TRIAL VERSION | March 20, 2024 | Dear Reader, Are you or a loved one dealing with the daily challenges of arthritis and chronic pain? We understand the impact these conditions can have on your quality of life, and we're here to provide you with the latest findings and helpful insights. Our Arthritis and Chronic Pain Newsletter is a subscriber-exclusive newsletter. It is your trusted resource for staying up-to-date on cutting-edge research, effective treatments, and practical lifestyle adjustments that can offer relief. With a team of experts dedicated to sharing knowledge on herbs, exercises, therapies, and daily habits, we're committed to empowering you with the tools you need to take control of your well-being. If you find this sample newsletter informative and useful, sign up with 1-click to receive future editions every Wednesday. | Anti-Inflammatory Drug Might Lead to Chronic Pain, While Inflammation Could Heal: Experts | Doctors have recommended nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to relieve acute inflammation for decades. But does short-term relief—and interfering with the body's natural healing process—come at the cost of chronic pain? Pain from a minor injury, such as a sprained ankle or thrown-out back, often resolves on its own. But for some, acute pain lingers, becoming chronic. "[The] standard medical care for this type of pain is probably making matters worse, is what the research suggests," Jeffrey Mogil, a neuroscientist at McGill University, told The Epoch Times. | Early-Stage Inflammation Prevents Chronic Pain Injuries trigger inflammation for a reason, and researchers are working to understand it better. One study, published in Science Translational Medicine, focused on 98 lower back pain patients over a three-month period. During that time, half of the volunteers fully recovered, while the other half developed chronic lower back pain. Using RNA sequencing, the researchers compared the activity levels of immune cells between both groups. They discovered that neutrophils, immune cells that feature prominently at the onset of the inflammation sequence, play a role in remaining pain-free. Neutrophils help the body to fight infection and repair tissue damage. According to the researchers, those in the chronic pain group started with less inflammatory neutrophil activity and later had little to no activity in the cells that create inflammation. In contrast, the genes of the recovered patients were very active with inflammation-related cells. "Neutrophils rush in pretty early after some sort of injury, causing a process that ends up preventing chronic pain," said Mr. Mogil, a senior author of the paper, "and you probably shouldn't block it." | Scientists have known that anti-inflammatory drugs inhibit neutrophil activity in people and animals. However, the link to chronic pain had been missed because prior studies did not follow patients long enough beyond immediate pain reduction. "NSAIDs definitely interfere with the process," Eugene Aiello, a chiropractic physician and neurologic researcher, told The Epoch Times. "But not everybody in the chronic [pain] group was taking NSAIDs. More studies are needed to identify what else is preventing the neutrophils from completing the repair process." Recognizing Whether Inflammation Is Good or Bad There are generally two types of inflammation: acute and chronic. To determine whether inflammation is helpful or not, we must understand how these differ. Chronic inflammation is long-lasting and spreads throughout the body. It becomes the problem rather than the solution to infection or injury. It can lead to more serious conditions such as heart disease or even cancer. In contrast, acute inflammation is beneficial—provided that it is robust, short-lived, and site-specific. When a ligament or tendon is strained or torn, it triggers an influx of blood, fluids, and immune cells to the area. | "Swelling is the body's innate wisdom to increase the surface area so that healing mediators can then come into that area," Brandon LaGreca, a licensed acupuncturist who is nationally certified in Oriental medicine, told The Epoch Times. Neutrophils are part of these first responders. Their presence is key to removing damage and debris through lymphatic drainage, setting the stage for damaged tissue to be repaired. Pain and swelling are a clear message that the "paramedics" are at work. Decreasing pain without shutting down the "highway" is critical for supporting the healing process. "If you're injured, one Advil for discomfort or to get sleep is different than taking 800 milligrams of Advil three times a day for three weeks," Mr. Aiello said. "That's when you're likely to have a problem." Mr. Mogil said, "There are ways to block pain without blocking inflammation, and the most well-known of those is Tylenol." But the overuse of Tylenol, or acetaminophen, comes with risks such as liver injury. Reconsidering the Standard Treatment for Acute Pain Based on their initial study, Mr. Mogil and the other researchers hypothesized that inhibiting the body's initial inflammatory response leads to chronic pain. They expanded on the research with a study in which mice with an injured paw were given either an over-the-counter anti-inflammatory drug or saline. Although the mice in the drug group initially showed fewer pain symptoms because their inflammation response was dulled, the pain eventually returned and became chronic. For mice that received saline, the pain subsided in half that time, and they remained pain-free. To see if their hypothesis might apply to humans, the researchers did a separate analysis of patients in the UK. Those with acute back pain who reported taking anti-inflammatories were about 70 percent more likely to have pain two to six years later, an effect not seen in people taking acetaminophen or antidepressants. | While the researchers linked blocking early-stage inflammation to the development of chronic pain, decades of medical orthodoxy will not be overturned by a single study. Clinical trials are needed for that, but the funding for them has proven difficult. Mr. Mogil noted that the findings shouldn't be confused with the use of NSAIDs for chronic conditions, where reducing inflammation is essential. Working With the Body's Natural Inflammatory Response How can you enhance the body's natural healing process, ensuring a full recovery? Traditional Chinese medicine (TCM) has used multiple methods to treat acute injuries for thousands of years. TCM focuses on stimulating circulation to the area of injury, restoring movement and function, and enhancing the body's natural healing process, according to Mr. LaGreca. "We encourage the healing process so that inflammation resolves on its own, as opposed to suppressing it," he said. A combination of approaches that use TCM principles to work with—not against—acute inflammation can be used. Practice Gentle Movement Pain, heat, redness, and swelling can last for one to three days following an injury. While rest is important, too much weakens the body, delaying healing. Rest should be balanced with gentle movement within pain tolerance. "It's injury dependent, but you can cautiously explore range of motion, stretching, and movement immediately," Mr. Aiello said. Gentle range-of-motion movements, including walking and slowly rotating the joints, help to maintain the health of ligaments and tendons by preventing stiffness and promoting circulation. This also helps to move fluid through the lymphatic system. "For example, with an ankle injury, you may not want to walk on it with a lot of pressure," Mr. LaGreca said, "but you can start with gentle ankle rotations." As pain and swelling decrease, careful movement can increase until there is a regular exercise routine. "Putting a small amount of load on the ligament helps new tissue grow back in the right way," Mr. Aiello said. Ideally, this is done with a physical therapist or sports trainer. Studies have shown that exercise and other physical therapies are effective for people with musculoskeletal pain, such as lower back pain. Try Drug-Free Remedies Nutrition can help to provide relief from acute pain. "Your immune response needs fuel from nutrients and lots of antioxidants because the key to overcoming the pain is for neutrophils to help clear the damaged tissues," Mr. Aiello said. "That debris is what's eliciting the pain." Many Chinese herbs can also be applied topically to help with pain, according to Mr. LaGreca. Acupuncture or acupressure on specific points is one of the most direct methods for immediate pain relief that also promotes circulation, increasing lymphatic drainage. Multiple studies have shown that acupuncture effectively treats sports injuries such as strains, sprains, and swollen muscles. One randomized controlled trial published in the American Journal of Emergency Medicine demonstrated that acupuncture is more effective, faster in relieving pain, and has fewer adverse effects than intravenous morphine. Studies on acupressure have shown that applying pressure to stimulate specific points can also reduce acute pain. Acupressure is easily self-administered. Opt for Heat Over Ice From the TCM perspective, heat increases circulation. Mr. LaGreca recommended a warm bath with Epsom salts "to stimulate circulation and help the process along." Cold does the opposite, slowing down movement and impairing the circulation of blood and fluids, he said. "Ice might make you feel better by reducing swelling, but that swelling is there for a reason," Mr. LaGreca said. Dr. Gabe Mirkin, who introduced R.I.C.E.—rest, ice, compression, elevation—to the sports medicine world in 1978, revised his recommendation in 2015. "Both ice and complete rest may delay healing, instead of helping," he wrote. Get Deep Sleep While resting for hours on end isn't recommended, deep sleep is crucial for injury recovery. When the body enters its deep sleep stage, the pituitary gland releases growth hormones that stimulate muscle repair and growth. Growth hormones must be released in greater amounts when the body is healing from an injury. Healing takes time and requires trust in the body's natural process. "We need to do things that encourage that healing process," Mr. LaGreca said. "Mr. Aiello said, "Inflammation isn't always bad. Knowing how to use it to fully heal can prevent longer-term problems." | Thanks for reading! See you next week. | Your Feedback We'd love to hear from you. If you have any suggestions for us to improve, or a wellness story that you'd like us to cover, you can email me at healthnewsletter@epochtimes.nyc
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