Short term use of painkillers can lead to chronic pain

[HeronNS]

Seems like a kind of evil twin of homeopathic remedies. Treatment gives you more of what you're treating. Obviously if you already have the chronic pain you must take something to relieve it, but it does call into question what longterm use does in that case. Maybe helps explain why some of us end up finding it very difficult to complete a taper to zero.

theguardian.com/society/202...

[SheffieldJane]

Just read this. Acupuncture, talking therapies, distraction, oh dear!

[Abcd123455]

Hi, thanks for this. They do say it’s a small study. We don’t know enough about it in my opinion to know if the results are valid. Back pain is a difficult one as there could be underlying issues such as herniated disc etc and age makes a difference too as the back degenerates which can cause pain. Also some people develop arthritis as they get older affecting old injuries causing pain. Interesting concept though.

[Koalajane]

Help, what is there for us!

[Bcol]

Interesting, though very small study, does make me quite pleased that I don't take Ibuprofen though. Tried it many years ago but it never helped, possibly because it was never suggested to take in the dose size I now understand it was originally designed for.

[ubaoz]

Definitely interesting. I love the term "evil twin of homeopathic remedies" HeronNS!

The article also begs the question that if people had back pain in the first place, for which they then took Ibuprofen, then wouldn't they then perhaps be more predisposed than the general population to continue to have back issues as the ibuprofen does nothing to treat the cause, just the inflammation?

The idea that treatment can cause more of the same is definitely true too in my experience. I nearly always get a rebound headache (different to the original headache, so I know it's not the original returning) after taking painkillers of any sort for a headache, making me reluctant to take the painkillers in the first place unless absolutely desperate.

[Nightingales]

This is the original article science.org/doi/10.1126/sci... cohort were people with new onset low back pain or TMJ, far different to PMR and they only followed them for three months. There’s a lot of discussion about mouse studies. So not as revolutionary as the Guardian article makes it sound. But any research into pain is welcome to me.

[Nightingales in reply to Nightingales]

Sorry link doesn’t work. Will try to find another one.

[Nightingales in reply to Nightingales]

neurosciencenews.com/inflam... Trying again. If you go to the bottom of the page there is a link to the free access full article.

[HeronNS in reply to Nightingales]

But this paragraph in the summary you send is interesting and *possibly* pertinent to the development of chronic pain of whatever kind:

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.

[PMRpro Ambassador in reply to HeronNS]

I don't use paracetamol much for back pain - it hasn't enough anti-inflammatory effect. And that isthe opinion of my doctors too. So patients for whom paracetamol doesn't work for their chronic condition would be more likely a) to use ibuprofen and b) to still need it 10 years later.

[Constance13 in reply to PMRpro]

Paracetemol alone doesn’t work for me either, but together with Codeine it’s fine.

[HeronNS in reply to PMRpro]

I find acetaminophen useless most of the time, sometimes it helps with a tension headache and occasionally with a non-PMR muscle ache or pain. I just wonder, thinking back through a lifetime of dealing with headaches and using aspirin. I remember as a teenager being reluctant to use it too often because I perceived I quickly developed a resistance to it. In other words I needed more or larger doses to cure a headache if I had already used it fairly recently. As time went by I gave up on that and just took what I needed to kill the headache. I often ended up with 8 extra strength aspirin days. That's when I asked my doctor for an alternative. His answer was (then by prescription only) naproxen, which was miraculous. Until it wasn't and I needed an additional prescription to protect my stomach. At which point I stopped using naproxen and started to use a combination of aspirin and acetaminophen. I also got codeine otc, which was a low dose initially combined with aspirin but now only with acetaminophen, and hard for me to get a small enough quantity so it doesn't go way past expiry date before all used up. As I got older the headaches decreased in frequency and intensity. But then I developed a chronic pain condition! I also most recently found that I am beginning to react badly even to the 8 mg of codeine (I think those otc tablets used to contain 15 or maybe even 30 mg), getting a bit spaced out and generally feeling unwell, so haven't been in a hurry to search around for it.

[Grammy80]

Because of previous stomach bleeds and a stomach ulcer....I only take Tylenol. NSAIDs are a no-no for me personally. NOW...Tylenol or acetaminophen is being studied in California as a possible carcinogen? It seems that is kind of the norm....than there will be another study.💕

[discoballs]

Only Co-Codamol works for me but the previously mentioned comments about blockages does worry me.