Coffee is the Best treatment for Chronic pain

Coffee is far better treatment for chronic pain than over-the-counter pills, new research shows.
Feeling tired drastically increases pain sensitivity, the study found.
To counteract that, scientists from Boston Children’s Hospital gave exhausted lab mice either painkillers, coffee or more time asleep.

They found the most wide-awake mice – after a jolt of caffeine or a long sleep – were more impervious to pain than those on painkillers. In the caffeine-drinking mice, they saw a rush of dopamine to the brain’s pleasure center, which alleviated their feelings of pain.

To keep the mice awake, researchers kept vigil, providing the mice with custom-made toys as interest flagged while being careful not to overstimulate them. This is similar to what most of us do when we stay awake a little bit too much watching late-night TV each weekday,’ said sleep physiologist Dr Chloe Alexandre.

Dr Alexandre and her co-investigator, pain physiologist Dr Alban Latremoliere, monitored the mice with EEG heart rate machines. When they got tired, their rate slowed, so Drs Alexandre and Latremoliere would distract them
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For mice, their distractions are a bit different to humans scrolling through Instagram or TV channels. They were given wipes or a cotton ball to nest with, or things to chew.

In this way, they kept groups of six to 12 mice awake for as long as 12 hours in one session, or six hours for five consecutive days, monitoring sleepiness and stress hormones (to make sure they weren’t stressed) and testing for pain along the way.

Pain sensitivity was measured in a blinded fashion by exposing mice to controlled amounts of heat, cold, pressure or capsaicin (the agent in hot chili peppers) and then measuring how long it took the animal to move away (or lick away the discomfort caused by capsaicin).

The researchers also tested responses to non-painful stimuli, such as jumping when startled by a sudden loud sound.We found that five consecutive days of moderate sleep deprivation can significantly exacerbate pain sensitivity over time in otherwise healthy mice,’ says Dr Alexandre.

The response was specific to pain, and was not due to a state of general hyperexcitability to any stimuli.Surprisingly, common analgesics like ibuprofen did not block sleep-loss-induced pain hypersensitivity.Even morphine lost most of its efficacy in sleep-deprived mice.

These observations suggest that patients using these drugs for pain relief might have to increase their dose to compensate for lost efficacy due to sleep loss, thereby increasing their risk for side effects.

In contrast, both caffeine and modafinil, drugs used to promote wakefulness, successfully blocked the pain hypersensitivity caused by both acute and chronic sleep loss.

Interestingly, in non-sleep-deprived mice, these compounds had no analgesic properties.

‘This represents a new kind of analgesic that hadn’t been considered before, one that depends on the biological state of the animal,’ says Dr Clifford Woolf, director of the Kirby Center at Boston Children’s.

‘Such drugs could help disrupt the chronic pain cycle, in which pain disrupts sleep, which then promotes pain, which further disrupts sleep.’

The researchers conclude that rather than just taking painkillers, patients with chronic pain might benefit from better sleep habits or sleep-promoting medications at night, coupled with daytime alertness-promoting agents to try to break the pain cycle.

Some painkillers already include caffeine as an ingredient, although its mechanism of action isn’t yet known.Both caffeine and modafinil boost dopamine circuits in the brain, so that may provide a clue.

Many patients with chronic pain suffer from poor sleep and daytime fatigue, and some pain medications themselves can contribute to these co-morbidities,’ notes Kiran Maski, MD, a specialist in sleep disorders at Boston Children’s.

This study suggests a novel approach to pain management that would be relatively easy to implement in clinical care.Clinical research is needed to understand what sleep duration is required and to test the efficacy of wake-promoting medications in chronic pain patients.