ANTI-INFLAMMATORIES & STEROIDS LINKED TO CHRONIC PAIN
                     ANTI-
INFLAMMATORI
ES & STEROIDS 
LINKED TO 
CHRONIC PAIN
http://www.virtualphysicaltherapists.com/
Taking anti-inflammatories such as ibuprofen and steroids for 
pain relief may increase your chances and are linked to 
developing chronic pain!
When you sustain an injury or infection, the body responds by releasing chemicals to 
clear and clean the area. This initial stage of healing causes swelling, increased 
warmth, and discomfort and is known as the inflammatory stage. Currently, the 
medical protocol would be to recommend anti-inflammatories to decrease the pain 
and swelling, and if the symptoms are significant, a 5-day steroid pack.
New research has shown that blocking inflammation with drugs can lead to harder-
to-treat chronic pain. Taking anti-inflammatories and steroids was linked to chronic 
pain. Researchers in this study examined pain mechanisms in both humans and mice. 
They found that ‘neutrophils’ play a key role in resolving pain. Neutrophils are a type 
of white blood cell that has a broad variety of functions that include: the release of 
inflammatory mediators, fighting infection, removal of debris, and much more.
Inflammation plays a crucial 
role in resolving pain.
Neutrophils are the most abundant type 
of white blood cells. In healthy adults, 
they typically constitute about 50 to 70 
percent of white blood cells and function 
as innate immune cells. They are the first 
line of defense against bacteria and other 
foreign organisms. Neutrophils respond to 
inflammation and fight bacteria mainly by 
their swallowing function (phagocytosis). 
They also release powerful chemicals that 
help with tissue healing after injury.
Opposite to our current understanding, pain resolution is an active biological 
process in which the inflammatory process uses neutrophil cells to stop the pain 
process. Taking anti-inflammatories and steroids are linked to developing chronic 
pain because they interfere with the healing process.
It is DANGEROUS to interfere with 
the INFLAMMATION process.
Neutrophils dominate the early stages of 
inflammation and set the stage for repairing 
tissue damage. Researchers found that when 
those with acute pain had a higher 
percentage of neutrophils, they were 
protected against chronic pain development. 
Inflammation occurs not only to clean and 
repair wounds but is also critical in reducing 
pain as the injury heals.
 NSAIDs increased the risk of continued back pain 2 to 6 years later.
 Experimentally blocking neutrophils in mice prolonged the pain up to 10 times 
the normal duration.
 These findings are also supported by a separate analysis of 500,000 people in the 
United Kingdom that showed that those taking anti-inflammatory drugs
 to treat their pain were more likely to have pain two to ten years later.
Acute pain does not build in a progressive process to become chronic. Instead, it is 
an active biological process causing changes to occur in genes that results in the 
subsiding of pain.
Instead of Medicating, Proper Pain Treatment MUST Start with 
Identifying the Type of Pain: Chemical,   Mechanical,  Thermal
 Mechanical Pain
Mechanical Pain occurs when stress is placed on a joint or 
soft tissue, such as when you bend your finger all the way 
back. If you go back far enough, you will feel pain. As soon 
as you release, the pain immediately abates. There is no 
injury or damage to the tissue. Bending your finger 
backward produces mechanical stress that causes pain. 
Movement in opposite direction relieves the pain. 
Mechanical pain is usually intermittent, but it can be 
constant as when the stress is constant – holding your finger 
backward.
When you have pain that comes and goes or changes with 
different movements and/or positions, it is mechanical.
 Chemical Pain
Chemical pain is caused by the body’s 
inflammatory response to injury. It is a complex 
chemical reaction and occurs to aid the initial 
repair of tissue damage by releasing chemicals 
from the blood, fibroblasts, and local 
macrophages to clean up the area and start the 
healing process. An example of chemical pain 
would be hitting your thumb with a hammer or a 
toothache.
Chemical pain is described as throbbing, constant, and does not change with 
movement. Pain that comes and goes cannot be chemical. Back pain that is 
worse with sitting and bending but a bit better with walking is not chemical or 
inflammatory pain. It changes with movement and will not respond to chemical 
treatments such as anti-inflammatories and muscle relaxers. Inflammation can be 
uncomfortable, but it is part of the miraculous natural healing process. It usually 
lasts only a few days. Symptoms of a localized injury that continue after a few 
weeks result from re-injury / re-tearing of poorly healed tissue or unresolved 
mechanical problems.
Treatment Differences Between Mechanical & Chemical Pain
Mechanical pain only responds to a mechanical 
treatment or a CHANGE of position or movement. 
Mechanical treatment must therefore be targeted to a 
specific joint or tissue to change that tissue’s current 
position or property. An example of a mechanical 
disorder would be a shoulder dislocation. A dislocation 
is very painful and requires heavy narcotics to mask 
the pain for relief. But, if you can relocate the shoulder, 
90% of the pain is instantly resolved because the 
mechanical stress or dislocation is resolved.
Chemical pain is the result of the inflammatory 
process. The body releases chemicals to clear and 
clean the area to begin the healing process. This initial 
stage of healing causes swelling, increased warmth, 
and discomfort.
Medications can assist in decreasing the swelling and pain, BUT the inflammatory 
process has a vital role in cleaning the area and properly initiating the healing 
process. Our goal should be to manage this phase, NOT stop it.
Differentiating between pain caused by a mechanical or a chemical stimulus is 
critical. To get relief, you must first know if you need to remove mechanical stress 
or an inflammatory component. Chemical and Mechanical pain are different, and 
so are their treatments.
Only a correct diagnosis will produce the proper treatment and outcome.
VIRTUAL 
PHYSICAL 
THERAPISTS
[email protected]
HTTP://WWW.VIRTUALPHYSICALTHERAPISTS.COM/
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