Discovery reveals blocking inflammation may lead to chronic pain Findings may lead to reconsideration of how we treat acute pain Date: May 12, 2022

hapl808

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Very interesting. I wonder if the treatment of inflammation in chronic vs acute should be totally different. And how it applies to us. The PEM headaches I get feel like neuroinflammation and can improve with anything from ibuprofen to even boswellia or resveratrol or other cox-2 inhibitors. But I've always tried to avoid taking NSAIDS for concerns about long term damage, even before some of the links with cardio health were known. I've wondered though at the possible long term effects from supplements since there's no guarantee that those methods are safe.
 

Pyrrhus

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Acute inflammatory response via neutrophil activation protects against the development of chronic pain (Parisen et al., 2022)
https://www.science.org/doi/10.1126/scitranslmed.abj9954

Abstract:
Chronic pain can develop from an acute pain state. The mechanisms mediating the transition from acute to chronic pain remain to be elucidated. Here, Parisien et al. focused on the immune system using samples from patients and animal models. Transcriptomic analysis in immune cells from subjects with low back pain showed that neutrophil activation–dependent inflammatory genes were up-regulated in subjects with resolved pain, whereas no changes were observed in patients with persistent pain. In rodents, anti-inflammatory treatments prolonged pain duration and the effect was abolished by neutrophil administration. Last, clinical data showed that the use of anti-inflammatory drugs was associated with increased risk of persistent pain, suggesting that anti-inflammatory treatments might have negative effects on pain duration.
(emphasis added)

Related discussion:

Anti-inflammatories may reduce symptoms in the short-term, but may not in the long-term
https://forums.phoenixrising.me/thr...hort-term-but-may-not-in-the-long-term.80492/
 

heapsreal

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Acetaminophen? Not sure what else.
I only saw the end of it on the news here in Australia but they want to reduce the packet size of acetaminophin/paracetamol to 8 tablets and only 1 box at a time. I think they mentioned it should be moved to a prescription item. I know within the last week there was a push on the news about making antihistamines prescription only. It wont be long and they will be controlling our food intake as we stand in line for dinner.

So many helpful otc medications have been made prescription items here in the last few years and they wonder why our Emergency Departments are full and ambulances ramped at hospitals for hrs. People don't even have access to simple medications to treat minor issues. Instructions on the box are there on how to use them. Sorry for the rant.
 
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Acetaminophen? Not sure what else.
This older paper describes several:

Non-NSAID pharmacologic treatment options for the management of chronic pain

Am J Med: 1998 Jul 27;105(1B):45S-52S

Excerpt:

" Several non-NSAID, non-narcotic therapies are available for noninflammatory pain. Acetaminophen is as effective as NSAIDs for the management of mild-to-moderate OA pain and is the recommended first-line therapy by the American College of Rheumatology (ACR). Propoxyphene, widely believed to be safe and effective, may, in fact, be no more effective-and perhaps less effective-than acetaminophen or ibuprofen. A relatively new analgesic, tramadol, appears to be a useful therapy for patients who do not receive adequate pain relief with acetaminophen and are at risk for NSAID-related side effects. For localized chronic pain associated with OA, topical capsaicin is also an effective analgesic."
 

Wishful

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I think they mentioned it should be moved to a prescription item.
Let me guess: the lawyers can easily pull statistics on the number of cases of harm from abusing these drugs, but can't get reasonable figures for the number of people helped by easy access to them. Profits may also play a role, as they can charge more for prescription drugs. :grumpy:

Instead of trying to make the world safe for fools, how about improving schooling to make citizens less ignorant/unwise?
 

heapsreal

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Let me guess: the lawyers can easily pull statistics on the number of cases of harm from abusing these drugs, but can't get reasonable figures for the number of people helped by easy access to them. Profits may also play a role, as they can charge more for prescription drugs. :grumpy:

Instead of trying to make the world safe for fools, how about improving schooling to make citizens less ignorant/unwise?
I think your right. I know alot of people who use to manage their chronic pain issues with otc low dose codeine/paracetamol meds. Chemist have a register to put your name down and if overuse is an issue they'd notify your dr. But even this wasn't enough and it got banned because supposedly everyone was becoming addicted. But now these people who use to use mild medications are now on stronger pain meds from their dr but apparently addiction isn't a problem.

The world's gone mad. Too many organisations/govts trying to control every aspect of our lives and people should have personal responsibility. There's alot of people with chronic pain conditions that can't get treatment as well because their drs don't believe fibro, back pain etc etc is real. There's much more of these people than those who are trying to get high. If they want to get high, that's their personal responsibility. Not that I've seen anyone high on otc codeine/paracetamol, the paracetamol would kill you before you got any sort of high from codeine. Plus codeine has a ceiling effect where at 60mg more codeine doesn't do anything, there's a limit to converting it to morphine in your liver. Why it was originally over the counter because it was safe.

I believe alot of these govt controls are pushing things underground and or all these politicians have shares in medical cannabis, so running out the competition for pain management and then places where it's not already legal, it will be legalised. Follow the $$$ .

I guess it pisses me off has its getting harder to see a Dr for many and alot of drs don't give a crap. If someone has a chronic condition they are seen more as a nut job than someone who is struggling and in pain.