“For me to change my prescribing behaviour I would really want to see a human trial. To really see if anti-inflammatory medicines make back pain persist, we would need a randomised trial comparing different kinds of painkillers, says Feder. “But that is only a proxy,” says Gene Feder, a doctor in Bristol, UK, who specialises in treating back pain. Those who had reported new back pain were more likely to see their problem persist if they were taking non-steroidal anti-inflammatory drugs such as diclofenac than if they were taking other painkillers such as paracetamol.Ī problem with this part of the study is that people who had worse pain could have been more likely to be prescribed an anti-inflammatory, says Diatchenko – meaning that the drugs don’t cause prolonged pain, they merely correlate with it.Īs the UK Biobank study didn’t ask people about their pain severity, the team instead adjusted these results by taking into account how many different sites of pain each person had, which previous work suggests correlates with pain intensity. Next, the team looked at people who had filled out surveys as part of a long-running medical study called the UK Biobank. “Pain resolution is an active process that requires neutrophil activation.” “Inflammation is painful, but this inflammation is needed for our body to resolve pain,” says Diatchenko. Without any anti-inflammatory drug treatment, the animals also experienced longer-term pain if their neutrophils were killed by injections of an antibody. This suggests that some inflammatory cells can help people overcome their pain – a process that might be disrupted by anti-inflammatory drugs.ĭiatchenko’s team also found that in mice given a back injury, treatment with anti-inflammatories such as dexamethasone and diclofenac relieved their pain in the short term, but led to more pain longer term. In those whose pain subsided over the next three months, one type of inflammatory immune cell – the neutrophils – showed higher levels of activity than in people whose pain persisted. Read more: The back pain epidemic: Why popular treatments are making it worse
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