Irst report on the association between pain sensitivity and analgesic use

Cross-sectional analysisPrevalence n Persistent Rx analgesic useb No Yes Self-reported analgesic use Any use last four weeks No use OTC only Rx only Both OTC and Rx Regular use PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25112874 last four weekscCrude 96.0 4.0 HRa 1 1.58 95 CI Ref 1.37?.Model A HR 1 1.45 95 CI Ref 1.25?.Model B HR 1 1.33 95 CI Ref 1.14?.10,0625,461 3,292 495 909 8,339 593 668 524 109 253 9,50253.8 32.4 4.9 8.9 79.5 5.7 6.4 5.0 1.0 2.4 92.4 7.1 1.32 1.47 1.59 1 1.30 1.28 1.26 1.77 1.60 1 1.Ref 1.22?.42 1.26?.72 1.42?.79 Ref 1.13?.49 1.13?.46 1.08?.46 1.34?.34 1.32?.94 Ref 1.50?.1 1.14 1.28 1.30 1 1.07 1.16 1.06 1.49 1.42 1 1.Ref 1.05?.23 1.10?.50 1.15?.46 Ref 0.93?.23 1.02?.33 0.91?.23 1.12?.98 1.17?.72 Ref 1.32?.1 1.11 1.20 1.20 1 1.03 1.11 0.99 1.36 1.29 1 1.Ref 1.03?.21 1.02?.41 1.06?.36 Ref 0.90?.19 0.97?.27 0.85?.16 1.02?.81 1.06?.57 Ref 1.25?.No use Paracetamol onlyd NSAIDs only NSAIDs + paracetamold Opioids only Combinations w/opioidsLast 24 hourseNo YesHR hazard ratio, CI confidence interval, OTC PF-04447943 buy non-prescription, Rx prescription, NSAIDs non-steroidal anti-inflammatory drugs Model A: Adjusted for age, sex and education. In the study period, the persistent treatment episodes consisted on average of 39.3 NSAID, 44.0 opioid and 16.7 paracetamol prescriptions c Only the "classical" analgesic groups NSAIDs, paracetamol or opioids are counted here, i.e. adjuvant/atypical analgesics are not included d "Paracetamol" includes the Anatomical Therapeutic Chemical group N02B "Other analgesics and antipyretics", and consists COTI-2Purity & Documentation almost exclusively of paracetamol use but also minor use of phenazone-caffeine or aspirin (acetylsalicylic acid) (see [24]) e Use of any analgesics within the 24 h prior to the cold pressor test0.0.logrank p < .0.0.Cumulative proportion aborting 0.1 0.2 0.3 0.Cumulative proportion aborting0.0.0.0.Endurance time (s)Endurance time (s)Persistent prescription analgesic useNo (n = 10,062) Yes (n = 424)Self-reported regular analgesic useNo use (n = 8,339) NSAIDs only (n = 668) Opioids only (n = 109) Paracetamol only (n = 593) NSAIDs + paracetamol (n = 524) Combinations w/ opioids (n = 253)Fig. 1 Cold pressor tolerance and persistent prescription analgesic use (left) and self-reported regular analgesic use (right).Irst report on the association between pain sensitivity and analgesic use in a general population.Analgesic use causing increased pain sensitivityLong-term analgesic use may cause a paradoxical increase in pain, e.g., through medication-overuse headache [27] or OIH. OIH can be described as an increase in pain sensitivity, which is not accounted for by withdrawal symptoms [15] or a deterioration of the pain-causing disease [18], but the clinical relevance is somewhat contentious [16].