Taking Ibuprofen for a bad back may actually prolong the pain, new research suggests.
Researchers found Brits taking such nonsteroidal anti-inflammatory drugs (NSAIDs) were 76% more likely to see the pain last for more than three months than those taking paracetamol.
They suspect the inflammation that pills such as Ibuprofen dampens down actually has a protective effect that helps resolve back pain.
Scientists say large human clinical trials should now be launched to confirm the theory and warn against avoiding NSAIDS altogether.
Lower back pain is the most commonly reported form of chronic pain, and results in massive economic and medical costs each year for patients and society.
Author Dr Luda Diatchenko, of McGill University in Canada, said: “The highest revelation to me was that we always think of pain as some active pathological process happening to us.
“But looking now at the data, it’s the opposite. It’s an active adaptational process that’s happening in people who resolve pain, and having chronic pain is the absence of it.”
The team followed 98 patients who suffered with lower back pain. Those for whom it resolved within three months had a highly active inflammatory responses, driven by neutrophils.
They then analysed the UK Biobank database of 500,000 participants and found a 76% higher risk of lasting pain than in those taking pain-relieving but not anti-inflammatory drugs.
A third study involving mice found anti-inflammatory drugs prolonged pain in the long term.
Prof Blair Smith, of Dundee University, said: “This is excellent science.
“This excellent group of researchers not only found that factors associated with the normal inflammatory response were likely to protect people with acute back pain from transition to chronic back pain, but also tested the hypothesis by seeing if artificial reduction of inflammation led to prolonged pain in mice, which it did.
“They then tested whether drugs known to dampen inflammation were associated with long-term pain in humans, which proved to be the case.
“The theory is that inflammation may have a protective effect in the long-term, and that overly reducing inflammation may be harmful.”
The NHS says back pain is very common and usually improves within a few weeks or months.
As well as Ibuprofen, it recommends cold compression packs, hot water bottles and says sufferers should try to remain active and continue daily activities.
Dr Franziska Denk, senior lecturer at King’s College London, said: “How exactly inflammation impacts chronic low back pain is a crucial question, and the authors are to be commended for generating a big dataset in this space.
“This study is a wonderful start to providing an answer to this question, but it now needs to be replicated and further investigated by other scientists.
“It would most definitely be premature to make any recommendations regarding people’s medication until we have results of a prospectively designed clinical trial.
“In my opinion this study should not generate a debate around the use of NSAIDs in low back pain – much more research is needed to confirm these findings first.”
