Taking aspirin and ibuprofen as painkillers could be completely pointless, a study suggests.
Experts have now warned the cheap drugs may actually leave patients in agony for longer.
The findings call into question the conventional practice of treating pain with anti-inflammatory drugs, taken by millions around the world.
Researchers today praised the ‘excellent’ study, which was based tests in the lab on human cells and mice.
However, they have urged people not give up their painkillers overnight because the drugs are proven to be effective in the short-term.
Taking aspirin and ibuprofen as painkillers could be completely pointless, a study suggests. Experts have now warned the cheap drugs may actually leave patients in agony for longer
The study by researchers in Canada and Italy suggests inflammation may not be the nemesis after all.
Instead, it could be protective in the long-term. One researcher said that it ‘may be dangerous to interfere with it’.
Popular anti-inflammatories include diclofenac, naproxen, and piroxicam.
The research, in the Science Translational Medicine journal, also looked at steroids like dexamethasone, which works in a similar fashion.
Anti-inflammatory drugs work by blocking neutrophils, white blood cells which help the body begin the healing process.
Experts analysed blood samples, taken on three occasions, from 98 people battling lower back pain.
Patients whose pain eventually went away had significantly more neutrophils in their blood, compared to those still struck down.
This inspired the researchers to test blocking neutrophils in injured mice with anti-inflammatory drugs dexamethasone and diclofenac.
Scientists have found blocking neutrophils, a type of white blood cell which causes inflammation as part of healing tissues, actually prolonged the duration of pain in studies on mice. The experts were inspired to run the experiment after finding differences in genetic samples taken from people who suffered from ongoing lower back pain
HOW AMERICA GOT HOOKED ON OPIOIDS AND IS THE SAME HAPPENING HERE?
Research has shown hospital admissions for opioids has soared 50 per cent in the last decade in England adding to fears the UK could be facing a similar opioid crisis to the one in the US which has devastated thousands of families.
In the early 2000s, the FDA and CDC started to notice a steady increase in cases of opioid addiction and overdose. In 2013, they issued guidelines to curb addiction.
However, that same year – now regarded as the year the painkiller epidemic took hold – a CDC report revealed an unprecedented surge in rates of opioid addiction.
Overdose deaths are now the leading cause of death among young Americans – killing more in a year than were ever killed annually by HIV, gun violence or car crashes.
In 2019, the CDC revealed that nearly 71,000 Americans died from drug overdoses.
This is up from about 59,000 just three years prior, in 2016, and more than double the death rate from a decade ago.
It means that drug overdoses are currently the leading cause of death for Americans under 50 years old.
The data lays bare the bleak state of America’s opioid addiction crisis fueled by deadly manufactured drugs like fentanyl.
Most control mice stopped feeling pain within two months.
But rodents on the anti-inflammatory drugs experienced for pain for twice as long on average, with some in pain for 10 times longer than the control group.
Replicating the experiment with painkillers that don’t target inflammation, such as paracetamol (acetaminophen), did not produce the same extended pain response.
This suggested inflammation played a role in healing injuries and resolving pain, the authors said.
The findings were supported by a separate analysis of 500,000 people that showed that those taking anti-inflammatory drugs to treat their pain were more likely to have pain two to 10 years later.
Professor Jeffrey Mogil, author of the study from McGill University in Canada, said by interfering with this initial painful period medics could be doing more harm than good.
‘Neutrophils dominate the early stages of inflammation and set the stage for repair of tissue damage,’ he said.
‘Inflammation occurs for a reason, and it looks like it’s dangerous to interfere with it.
‘For many decades it’s been standard medical practice to treat pain with anti-inflammatory drugs.
‘But we found that this short-term fix could lead to longer-term problems.’
He added that while ibuprofen was not studied explicitly in the experiments, it would have been reflected in analysis of 500,000 Britons.
‘It is highly likely that a large percentage of those in the UK Biobank who reported taking non-steroidal anti-inflammatory drugs were in fact taking ibuprofen,’ he said.
Fellow author, Dr Massimo Allegri, from Monza Hospital in Italy, argued the findings could mean medics need to treat painful injuries differently.
‘Our findings suggest it may be time to reconsider the way we treat acute pain,’ he said.
‘Luckily pain can be killed in other ways that don’t involve interfering with inflammation.’
Experts called for further trails comparing anti-inflammatory drugs to other painkillers that don’t disrupt inflammation.
Chronic pain, and the medications prescribed to counter it, are one of the drivers of the prescription painkiller addiction crisis in both the US and Britain.
Dr Franziska Denk, an expert in chronic pain from King’s College London, said the study was a ‘wonderful start’.
But she claimed further research needed to be done before changing how medics treated patients.
‘It would most definitely be premature to make any recommendations regarding people’s medication until we have results of a prospectively designed clinical trial,’ she said.
‘In my opinion, this study should not generate a debate around the use of NSAIDs in low back pain – much more research is needed to confirm these findings first.’
Professor Blair Smith, an expert on pain from the University of Dundee, said the latest study was an ‘excellent’ piece of research but people should continue to take their medications as advised until further scientific work is completed.
‘It is also important to note that anti-inflammatory drugs are effective in short-term pain management,’ he said.
‘There is good quality evidence to back this up and they should not be withheld unnecessarily.’
Ongoing chronic pain has been blamed for fuelling a painkiller addiction crisis in both the UK and the US which has blighted thousands of lives.
A London School of Economics study published in February found hospitalisations for opioid overdoses in England have soared by 50 percent in a decade.
Experts have also warned prescription painkiller use is likely on the rise as millions of patients suffer in agony while trapped on record-high waiting lists for surgeries like hip replacements on the NHS.
In the US the opioid addiction crisis has resulted in 600,000 deaths from overdoses since 1999.
Around 5million people a year in England are given prescription opioids, and more than half-a-million taken them for at least three years, according to a 2019 Government report.
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