Astringent, tangy, nippy, delicate, or (if you’re really into coffee) piquant; Everybody loves their own, perfect, morning java. And if you’re familiar with the Specialty Coffee Association of America, you’ve got a million ways to describe that exquisite blend! But is it just improved alertness that we use our caffeine source for? Could it be that we can also diminish our pain?
How might this happen?
Image from SCAA
Without getting too technical, caffeine (also known as methyltheobromine) has a similar molecular structure to adenosine, a commonly used molecule in our body that promotes s-l-o-w-i-n-g things… down……….. Because caffeine is similar in shape, it steals adenosine’s place on our body’s receptors, which means we cannot slow things down — we become more excited (yay coffee!). Therefore, it probably isn’t that caffeine makes us hyper, but rather by blocking adenosine it doesn’t let us pull on the reigns.
The Research: Caffeine and Pain Regulation
The Cochrane Collaboration reviews scientific literature, synthesizing data with stringent rules to ensure high-quality recommendations as an overview of health information. They are a fantastic resource for getting a sense of what does work, does not work, or can’t be absolutely defined either way at this time.
More importantly, they have reviewed the issue we are discussing! With their rigorous requirements in place, they only considered double-blind studies comparing a single dose of analgesic (like tylenol, advil, etc) to the same dose of analgesic plus caffeine in acutely painful people. This includes painful-type issues like headaches, dental pain, and menstrual period pain.
(A Double-Whatnow? A double-blind study is a type of research design where the participants do not know which group they are a part of (in this case, analgesic only or analgesic plus caffeine), and the researchers do not know which group the participants are in either! This is a great study design because it eliminates any unintentional influence (bias) on patients by the researchers, or any preconceived opinions of the participants from altering outcomes.)
What they found
It did not matter which painful condition participants had, which analgesic was used, or what the dosage of caffeine was — in all cases there was a visible trend to less painful complaints when caffeine was used with an analgesic as compared to the analgesic alone. This trend was most apparent when caffeine was at least 100 mg.
Given their findings, overall caffeine appears to have beneficial pain-reduction qualities when used with an analgesic, superior to that of just taking an analgesic on its own. Unfortunately, it is unclear if or how more or less caffeine impacts these outcomes — so taking more (>100mg, or drinking 5-6 cups of coffee instead of 1-2) doesn’t appear to produce better outcomes regarding painful complaints.
Where can I find ~100mg of caffeine?
According to the Dieticians of Canada, here are some common sources of caffeine.
- Brewed Coffee: 250mL (8 oz/1 cup) = 80-180 mg
- Brewed Espresso: 30mL (1 oz) = 64-90 mg
- Tea, Leaf or Bag (Black): 250mL (8 oz/1 cup) = 43-60 mg
- Energy Drink (various): 250mL (1 cup) = 80-125 mg
- Cola: 355mL (1 can) = 30 mg
- Chocolate covered coffee beans, dark or milk chocolate: 60mL (1/4 cup) = 338-355 mg
- Dark Chocolate: 1 bar (40mg) = 27 mg
Summary
Consuming ~100 mg of caffeine with an analgesic can diminish the acute pain you experience compared to just taking an analgesic on its own, according to high-quality research. This could mean consuming a single coffee, two teas, or one to two espressos along with your preferred analgesic.
Please note that I’m not promoting or recommending analgesic use for acute pain, we’re simply discussing the impact that caffeine in addition to their use has on pain outcomes.
Questions or comments? Have a problem that you’d like to address with something other than analgesics and caffeine? Contact Dr. Gilliard at (905) 634-6000, send him an email at drjimgilliard@gmail.com, or book an appointment at Endorphins Health and Wellness Centre.
Primary Reference:
Derry CJ, Derry S, & Moore RA. Caffeine as an analgesic adjuvant for acute pain in adults (Review). The Cochrane Library, 2014; 12: 1-62.