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Ok, it’s confession time – I’m an addict. My drug? Caffeine. I panic if I find myself unable to access my morning coffee ‘fix’. I agree that’s not good, but caffeine is – by a considerable margin – the world’s most popular psychoactive drug.
Its medicinal effects have been known for centuries. And while the available evidence suggests that caffeine carries minor risks to health, in moderation, its long-term benefits appear to outweigh those risks.
Caffeine increases energy, alertness, and concentration, decreases fatigue, and enhances short-term memory and physical and cognitive performance. It also helps relieve certain types of pain.
Caffeine for pain relief
Have you ever wondered why caffeine forms an ingredient in some pain-relieving medicines? Research has shown that it’s a very effective adjuvant – i.e. something added to medicines to enhance their performance. In particular, caffeine enhances the pain-relieving effect of paracetamol.
Nociceptive vs neuropathic pain
Nociceptive pain has an identifiable cause, e.g., a stubbed toe. As the injury heals, the pain reduces. Conversely, neuropathic pain, such as in CRPS, is the result of our nervous system not working correctly—call it faulty wiring.
Research shows that caffeine reduces pain sensation in nociceptive pain by targeting specific receptors that play a role in the pain signalling process.
A study at the University of Alabama, published in 2018, discovered that “individuals who habitually consume greater amounts of caffeine as part of their daily diets demonstrate diminished sensitivity to painful stimuli in a laboratory setting.” Putting that into context, the study group’s average daily caffeine consumption was around 170 milligrams – roughly two pretty standard cups of coffee.
This followed an earlier study at the University of Pittsburgh, where researchers concluded that “high‐dose caffeine exhibits considerable analgesic efficacy in experimental muscle pain”. Yet another, at the University of Georgia, found that two cups of coffee can reduce post-workout muscle pain by up to fifty per cent.
Caffeine for pain relief: Breaking the cycle of pain
It will come as no surprise to hear that fatigue increases pain sensitivity. Research shows that five successive days of sleep deprivation can “significantly” exacerbate pain sensitivity.
Unfortunately, fatigue is a common side-effect of painkillers, and in turn, when you’re fatigued, medication is less effective. So, you then take more drugs, but as a consequence, you feel more tired – a seemingly never-ending cycle of pain and fatigue. But caffeine is effective at disrupting this cycle. Indeed, it’s been found to be more effective at reducing pain than some common painkillers.
But isn’t there a fatal flaw in all this? Caffeine consumption is not exactly conducive to promoting a refreshing night’s sleep – difficult enough if you’re also in pain!
However, the amount of caffeine required to disrupt the pain cycle is relatively modest. There’s also a balance to be struck. The Boston researchers introduced those suffering chronic (i.e. long term) pain to what proved to be an effective daily pain management plan involving stimulants earlier in the day, with sleep-promoting strategies and medication later on. Indeed, this is similar to my self-imposed rule of no coffee after midday!