After an acute painful soft-tissue injury, why do some fully recover while others go on to develop persistent pain despite the resolution of the original injury? That is certainly a complex question to answer. However, a team of 20 international scientists from McGill University, Queen’s University, Laval University, North Carolina, Netherlands, Italy, and Switzerland, have published a paper that at least in part attempts to answer that question.
They propose that the use of Non-steroidal Anti-inflammatory Drugs (NSAIDs) is a significant contributing factor to the development of chronic pain! If the ability to produce an optimal inflammatory response is inhibited, it may perpetuate the pain response.
What if the acute inflammatory response was not only crucial for healing, but also necessary for the resolution of acute pain?
“…higher percentages of neutrophils at the acute pain state protected against chronic pain development.” – Parisien et al 2022
I wish this research article would be read by EVERY single healthcare provider who promotes the use of NSAIDs following acute soft-tissue injuries. This study focused on low back pain (LBP) and temporomandibular disorders (TMD).
“…we confirmed that the acute treatment of inflammation with either the steroid, dexamethasone, or the NSAID, diclofenac—although both effectively reducing pain behavior during their administration—greatly prolonged the resolution of neuropathic, myofascial, and especially inflammatory pain states.” – Parisien et al 2022
The study found that use of NSAIDs (not analgesics) in the acute stage of low back pain increased the risk to still report of back pain 2-6 years later.
“…impairment of such inflammatory responses in subjects with acute LBP (or TMD) increases the risk of developing chronic pain.” – Parisien et al 2022