The Problem with Painkillers

The most commonly used over-the-counter medicines for conditions like back pain, neck and shoulder pain, headaches and period pains, to name a few, include paracetamol and ibuprofen (Non Steroidal Anti-Inflammatories).  When these fail to adequately control pain people go to their doctors and may be prescribed stronger NSAIDs, Triptans, Opioids, steroids or even anti-depressants (which are said to be effective for treating pain).  In the most chronic pain cases people will be referred to hospitals and public pain management clinics for surgery and help managing their conditions with techniques such as cognitive behavioural therapy and mindfulness meditation.

But what if painkillers do not adequately help your condition, or you experience unacceptable side effects?  And what about recent question marks regarding the effectiveness and safety of NSAIDs such as Ibuprofen, or paracetamol?  Or concerns about long term use of anti-depressants?

Peter C Gøtzsche, peter-gora co-founder of the Cochrane Collaboration, the world’s foremost body in assessing medical evidence and the head of the Nordic Cochrane Centre, an independent research and information centre disseminating research about the effects of health care, estimates that 100,000 people in the United States alone die each year from the side-effects of correctly used drugs, the worst culprits being, in his opinion, antidepressants and the painkillers such as ibuprofen, diclofenac and celecoxib. Yes, that’s right, even when used correctly they can still cause unnecessary deaths.

And what about surgery? Is it guaranteed to help, and what are the risks?

All of the above might well give you cause for concern or at least make you pause before taking painkillers or anti-depressants, or agreeing to surgery, and rightly so. Not that drugs or surgery are a bad thing, per se.  They’re great when, in the most dire conditions, even the worst side effects pale into insignificance compared to excruciating pain.  But in less dire circumstances its the side effects, addiction and – yes – the sometimes questionable evidence for what they are actually supposed to do that should make you consider very carefully whether they are absolutely necessary and can be taken on a regular basis without doing more harm than good.

Of course, Acupuncture is no panacea either. For severe trauma, advanced rheumatoid diseases, neuropathic pain, cancer pain, operations etc. there is simply nothing to touch drugs for pain relief.  And in truth, research is still only giving approval to the use of Acupuncture for pain relief in certain circumstances, although the lack of wider endorsement is largely a reflection of the lack of good quality trials and disagreement about what Acupuncture should be measured against.  Some researchers argue that it should be measured against sham acupuncture claiming that sham acupuncture is ‘inert’ (has no effects), while others assert that sham acupuncture is not inert and that the only ‘real world’ comparison is against conventional treatments such as painkillers and physiotherapy.

One of those researchers is Dr Hugh MacPherson, photo-at-desk-hugh-macpherson_2_origthe UK’s first Professor of Acupuncture Research whose work has concluded that real acupuncture is superior to sham acupuncture, and superior to standard care (e.g. conventional medical treatments) for a number of conditions including chronic pain, and osteoarthritis of the knee. You can hear him talking about these and other findings findings here. Moreover, he argues that conventional medicines are ‘let off the hook’ when it comes to demonstrating genuinely robust evidence to support their claims, while Acupuncture is held to a much higher standard (Lecture to TCMCI, Limerick, 1.10.16).

So, what to do?

Well, depending on what kind of pain you have and its cause, the first thing to do is look at your lifestyle and diet.  Are you getting enough exercise, or too much, do you need to lose weight, is your diet balanced, do you have poor posture when sitting at a desk or driving?  Are you stressed and anxious? Is your mattress too soft, do you have issues with your feet?

Thereafter consider Acupuncture – or any other kind therapy, CBT or Mindfulness – for your pain.

Finally, if nothing helps, consider the conventional medical treatments outlined above.

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