New Side Effects of Popular Medicines Discovered: Anti-Inflammatory Drugs Could Cause Chronic Pain

New research from McGill University reveals blocking inflammation may lead to chronic pain.

Findings may change how we treat acute pain

Whenever you have a headache, your back hurts, your arthritis flares up, or you have a fever, odds are you will be taking some anti-inflammatory medicine. NSAIDs, or nonsteroidal anti-inflammatory drugs, are the most prevalent form of anti-inflammatory medication. According to the American Gastroenterological Association, nearly 30 million Americans take them every day to ease pain or discomfort.

The most common types of NSAIDs include aspirin, ibuprofen (commonly referred to as Advil), and naproxen (known by the brand name Aleve and Naprosyn). However, despite their popularity, these medicines can have side effects.

According to McGill University and colleagues in Italy, using anti-inflammatory drugs and steroids to treat pain may increase the risk of developing chronic pain. Their findings call into question traditional pain-relief methods. Normal recovery from a severe injury involves inflammation, and medicines that prevent that inflammation may result in more difficult-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.

The difference between people who get better and don’t

In the study published on May 11th, 2022 in Science Translational Medicine, 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 the 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.

Blocking neutrophils in mice increased pain duration by up to tenfold. Anti-inflammatory medicines and steroids such as dexamethasone and diclofenac had the same effect, despite being helpful against pain early on.

These results are also corroborated by a separate study of 500,000 individuals in the United Kingdom, which found that those who used anti-inflammatory medicines to alleviate their pain were more likely to have pain two to ten years later, an effect not observed in people who took acetaminophen or anti-depressants.

Reconsidering standard medical treatment of acute pain

“Our findings suggest it may be time to reconsider the way we treat acute pain. Luckily pain can be killed in other ways that don’t involve interfering with inflammation,” says Massimo Allegri, a Physician at the Policlinico of Monza Hospital in Italy and Ensemble Hospitalier de la Cote in Switzerland.

“We discovered that pain resolution is actually an active biological process,” says Professor Diatchenko. These findings should be followed up by clinical trials directly comparing anti-inflammatory drugs to other pain killers that relieve aches and pains but don’t disrupt inflammation.”

Reference: “Acute inflammatory response via neutrophil activation protects against the development of chronic pain” by Marc Parisien, Lucas V. Lima, Concetta Dagostino, Nehme El-Hachem, Gillian L. Drury, Audrey V. Grant, Jonathan Huising, Vivek Verma, Carolina B. Meloto, Jaqueline R. Silva, Gabrielle G. S. Dutra, Teodora Markova, Hong Dang, Philippe A. Tessier, Gary D. Slade, Andrea G. Nackley, Nader Ghasemlou, Jeffrey S. Mogil, Massimo Allegri and Luda Diatchenko, 11 May 2022, Science Translational Medicine.
DOI: 10.1126/scitranslmed.abj9954

Chronic PainDrugsInflammationMcGill UniversityMedicinePopular
Comments ( 47 )
Add Comment
  • M Tefft

    I was told this from my Pain Management Doctor. He told me that a study was done at a VA clinic using two control groups, one was given narcotics and the other was given placebos. The control group using the narcotics claimed about increased pain as well as not being able to completely control their pain whereas the placebo control group reported less pain and better pain control.

  • G. Kaissieh.

    Just looking for excuses to not help people. If you have several kinds of arthritis you should be able to get your pain meds without this continual b.s. and at the strength needed.

    • LTR

      I wholeheartedly agree with you! Everyday countless ppl suffer needlessly due to being in pain, makes one wonder where empathy and compassion have gone. I have 2 types of arthritis (RA, OA), progressive MS, as well as other illnesses, pain is my constant companion. The truth remains that ppl should not have to suffer. I’m not even 40 yet, can’t imagine living in this misery for another 5 years.

  • Ryan

    So this study is in regards to acute pain from a single injury. How do NSAIDs play an effect in repeated injuries and chronic pain? Say if you spent a career in the Infantry and now have osteoarthritis in all of your major joints and spine. Is taking NSAIDs prolonging my chronic pain and recovery?

  • Nat DR.

    I would be highly suspect of such a statement especially considering it’s origins. Personally I hate narcotics due to side effects but it’s been common knowledge for decades NSAIds have far more detrimental long term side effects starting with the destruction of one’s intestinal Flora which leads to a whole Cascade of maladies. But just like COVID farce Big Pharma Money always wins.

    • Gerard

      Covid is a farce? That statement negates anything medical you have to say.

  • Kathy

    We’ll, I’ll remember that when I’m hurting

  • Heather

    And this is why I make my own pain relief from natural ingredients (nothing human-made) that do not create dependency, are effective, promote long term relief, are usually all organic, and I know every single ingredient and where it comes from.
    I also avoid or severely limit those foods that are pro-inflammatory for me…we all have them and would be better served by learning what those are for ourselves. The impact of avoiding pro-inflammatory foods is incredibly impactful on pain avoidance – a superior option to pain relief.

    • Sonjs

      Interesting…how do I find that out

  • Derek Kantosky

    BULL CRAP!

  • Pam Beaty

    Taking NSAIDS for 20 plus yrs for arthritis and fibromyalgia has caused me to have Stage 3 Liver Fibrosis and if I can’t reverse it then I’ll have to have a liver transplant and could die from it. DON’T TAKE NSAIDS!!

  • Mark P Behar, PA-C

    Perhaps another reason to always start with acetaminophen (Tylenol) but no more than 3 g per day (two 500mg tabs three times a day). (Lots of over-the-counter cough & cold meds also contain acetominophen; taking a total dose of 4g or more per day can cause liver failure!)

  • Joe

    These caused a UTI. I felt a tingling sensation only while I used it, Naproxin, so I stopoed. Weeks later I needed help w pain, thats when the UTI occurred.

  • Laura

    M Teft this article has nothing to do with narcotics. It is referring to the famous Ibuprofen and Tylenol we are always told to take for pain.

  • Wmr

    I done believe that study.

  • Sue

    Anti- inflammatory drugs also keep down inflammation so cytokine storms are not as bad.. Strange that they’re coming up with this in light of the plandemic and all the inflammation that goes with it.

  • Theresa

    My doctor refuses to believe me that OTC Tylenol constipates.i have osteoarthritis multilevel degenerative disc disease and just found scoliosis of middle spine and neck.she told me to up tylenol to 4 a day for pain. I did that a week later bowels stopped for 5 days on the 6th i then took 4 ducolax pills plus 3 Magnesium pills it took 3 more days before my bowels moved I told her week in phone call only what happened she still said to me NO tylenol does not do that I told her I’m not gonna risk a bowel obstruction to take tylenol which didn’t help with pain . She then 3 weeks later phone call only said she give me script for Naproxen but advised could have stomach problems and bleeding. I’m like omg I already have major stomach problems now seeing a Gastroenterolgy specialist now .Needless to say went get to get prescription she did not fax prescription to pharmacy.I don’t think my doctor really know what pain for seniors is like I’m 74 yrs old it’s dam cruel .Now I gotta start over with her I refuse to take tylenol now my bowels are moving properly again. Geez their is no geriatric care in Ontario

  • Kat

    Narcotics are NOT NSAIDS people! .

  • Kristal

    This article is very interesting. I am noticing less chronic pain since I was told not to take NSAIDs anymore and only take tylenol. The pain I’m having from a shoulder injury though is taking forever to go away and the tylenol doesn’t seem to help it??? The pain from it is in my arm.

  • Natausha

    I’ve had chronic pain since 16 years old. Tylenol doesn’work for me, narcotics make me too ill, and NSAIDS kinda work. Ive been on so many meds to help and none do. Ive seen surgons they tell me there is nothing they can do. Ive had trial implant devices dont work. What do u suggest for a person like me??? And Im only 40 now.

  • Eileen Shea

    Just another excuse not to treat a person’s pain. NSAIDS are dangerous in the long run damaging kidneys with long term use. I’m suffering every second of everyday with widespread bone, joint and muscle pain. What did my NPo do? She cut my pain meds by one third in one capricious move after being on them for 38 years. Now I don’t get out of bed at all. I went into withdrawal and my daughter told me I tried to stab her and jump out of the window. I don’t remember this. I pray for death.

  • Eileen Shea

    Just another excuse not to treat a person’s pain. NSAIDS are dangerous in the long run damaging kidneys with long term use. I’m suffering every second of everyday with widespread bone, joint and muscle pain. What did my NP do? She cut my pain meds by one third in one capricious move after being on them for 38 years. Now I don’t get out of bed at all. I went into withdrawal and my daughter told me I tried to stab her and jump out of the window. I don’t remember this. I pray for death.

  • Alexis Preisser

    Am so sick of the government sticking their nose where it doesn’t belong! Bureaucrats are mostly ignorant louts trying to take away medications needed by people suffering from severe pain because modern parents suck at parenting and their kids are drug addicts! They will still get their claws on drugs but why should we suffer because people are idiots and want to get high and we don’t wish to suffer? Get medications back to those of us who want a pain free life!

  • Jay

    Side effects are not new. Even if they aren’t known, or aren’t shared with the public, they’re still there.

    I have Osteogenesis Imperfecta, and my first major injury was at age 3. I’m now 43. I’ve been taking pain medicine in some form for 30 something years. Zero health issues from it. Ibuprofen, more than any 10 people likely. Percocet, Vicodin, all of it, all my life. Except of course, the last couple of years, after doctors got too scared of the federal government, and abandoned me completely. The ONLY side effect I care about, is stopping pain. The rest, just things people who should mind their business use to try to control my life, as a scare tactic. It works, I’ll give them that. Doctors simply are too afraid to help someone like me anymore. For years, doctors told me all they can do for me, is to control the pain, so I can have a life. That has been taken from me, because s tiny percentage of people abuse their prescriptions. Personally, in my entire life, I have never once had an issue with addiction. I’ve been praised for turning down secondary pain medicine prescriptions, and increases on my dosages. Now, that’s all gone. And, I’m on probation, because after I turned to buying them off the street, after being left with no choice, I got arrested. My first, ever.

  • Barry Crowe

    Aleve caused irreparable damage to my GI tract. Because it worked on the pain I kept taking it. The stuff got me hospitalized and now I cannot eat chocolate, tomato sauce, or drink coffee or orange juice. To some, Aleve is dangerous stuff.

  • Sheryl Askins

    I’ve always been told NSAIDS during acute pain (up to 2 weeks) was fine. Even short term narcotics/opioids (up to 3 days) after a severe occurrence was recommended. Things are changing. The opioid crisis is accelerating that change. In today’s society, we are on the move constantly. We need pain treatment that is quick and sustainable. Our jobs don’t allow us time to rest so that the inflammatory response can do its thing. Who has time for warm soaks, moist heat, PT/OT, massages, etc when you have a whole family depending on you and a life to live? I guess we’d better make some time. Apparently, we’d better make time if we want to live.

  • Dave

    I’ll stick with Scotch

  • Jennifer

    I am 39 and was on pain medication for about 18 years. Also have taken nsaids my whole life. All pain meds made my pain worse. I was diagnosed with non alcoholic cirrhosis of the liver. My Dr always told me to use nsaids or pain medication, not Tylenol. Now after almost dying of sepsis in the hospital, the doctor said no pain medication or nsaids. Tylenol only!!! Up to 3grams a day. Now I only take Tylenol and my chronic pain is pretty much gone, very little. But I also think that some people do need their pain medication. Some people have conditions that if they don’t have their pain medication they cannot do their activities of daily living. Doctors are doctors. Politicians are not doctors.

  • D

    Hmm. Let’s see, degenerative disc disease, scoliosis, spondolysis,2 back surgeries, 5 car accidents, over 30 years of home cleaning business, 3 broke ribs 2 broken ankles, and more. Government continues to impose on me what I should or should not be taking for pain. Step inside my body for one day and then propose to me what I can or cannot take for pain. Thousands of people who suffer from pain of different levels of pain, some even die from pain. Stop the nonsense and get to the rea problem and help treat there needs.really, the ama and government needs to really do studies of pain and not just what drugs you think it will cure. Enough is enough !

  • Sadie

    Such BS! They get ppl addicted to narcos. Now we can’t use Advil. The ppl with real pain needs are never heard. Multiply that by 10k if your a black female!

  • Kris

    I’ve been taking 800 mg I rip for Years and have only recently been having trouble with my doctor wanting to prescribe it to me. She did give me a 3 month refill but added a lower dose acetaminophen to take in-between. Hopefully it will still help because I do have chronic pain and don’t want the stronger addictive pain meds.

  • Don

    I use Ibuprofen because it is the only thing that works for me. Acetaminophen is totally useless for my pain and even fever reduction. Also, it is responsible for 48% of all liver failure in the U.S. If it you find that it reduces pain, you are rare and lucky. I don’t know what else to use. Maybe a mind over matter treatment like acupuncture but I took Chinese martial arts when I was younger and don’t think that Qi(chee) flow is a real thing. So that is out!

  • Maria

    I go to a doctor that deals with reason for the pain. Changed my food intake substantially. Before seeing her, I was told by my 3rd neurologist that I need a “pain management “ doctor. No pain meds for me! 2 years pain free.

  • Vic

    Look folks mankind does not have a answer to your problems. You are screwed. We are not developed enough to solve our medical problems. All we can do is Just try to mask the sythems with the cost of the side effects

  • Paigey

    This research based article seems to make sense, or be logical; however, all the comments made me sad. Chronic pain and getting old both just suck, and it just seems that taking any man-made pain killer (when or if they even help) is often just trading one painful problem/issue for another. I do thank God for modern medicine though. I will never put my total reliance or trust in it though. Hang in there my fellow humans. Move as much as you can, eat sensibly, and look for the good things in life that bring joy. God bless.

  • Gail E Triglia

    If you took bromaline and curecumin 3 times A-day You would take a lot less of anti flammatory drugs and no need for Tylenol they Are painkillers too And Anti-inflammatory They won’t hurt you try it you will like it

  • Jerome Loew

    This is why you should use opiates because they absolutely kill pain. I’ve been on low dose morphine sulfate for years now & the only side effect is sometimes constipation. I’ve not taken any for a couple of days for various reasons over the years & never had any withdrawal. Opiates are by God, they’re natural & specifically for pain. Doctors by forcing many people to live on crap like Tylenol & ibuprofen have been hurting their bodies needlessly because they all jumped on the no more opiates bandwagon. Thankfully I have an intelligent & free thinking doctor of 61 years old & a wealth of experience, knowledge & because of that lots of common sense.

  • This is me

    Hydroccodone and oxycodone should be sold OTC (over the counter). This would cut down on doctor shopping, insurance problems and buying these medicines on the streets. If you are in pain… you need ’em you got ’em.

  • Kim

    Narcotics are not anti inflammatory drugs. Unless there combined with one.

  • Diane D'aoust-simonds

    Sometimes you no choice and need to keep moving to perform your job duties and an anti-inflammatory allows you to do that!

  • CT61

    Nsaids are evil. I take ibuprofen occasionally, but too often it causes fluid retention and BP elevation. I know three people in kidney failure frome Aleve. My career has had me on my feet up to 10 hours a day for 42 years. I have arthritis in my feet, back, and knees. Thank God a have a defiant Dr who will still provide a light pain med Rx which I take in conjunction with acetaminophen every day. It keeps me moving. Working and fairly active. I’m uninsured so expensive therapies and surgeries aren’t an option. Being self employed means no time off either. I agree that it’s f’ing ridiculous that everyone is being punished for bad parenting and greedy corporations. Find another scapegoat and let responsible adults use the meds that keep them moving. I’m horrified to hear of so many in so much pain who can’t get help controlling it when they’ve proven themselves responsible with it.

  • Kimberley Guerne

    I have multi level degenerative disc disease, bulging disc’s, ruptured disc’s, stenosis, RA,OA, torn labrum on both sides, and neuropathy. The pain I endure is, well…there are no words to describe the depth of excruciating pain some days are. The pain has made me a different person. I have a VERY restricted life because of the pain. I am on narcotics which do help some. I am just tired of being treated like I am shooting heroine for a high. My family doesn’t do that but strangers want to judge me. That hurts. I have literally had one thing after another ripped away from me since 2014. There are more and more things I can’t do for myself. To top it off my narcotic is affecting my ability to think. The simplest words escape me some days. However the pain FAR out weighs the side affects. Darned if take them darned if I don’t. I can’t even sleep in my bed anymore because of the pain. I sleep in the recliner in my living room where all the hustle and bustle is going on. So I am sleep deprived. If I was offered my old life where I had to work, but there would be no pain and I couldn’t have medication I would jump so hard and fast on that offer it’s not even funny. What a beautiful dream.

  • Michael Kennedy

    The premise of this seem wrong. People are taking OTC pills because their chronic pain has started. So of course they go on to experience the full amout of chronic pain later. People who are not experiencing increase pain levels don’t take a lot of OTC because they are in an uncomfortable amount of pain. It seems to me the entire subject of chronic pain relief is going off track. I think a large number of these studies are biased, perhaps unintentionally.

  • Mel Stout

    I took various nasaids by themselves or in combinations to address pain. Finally they all quit working. Went to Doc found out I had bulging disks, scoliosis in lower back, bulging an broken disks in my neck. During surgery 4 bone fragments found in my spinal canal. And I thought it was a bad pillow. Felt great (and taller) for 1-2 years, working desk job. Then pain returned, doing 5 10mg vicodon or more per day. Could not keep thoughts straight. Finally I went on disability (surprised got approved 1st time) it took about a year. Now, 3-4 5mg Vicodon (less than 1/2 previous amt) sometimes 1-2, varies. BUT I do absolutely nothing physically. If I mow the lawn, I am in pain the next few days. Doc is OK, but still throws the OPIOID scare at me. Have to go in every 2mo for eye test to see if I’ve become a Addict. By the way don’t grow your hair out if you’re a man, it’s a sign of addiction per the government guidelines. Break-a-Leg all.

  • Mr m

    I have been suffering from lower back pain for 25 years,and when l turned 54 started to take a keto diet serious.After 6 months l lost 45 pounds,my head fog cleared up ,vision improves,and most important my backpain went from a 8 to almost not even noticing it.The main components in my diet that l dropped we’re sugar and wheat products, processed foods,and hydrogenated oils.The change has been awesome,l feel like a different person altogether.l also realize that this may not work for everyone since we’re all different,but it worked for me.

  • Connie

    Get your joints replaced! Osteoarthritis does not repair itself. The cartilage continues to disintegrate, and if I’m correct, no significant or appropriate replacement for deteriorated cartilage has been discovered yet. Suffer, if you want to, as your OA takes over your body. Or, as I have done, when the pain became intolerable and limiting to my movement, I replaced the diseased joints. The first one was done 21 years ago. I have had absolutely no problems with any of them. That includes pain. I will occasionally take Norco when I have overworked my back by doing things outside or in the house. Yes, I have severe scoliosis, degenerative disc disease and stenosis. But I have never been comfortable with NSAIDs and Tylenol. The Norco works fine and relieves my pain. I take it no more than three or four times a month. I am much less active than I used to be, but at 82 years old, I will have no intervention for my spine. Including physical therapy. I just try to limit my activity that causes stress on my spine. The six other joints are perfect.

  • Fxb

    I see a lot of angry pain med ADDICTS illogically ranting against scientific findings. Ok ADDICTS we get it you need your fix and this threatens the very core your life revolves around… your daily pill popping.