There’s no getting away from it, caffeine is by far and away the world’s most commonly used psychoactive drug. Indeed, its medicinal effects have been known for centuries. The majority of us look forward to our daily ‘fix’ and can get twitchy if, for whatever reason, it’s not forthcoming.
On the basis of the available evidence, whilst the consumption of caffeine can result in minor risks to health, in moderation its long-term benefits seem to outweigh any short-term risks. As we are all aware, it can increase energy, concentration and alertness, decrease fatigue and enhance short-term memory as well as physical and cognitive performance.
Considered less has been the role of caffeine in pain relief.
Caffeine is an adjuvant
We have all seen and possibly wondered why caffeine is added to certain pain-relieving medicines. The reason is that it has been shown to be an adjuvant – ie something added to medicines to improve their performance – in particular, it enhances the pain-relieving effect of paracetamol.
Nociceptive pain is the most common type of pain we experience. It’s pain which has a specific cause, eg a stubbed toe or a fractured finger. The pain improves as the injury heals. The other type of pain is neuropathic pain which develops when our nervous system is not working properly.
In nociceptive pain, it has been shown that caffeine reduces the sensation of pain by targeting our adenosine receptors which influence the pain signalling process.
In a 2018 study at the University of Alabama at Birmingham, researchers found 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.” The group’s average daily consumption of caffeine was around 170 milligrams, which equates to about two cups of coffee.
This followed a study at the University of Pittsburgh which concluded that “high‐dose caffeine exhibits considerable analgesic efficacy in experimental muscle pain” and another at the University of Georgia which found that two cups of coffee could reduce post-workout muscle pain by up to fifty per cent.
Breaking the pain cycle
Research in Boston has now established what we all probably suspected anyway; that fatigue increases our sensitivity to pain. Indeed, it’s been shown that just five successive days of sleep deprivation can significantly exacerbate pain sensitivity.
The problem is that fatigue is a common side-effect of painkilling medications, but then in turn, medication is less effective if you’re fatigued. Taking more drugs to combat pain can result in increased fatigue, leading to the need for more drugs – and so it can go on in a seemingly never-ending pain cycle.
However, caffeine can disrupt this cycle. In fact, it has been found to be more effective at reducing pain than some common painkillers.
Caffeine and sleep
But is there a fatal flaw in using caffeine for pain relief? Consuming caffeine is hardly conducive to promoting a good night’s sleep, which if you’re in pain is difficult enough anyway.
However, the amount of caffeine required to disrupt the pain cycle seems relatively modest – certainly compared to my own daily caffeine consumption!
The researchers in Boston concluded that a balance was required. As part of their daily pain management (including medication) regime, people suffering chronic (long term) pain may benefit from sleep-promoting strategies and medication later in the day and at night time, coupled with a stimulant (such as caffeine) earlier in the day.
Caffeine is a drug
This piece began with reference to caffeine as a drug and just as with any drug, extreme caution is required.
Self-medication in any form is always discouraged, if for no other reason than the possible negative interaction with other drugs being taken. Any change, however slight, to your daily medication regime should of course always be discussed with your doctor before it is instigated.