Overconsumption of analgesics
Lively, throbbing or tenacious, localized, diffuse or wandering, pain plays troublemakers in our life. Between migraines, tooth rage, low back pain, digestive disturbances, spasms inherent in the rules or inflammations due to osteoarthritis, it spares no one. Neither the most valiant nor the most fragile of us. Yet she is not always heard. Both by health professionals, who still consider it sometimes as a wake-up call with which we must deal, than by the patients themselves. Many people who trivialize it, surmount it with the means on board or rely on the inevitability, even to spend very bad quarters of hour. Indeed, as pointed out by Dr. Michel Lanteri-Minet, neurologist at Pasteur Hospital in Nice and president of the French Society for the Study and Treatment of Pain, " there is no match between the severity pain and consulting . As proof: according to a survey conducted by Ifop *, a quarter of real painful people do not use any analgesic treatment and nearly half relieve their pain by practicing only self-medication. On their own, they swallow piles of paracetamol tablets - the painkiller spontaneously used in 65% of cases in France - ibuprofen or aspirin. Even touching overconsumption. Of the 3.7 million migraineurs, nearly one million have never spoken to their doctor about this problem. No wonder, therefore, that analgesics are the best-selling drugs outside the medical prescription: one out of every three boxes is delivered in pharmacies without a prescription. And, inevitably, not all are used wisely. But poorly treated, the pains cause havoc.
* In March 2010 on a sample of three thousand people.
The evil must not settle
The afflictions that have become rebellious are a powerful factor of depression and social exclusion. They affect emotional and professional life in 25% of cases. " Many people are no longer able to take on a job at all ," says Martine Chauvin, founder of the Francophone Association to Overcome Pain. They are also part of the nervous system. This archaic biological memory, which allowed our ancestors to learn to be wary of dangers, was for a long time an asset for the survival of the human species. But our bodies, battered by modern life, often suffer today in totally inappropriate ways. Instead of serving as a punctual warning, the evil takes root. It becomes encrusted in the long term, which generates stress and tilts the body into a state of generalized hypersensitivity. A vicious circle highly pathogenic, insofar as certain commonplace pains end up becoming chronic. At this stage, they are no longer a symptom but a disease in their own right.
Despite three national plans to fight against pain since 1998, this situation is unfortunately more and more frequent. " At the hospital, the resources and staff of the specialized centers remain insufficient to meet the increased demand, " says Dr. Françoise Laroche, rheumatologist at the Saint-Antoine Hospital in Paris. Not to mention the aging pharmacopoeia. The majority of painkillers reach their limits. More than a century old, they offer no answer to all evils. This is the reason why one in five French people continues to suffer regularly. Worse: their active ingredients seem more and more to induce serious side effects.
No risk does not exist
In recent months, new scientific evidence of their deleterious impacts is increasing . At the beginning of May, researchers from the Research Institute of Health, the Environment and Labor in Rennes have shown that, at high doses, painkillers can reduce human fertility. Testes fragments of adult males were exposed in the laboratory to paracetamol, aspirin and indomethacin (an anti-inflammatory). Forty-eight hours later, all the samples studied produced much less testosterone (male sex hormone) than they would have usually done. The synthesis of a compound involved in descent of the testes in young adolescents was also reduced. These painkillers play the role of endocrine disruptors, like the bisphénol A or phthalates, so much criticized.
Late last May, the medical journal The Lancet published an equally informative British study. Their authors, biologists at the University of Oxford, accused ibuprofen and diclofenac (Voltarene) of increasing the risk of cardiovascular accidents by 40%. " It was known for a long time that this class of drugs could be responsible for gastrointestinal bleeding, said Professor Bernard Bégaud, pharmacologist at the University of Bordeaux and director of the Inserm research unit of pharmacoepidemiology. But only Vioxx, an anti-inflammatory drug withdrawn today from the market, was previously associated with a cardiac risk . No panic for all that. If the danger exists, it remains rather weak and seems to concern only long-term catches (maximum dose for several months in a row). Nothing prevents us from using these tranquilizers sporadically to soothe a headache or a renal colic crisis. But, in case of chronic pain, caution is advised, especially if you have hypertension, heart failure or a history of myocardial infarction.
Over a long period, aspirin appears to be harmful for the eyes. The work of the University of Sydney published last January in the J ama Internal Medicine suggest that this star of analgesics makes blind by promoting the development of macular degeneration related to age. Of the 2,390 patients followed for 15 years, this disease only affected 3.7% of occasional users of aspirin, compared with 9.3% of regular users. And that's not all. Since September 2012, American doctors have been worried about the health of our ears after highlighting the existence of a link between the wrinkling of analgesics and the degradation of hearing. According to data analyzed at the Boston Hospital, the risk of hearing loss would be increased in women by 13% when they take ibuprofen two to three days a week, 21% if they take four to five days a week and more than 24% if their consumption goes up to six days a week. For paracetamol, the risk increases by 11%, 21% and 8% respectively. As a result, beware of abuse!
New analgesics
Fortunately, the succession is announced. After decades of unsuccessful research, the intimate biological mechanisms of pain are finally beginning to be elucidated. Thanks to the work of Professor Michel Lazdunski, a CNRS gold medalist in 2000, we now understand how painful signals are created and transmitted. On the surface of nerve cells are thousands of microscopic pores that open and close at the mercy of unpleasant stimuli (compression, sting, burn ...). When the skin, a muscle or a joint are attacked, they let in millions of ions (sodium, potassium, calcium ...). This sudden influx causes the birth of electrical microcurrent in the cells, which triggers biochemical reactions cascading and spreads the information step by step, up to the spinal cord and then to the brain. By muzzling the activity of these ion channels, researchers hope to suppress the genesis and transmission of these messages. And thus eradicate the perception of pain.
Molecules capable of such a feat are already under study. Of all the existing channels (there are more than four hundred types), the efforts are mainly focused on some (sodium Navl channels) whose dysfunction is the cause of insensitivity ... fakirs! Holders of a genetic mutation, they can swallow swords with a smile or sleep on nail boards without any discomfort. Royal cobra or black mamba venom proteins, two deadly snakes, seem to have the same effect. Tested successfully on the mouse, these molecules could be 2,000 times more effective than morphine against acute pain. The icing on the cake: they would not generate dependency or addiction. Extracts of sea anemone toxins or Japanese poisonous fish (fugu) are also screened. Another promising avenue: the eradication of germs which (as absurd as it may seem) are involved in triggering certain pains, especially chronic low back pain. Two Scandinavian studies, published at the end of May in the European Spine Journal , stipulate that a third of lumbago with herniated discs are caused by bacteria (Propionibacterium acnes) nested in the spine. A simple antibiotic treatment would then be enough to curb the pain. The experience has been tried by Danish rheumatologists from the University of Odense. About sixty patients with low back pain who were resistant to conventional treatments received either antibiotics or placebos. As a result, only those treated with antibiotics were largely relieved. A year later, only 19% were still complaining of constant pain, compared to 75% of those who were given placebos. Amazing! But caution: the relevance of this new therapeutic strategy must be validated by other studies before we can enjoy it. In the meantime, if you are in pain, consult immediately. There is no reason today to suffer in silence.
Acupuncture works!
Taking analgesics is not always the best solution to overcome rebel pain. Alternative medicine sometimes brings greater relief. Starting with acupuncture, whose effects are finally validated by science. An American study published in Archives of Internal Medicine at the end of September 2012 analyzed the data collected on 17,922 people suffering from chronic pain treated in different ways. Verdict: in cases of recurrent migraine, back pain, torticollis and osteoarthritis, acupuncture is more effective than drugs and placebos. Recent clinical trials have also shown the benefits of manual medicine: osteopathy for cervicalgia and chiropractic for low back pain (more than 57% of pain decreased compared to only 33% with the use of anti-inflammatory or muscle relaxants) .
Take control
Instead of clenching your teeth or, worse, falling into depression, try to tame the pain. Body relaxation therapies help to release stress (which amplifies suffering) and to put emotions at a distance. Sophrology, meditation and hypnosis are used successfully in hospital pain centers. Make it your own experience! Having fun (seeing friends, watching a movie ...) is also an excellent antidote. Not only does the pleasure procured diverts attention, but it promotes the secretion of dopamine and serotonin, hormones that diminish pain perception.
Migraines and intellect
Despite the microlesions they can induce in the brain, migraines do not cause cognitive decline. Researchers from the University of Bordeaux have analyzed the migraine history and the gray matter activity of six thousand patients over 65 years old. Contrary to their fear, their intellectual performance is equivalent to that of people who did not have significant headaches in previous decades. This work, published in the British Medical Journal in August 2012, however, evokes the possibility of a small increase in memory loss for migraine sufferers with aura (headaches preceded by neurological and / or visual signs).
