Caffeine for Pain? Maybe for Some, but Not Others…

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The enticing aroma of things like pumpkin spice, peppermint, gingerbread, and toffee nut latte is abound on the streets of most towns and cities these days and has become a tradition for many at this time of year. It can wake you up in the morning, give you a boost midday, and often help with that nagging “lack-of-sleep headache” so common at this time of year.  Despite its place in many of our daily lives, is drinking coffee the same as drinking other beverages?  No, as the ingredient that gives coffee those special properties is caffeine—which is great for some but downright dangerous for others. It turns out that caffeine also has a previously unknown unique property regarding pain and sleep.

What Could Caffeine Have to Do with Surgery?

We wouldn’t normally brew up a strong cup of coffee if we were struggling with sleep. And sleep deprivation can be especially frustrating if surgery is in our immediate future because many studies, including today’s feature study, have shown that even brief bouts of sleep loss before surgery increases pain and recovery time after surgery. However, today’s study also suggests that a good caffeine fix may be the solution to counteract increased postoperative pain due to preoperative sleep loss. So why caffeine?

Caffeine is best known as a stimulant. When we hear the term caffeine, a lot of us instantly think of our morning cup of java, the substance that wakes us up and energizes us to get our day rolling. Using caffeine for pain in certain circumstances is not unusual as it is also believed to be an analgesic, meaning a substance that can relieve pain; however, interestingly, in the new study, it wasn’t its analgesic properties that acted on the postoperative pain results.

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Study Review: Sleep Loss, Pain, and a Caffeine Fix

The new study consisted of a series of experiments related to sleep loss and pain following surgery. The first experiment found that sleep loss prior to surgery in rats did significantly increase postoperative pain and, therefore, recovery following surgery. A second experiment studied the effect of caffeine administration prior to surgery on pain following surgery. In this experiment a group of rats was kept awake and given caffeine while another group was kept awake and not given caffeine. All of the rats underwent the same surgical procedure, and pain levels were then studied. The result? In the caffeine group, there was a significant reduction in both pain and recovery time after surgery when compared to the no-caffeine group. Investigators concluded that caffeine given prior to surgery prevented the increase in postoperative pain caused by sleep loss prior to surgery.

Researchers found that it wasn’t a direct analgesic effect of caffeine but, in this case, caffeine’s ability to block adenosine (a biochemical in our bodies that induces sleep) in the area of the hypothalamus in the brain that also plays a part in pain sensitivity.

Should You Use Caffeine for Pain? There Are Risks Associated with Caffeine

Does this mean that you can drink a few cups of coffee or pop some caffeine pills to relieve a little pain? More studies are likely to follow on the heels of the one above to determine if postoperative pain (not associated with preoperative sleep loss) can be reduced with caffeine; however, using caffeine for pain for things like headaches and other minor aches and pains isn’t necessarily a good idea as caffeine carries risks in many people.

If you’re diabetic, caffeine can raise blood sugar, and even if you’re not diabetic, some people are just genetically wired to have a blood-sugar spike with caffeine. Genetic wiring can also have the opposite effect with caffeine in that it can raise insulin levels and drop blood sugar too low, making you feel hungry, and leading to overeating. The link above also looks at a study that showed that those who drink four or more 8-ounce cups of coffee a day increase their mortality risk (over age 31) by 50–100%. You’re halfway there with one Starbucks Grande-sized (16 ounce) coffee, and you’re just an ounce away with their giant Trenta-sized (31 ounce) iced coffee.

While we’ve seen studies showing that caffeine can lower the risk of Alzheimer’s and improve our memory, we’ve also seen studies showing, again depending on genetics, that it increases the risk of heart attack and high blood pressure. The “depending on genetics” part of the caffeine equation lies in the CYP1A2 gene. If you have the fast type, your body metabolizes caffeine quickly and lowers or neutralizes these risks; however, if you have the slow type, your body metabolizes caffeine slowly, and the longer caffeine lingers in the body, the greater the risks.

The upshot?  Would we recommend having a cup of coffee and staying up all night prior to surgery? Definitely not! This study did, however,  provide insight into the properties of caffeine for pain, which with further study may eventually provide new ways to prepare for surgery.  Given what we already do know though, it’s important to determine which genetic group you’re in so you’ll know whether caffeine is a major health risk for you or a delicious tool for headaches and that afternoon slump. There’s a simple test you can do yourself. If you can consume high amounts of caffeine in the evening and still sleep well, you have the fast type; on the other hand, if you’re still up pacing the floor at 1 a.m., it’s likely time to enjoy one of the Starbucks salads or protein snacks and “just say no” to that Grande Latte or Frappuccino!

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

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