Ruda Diachenko At McGill University in Montreal, her colleague investigated 98 people who recently developed back pain. Researchers regularly take blood samples and analyze them to see which genes are active in the immune cells that circulate in the blood.

In people whose pain subsided in the next three months, neutrophils, a type of inflammatory immune cell, showed higher levels of activity than those who had persistent pain. This suggests that some inflammatory cells may help people overcome pain. This is a process that can be destroyed by anti-inflammatory drugs.

Diachenko’s team also found that in mice with back injuries, treatment with anti-inflammatory drugs such as dexamethasone and diclofenac relieved pain in the short term, but caused more pain in the long term. discovered. Without treatment with anti-inflammatory drugs, animals also experienced long-term pain when neutrophils were killed by injection of antibodies.

“Inflammation is painful, but this inflammation is necessary for our body to relieve pain,” says Diachenko. “Pain relief is an active process that requires neutrophil activation.”

The team then looked at people who filled out the survey as part of a lengthy medical study called UK Biobank. People who reported new back pain were more likely to continue to have problems when taking non-steroidal anti-inflammatory drugs such as diclofenac than when taking other analgesics such as paracetamol. ..

The problem with this part of the study is that people with severe pain are more likely to be prescribed anti-inflammatory drugs. That is, the drug does not cause long-term pain, it simply correlates with it.

The UK Biobank study did not ask people about the severity of pain, so the team instead adjusted these results by considering the number of different pain sites each person had. “But it’s just a proxy,” he says. Gene FedderA doctor in Bristol, UK, specializing in the treatment of back pain.

To actually see if anti-inflammatory drugs persist back pain, randomized trials comparing different types of painkillers are needed, Fedder said. “To change prescribing behavior, I really want to see human clinical trials. This leaves me a lot of uncertainty.”

Journal reference: Scientific translation medicine, DOI: 10.1126 /scitranslmed.abj9954

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2/ https://www.newscientist.com/article/2319844-some-medicines-prescribed-to-treat-back-pain-may-prolong-the-problem/

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