What do you do if you have an injury resulting in low back pain? As a society we have been conditioned to take something for it. Most commonly it is an NSAID (non-steroidal anti-inflammatory) which include: Aspirin, Ibuprofen (Advil or Motrin) and Naproxen (Aleve).
Several new studies summarized in May 2022 from the American Society for the Advancement of Science suggest this is the wrong approach. It turns out that a significant amount of people who take NSAIDs have a higher risk of developing chronic pain. Inflammation appears to be necessary in our body’s healing response so that acute pain doesn’t become chronic. No one knows why yet, but it is postulated that the more inflammatory cells in the blood after an acute injury, the less chance from chronic pain. Inflammation appears to be an important component of the healing process. NSAIDs arrest the production of inflammatory cells
By most definitions chronic pain is pain that last more than 6 months. This is an important finding since chronic back pain is prevalent and costly in the US. About 20% of Americans have chronic back pain which leads to around $300 billion in annual healthcare costs. Not to mention what happens to the chronic pain suffers quality of life
In one study in England, those who took NSAIDs for acute back injury had almost twice the likelihood of developing chronic pain than those who took acetaminophen (Tylenol) which is a pain reliever which is not anti-inflammatory. It would be nice to say the take away from this study was to switch to Tylenol rather than take an NSAID, but Tylenol has its side effects also, it just reduces the risk of developing chronic back pain.
So what should you do if you have an acute back injury? First of all, remember that pain is you body’s way of saying something is wrong. Masking (or dulling) symptoms with pain meds does not get rid of the cause of pain, it just masks symptoms which increases the risk of you doing more harm, or injury, to your body. Like the warning lights in your car dashboard, ignore it and you may be in for some major repairs. Pain is like the engine light in your car. It goes off when something is wrong. Taking pain meds is like reaching under the dashboard and cutting the wires. It doesn’t fix the problem, it masks the symptoms.
What do you do after an acute back injury causing pain? I personally am a big fan of ice. You can’t have pain without inflammation. Ice is a very safe and effective way to reduce inflammation and thus pain. Ice lately has gotten a bad rap and there are some who question the validity, but I think that is because it is not being applied correctly. The best way to ice is 20 minute on, wait an hour and repeat. Icepacks put directly on the skin can freeze the skin. To be effective the ice must penetrate and the best way to do that is with a damp paper towel.
There are some natural products that also have pain relieving properties which do not have side effects. They work in different pathways to modulate the pain. Some of my favorites include turmeric, ginger and boswellia. Metagenics has a wonderful product called Inflavonoid that includes all three (3). I use as needed to reduce inflammation and reduce pain. More recently I have also added Specialized Pro-Resolving Mediators (or SPMs), which is the anti-inflammatory component of fish oils. SPMs have no side-effects and reduce inflammation and speed up healing. Which are better? It depends on you and your biochemistry, because we are all unique.
There are also topical products which can “distract” you from feeling pain and may also have their own healing benefits. These products include, BioFreeze, CBD creams/lotions, and a new product made in Massachusetts called Sore + Tired, which is touted as an Epsom Bath in a tube. I use all three!
So what is the take away? If you are in pain, or have an acute injury, think twice before taking an NSAID because it increased the risk of your pain syndrome becoming chronic. Tylenol and other classes of pain medications relieve pain, but have side-effects, so take with caution. Listen to your body and if you are in pain, your body is probably telling you to rest so as not to cause more injury. Lastly there are alternatives to pain meds which are proven effective without any side-effects.
If you have pain, or an acute back injury, best to contact your chiropractor who will get to the cause of the pain and provides physical treatment without any side-effects.
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