Marc Darrow MD,JD

Over twenty years ago, I wrote in my book the Collagen Revolution, that the body’s natural healing response is inflammation.

Inflammation is the trigger for the cascade of events that follow in wound and injury repair. In my opinion, the moment inflammation became the enemy of healing, is the moment chronic pain started becoming a billion-dollar business for drug companies. When Ibuprofen was introduced in 1974, it was heralded as one of the great steps in the management of pain. By 1976, two years after its introduction, 1.7 billion tablets had been produced. Today, millions of prescriptions for pain relievers are written annually and tons of aspirin are consumed each day. Yet chronic pain persists. Why?

Because these drugs only mask the problem of pain and do not attempt to cure it.

Furthermore, these drugs come with their own risks of addiction and unpleasant side effects. If you suffer from myofascial pain, joint pain, arthritis, sprained or strained ligaments, almost any kind of pain, most likely your doctor will prescribe one of the non-steroidal anti-inflammatory drugs, or NSAIDs. These drugs will reduce the inflammation, which in the short-term reduces the pain. However, in the long-term they set you up for more pain and long-term chronic injury and worse.

Why You May Win the Battle, BUT Lose the War

Understandably, people do not like to feel pain and would like to prevent it at all costs. They want immediate relief and getting rid of the inflammation often provides that relief. The basic truth is that immediate relief does not equal long-lasting relief. Interfering with the body’s healing process by stopping inflammation to reduce pain causes long-term suffering down the road. Inflammation does cause pain, but, pain can be your friend. It is the body’s siren alerting you that you have injured yourself. Getting rid of inflammation with NSAIDs provides some immediate relief from pain. It sets you up to win the battle, but lose the war.

By stopping inflammation we shut down the body’s natural healing which inhibits the growth of new tissue. In our practice, many alarmed patients have had to stop the use of NSAIDs because of stomach discomfort, nausea, and dizziness.

Inflammation, and the accompanying pain, are actually your allies in healing.

I went on to explain

Unfortunately, this is where chronic problems begin, because the conventional medical practice with its emphasis on pain relief, treats the symptom—pain, and not the problem—joint and spine instability brought on by ligament weakness. A patient will likely be told to take anti-inflammatory drugs, which is often precisely the wrong thing to do because inflammation is the first part in the body’s healing process. Nonsteroidal anti-inflammatories NSAIDS and cortisone (an anti-inflammatory steroid) can give immediate relief, but with a risk of creating a long-term injury with chronic pain. By blocking inflammation, anti-inflammatories never allow complete healing, and instead, aggravate the situation.

Twenty years later “Using anti-inflammatory drugs and steroids to relieve pain could increase the chances of developing chronic pain”

Now, let’s read from a press release issued in May 2022 from McGill University in Canada.

“Using anti-inflammatory drugs and steroids to relieve pain could increase the chances of developing chronic pain, according to researchers from McGill University and colleagues in Italy. Their research puts into question conventional practices used to alleviate pain. Normal recovery from a painful injury involves inflammation and blocking that inflammation with drugs could lead to harder-to-treat pain.

“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,” says Jeffrey Mogil, a Professor in the Department of Psychology at McGill University and E. P. Taylor Chair in Pain Studies.

In the study published in Science Translational Medicine, (1) the researchers examined the mechanisms of pain in both humans and mice. They found that neutrophils – a type of white blood cell that helps the body fight infection – play a key role in resolving pain.

“In analyzing the genes of people suffering from lower back pain, we observed active changes in genes over time in people whose pain went away. Changes in the blood cells and their activity seemed to be the most important factor, especially in cells called neutrophils,” says Luda Diatchenko a Professor in the Faculty of Medicine, Faculty of Dentistry, and Canada Excellence Research Chair in Human Pain Genetics.

Inflammation plays a key role in resolving pain

“Neutrophils dominate the early stages of inflammation and set the stage for repair of tissue damage. Inflammation occurs for a reason, and it looks like it’s dangerous to interfere with it,” says Professor Mogil, who is also a member of the Alan Edwards Centre for Research on Pain along with Professor Diatchenko.

Experimentally blocking neutrophils in mice prolonged the pain up to ten times the normal duration. Treating the pain with anti-inflammatory drugs and steroids like dexamethasone and diclofenac also produced the same result, although they were effective against pain early on.

These findings are also supported by a separate analysis of 500,000 people in the United Kingdom that showed that those taking anti-inflammatory drugs to treat their pain were more likely to have pain two to ten years later, an effect not seen in people taking acetaminophen or anti-depressants.”

In the companion article Anti-inflammatory medication side-effects – accelerated knee osteoarthritis, I write about patients being pain managed with anti-inflammatory medications and painkillers, and the one question they all seem to have is: “What are these medications doing to my knees.” TPossibly they are worsening your knee damage.

While NSAIDS can make knees feel better in the short-term, more and higher doses are needed to in the long-term to achieve similar results. In the over 22 years that we have treated patients with knee problems, there has always been the instance when a patient will ask us if they can continue with their anti-inflammatory medications. The answer is typically no. When the patient asks why? We remind them that regenerative medicine techniques like the ones we use, count on the beneficial aspects of inflammation. Inflammation is the way Nature heals. If we stop the inflammation, we stop the healing.

In my article Research comparing different  types of knee injections, I discuss various injections that may help. These include: platelet rich plasma (PRP), corticosteroids, mesenchymal stem cells (MSCs), and hyaluronic acid. Each injections is discussed within the latest research.

Do you have questions about your treatment options? Ask Dr. Darrow

Marc Darrow, MD. JD., discusses the treatment philosophy of the Darrow Stem Cell Institute. Transcript of video

A leading provider of stem cell therapy, platelet rich plasma and prolotherapy
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PHONE: (800) 300-9300 or 310-231-7000

References:

1 Parisien M, Lima LV, Dagostino C, El-Hachem N, Drury GL, Grant AV, Huising J, Verma V, Meloto CB, Silva JR, Dutra GG. Acute inflammatory response via neutrophil activation protects against the development of chronic pain. Science Translational Medicine. 2022 May 11;14(644):eabj9954.

 

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