Ibuprofen: Blocking Inflammation With Drugs Leads To Chronic Pain [Study]

May 23, 2022Dr. Grant Radermacher

Can Ibuprofen put you at risk for chronic pain?

A new paradigm-shifting study out of McGill University suggests that using anti-inflammatory drugs like ibuprofen, diclofenac or prednisone to treat an injury, like an ankle sprain or wrenched back, actually increases the risk of developing chronic pain.

The CliffsNotes summary: For decades it’s been standard medical practice to treat back pain with anti-inflammatory drugs. But when you use steroids or NSAID painkillers that work by stopping inflammation, you’re actually interfering with the body’s normal biological process of recovery, which requires short-term inflammation.

The outcome? These short-term fixes can actually lead to chronic, long-term pain conditions – something that 1 in 5 Americans now suffer with.

What the science says

The researchers involved in the study, published in the journal Science Translational Medicine, aimed to identify markers in the blood that would predict which patients would have pain that quickly improved and which would develop chronic pain.

The study followed 98 back pain patients, who had bloodwork collected at the time of the initial injury and again three months after their pain began. Those who said their pain went away had rapid and intense inflammation when the pain was acute. The markers of inflammation then diminished over the following three months. Those who had pain that became chronic never experienced the acute inflammation phase.

They found the exact same outcome in people with TMJ disorders and jaw pain. Once again, those who recovered had rapid and intense inflammatory responses, while those who had suppressed inflammation responses were far less likely to recover fully.

The researchers then turned to data from the UK Biobank, a repository with information about half a million patients’ medical conditions and drug use. They looked at data from 2,163 people with acute back pain, 461 of whom went on to have chronic pain.

They found that those who took NSAIDs or steroids for their back pain had nearly double the chance of developing chronic back pain as those taking other medications or no drugs.

“Standard medical management for this type of pain turns out to be probably making matters worse, not better.”

– Jeffrey Mogil, McGill University

It’s still not clear exactly why inflammation might be having this protective effect, although it really shouldn’t be shocking. While long-term inflammation is known to be debilitating, we’ll sometimes intentionally induce inflammation in a concentrated region to promote tissue repair – it’s the principle behind cupping and graston technique.

And we’ve long known exercise can have regenerative effects, even though it’s inflammatory.

Of course, it’s important to note that acute inflammation (from an injury) and chronic inflammation (say, from stress) are quite different. The former, as this study shows, is beneficial, while the latter isn’t.

A warning about taking drugs for pain

In mainstream medicine, the thinking on treating back pain – which the CDC says is the most common type of pain – usually goes like this: If it hurts, take an NSAID anti-inflammatory, and if it still hurts, use a steroid. This thinking persists despite these medications’ unimpressive performance – an analysis of randomized clinical trials found that these drugs had almost no benefit over placebo in reducing low back pain. That’s not even considering the fact that 100,000 people are hospitalized each year from NSAID-related complications.

The new findings suggest it may be time to reconsider the way we treat acute pain, focusing more on healing and correcting the source of the problem and not simply on suppression of inflammation.

The good news? Pain can be killed in ways that don’t involve interfering with the natural inflammation process.

So what does work for back pain?

Based on the latest research, chiropractic (by itself or combined with active exercise therapy) is your best – and most cost-effective – bet for back pain relief.

A 2017 review published in the Journal of the American Medical Association found that, compared to other popular mainstream medical treatments, spinal manipulation can’t be beaten for musculoskeletal low back pain relief.

That’s backed up by the Cochrane 2011 review on chronic low back pain that found that spinal manipulation significantly reduced pain and improved patients’ functional status. UpToDate’s review of the randomized trials that have come out since the Cochrane review further support those conclusions, finding that spinal manipulation delivered notable benefits for chronic back pain sufferers.

Those with acute back pain (less than 4 weeks duration) or subacute back pain (between 4-12 weeks duration) fared even better in those studies. In a 2013 trial published in SPINE journal, over 73% of people with acute or subacute back pain who saw a chiropractor in addition to their medical doctor found significant or complete relief from their pain, compared with 17% in the standard-medical-care-only group.

Add to that the fact that chiropractic care is by far more cost-effective than traditional medical care for back pain. According to data published in 2014 that looked at 3.7 million patients, those suffering from low back pain spent almost 500% more when they took the orthopedic route for treatment compared to those who saw a chiropractor first instead.

In fact, for most patients, the combined out-of-pocket cost for imaging, diagnosis, and a complete corrective treatment plan at Brookfield chiropractor Ascent Chiropractic is a fraction of the cost for just an MRI alone – which, by the way, has been shown to be mostly unnecessary when it comes to back pain.

When it comes to treating back pain, the science shows that nothing beats manual spinal manipulative therapy – aka chiropractic adjustments.

Brookfield Chiropractor Ascent Chiropractic

Suffering from back pain, or have friends or family members that could benefit from what we do at Ascent Chiropractic? Looking at the excellent clinical track record of what we do, it’s an easy decision.

Don’t be one of the growing number of people who suffer from chronic pain disorders. To get started, make an appointment at Ascent Chiropractic in Brookfield by calling 262-345-4166 or schedule an appointment with our online scheduling app.

About the Author

Dr. Grant Radermacher

Dr. Grant Radermacher is a Brookfield, WI chiropractor providing unmatched results through gentle, evidence-based chiropractic care. Our mission is simple: get you out of pain so you can get back to being you, only better.

See author's posts