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Dr. Jason Winkelmann

The Paradox of Pain: How NSAIDs and Steroids Prolong Your Suffering



In the realm of pain relief, NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) like ibuprofen aleve, and aspirin, as well as steroids, have long been considered go-to solutions. However, a closer look at their impact reveals a paradoxical twist—they may provide temporary relief, but they might also be contributing to the prolonged duration of your pain.


1) The NSAID Conundrum: Prolonging Pain Through Inhibition

A study delving into pain medications discovered a disconcerting truth about NSAIDs—while they can provide temporary pain relief they actually prolong the duration of pain 2 fold, twice as long! The irony lies in conventional medicine prescribing substances that, knowingly or unknowingly (not an excuse in general but especially not for such a well studied drug), worsen the problem they intend to alleviate.


How NSAIDs Make Pain Worse:

Your body, in its wisdom, triggers inflammation as a response to injury or distress. Acute inflammation is a healing mechanism, not a harmful one. It tells your body exactly where to send its resources to help fight the infection or to heal the damaged tissues. The acute inflammatory pathway is also known as the arachidonic acid pathway. NSAIDs are intended to shut down part of the pathway that produces inflammation. More than anything, inflammation is what causes pain after an injury or infection.

During the acute inflammatory response, prostaglandins are released. These chemicals produce inflammation and the symptoms associated with inflammation such as pain, warmth, redness, and swelling. So by halting the further production of these molecules you experience a temporary reduction in pain. Which is why people consume NSAIDs.


However, prostaglandins have a lesser known benefit. They activate lipoxins, a chemical that removes inflammation once the infection has been neutralized or the damaged tissues have been healed. Therefore, acute inflammation does not get removed properly and ends up prolonging pain, on average, twice as long!


2) NSAIDs Aren't The Only Problem

Similarly, corticosteroids, despite providing the same temporary relief, have also been found to extend the duration of pain twofold. Steroids work by shutting down the same acute inflammatory pathway as NSAIDs do, just more effectively. However, corticosteroids are almost always prescribed for chronic inflammation, which they do not affect. This echoes the pattern of conventional medicine prescribing solutions that inadvertently contribute to the persistence of the issue they aim to resolve.


3) Over-the-Counter Caution: NSAIDs and Chronic Pain

The accessibility of NSAIDs over the counter doesn't equate to safety. In fact, a study found that individuals taking NSAIDs for acute back pain are 1.76x more likely to develop chronic back pain! The seemingly innocuous nature of these medications conceals a significant risk—one that may turn acute pain into a persistent, chronic ordeal.


How Acute Pain Becomes Chronic Pain:

NSAIDs so not remove inflammation, they only slow down the production of new inflammation. After an injury or infection, acute inflammation does its job but then needs to be removed. As we've already discovered, NSAIDs and steroids inhibit the removal of inflammation. Acute inflammation that is not removed becomes chronic inflammation. Chronic inflammation is at the root of all chronic pain conditions and cannot be removed by any pharmacological interventions!


So What Can You Do?

The best way to treat acute inflammation is to support the body. Most people have an overactive arachidonic acid pathway due to a high consumption of pro-inflammatory omega-6 fatty acids. The more omega-6s you consume them more inflammation you will produce. An anti-inflammatory diet high in omega-3 fatty acids helps to regulate the arachidonic acid pathway so that it responds appropriately and without releasing an unnecessary amount of inflammation. Fish oil is a wonderful supplement that helps modulate the arachidonic acid pathway. Taking this supplement daily helps keep inflammation in check and can be increased after an injury to further support this pathway. After all, we do not want to completely shut down the arachidonic acid pathway and the acute inflammatory response! They serve an important role in our body. We just want to make sure they are working appropriately. This is where conventional medicine goes wrong and why they don't have an answer for chronic pain.


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