Impact of Pain Treatments on the Immune System

Impact of Pain Treatments on the Immune System

Editors note: The following article is being re-published with permission from author Cindy Perlin, LCSW. The full article and similar articles can be found on her website, .

Chronic pain patients already have enough physical, emotional and financial challenges. Now there’s COVID-19, the new coronavirus that is causing fear and havoc around the world. One thing that’s abundantly clear is that people with a healthy immune system are not at serious risk. There are many ways you can improve immune system health that aren’t being discussed by health authorities in the mainstream media.

When it comes to pain treatments, some of them are likely to decrease immunity and others are likely to help. What follows is a list of immune suppressing and immune boosting pain treatments. If you are on a drug that suppresses immunity, do not panic and go off of it—rapid tapering or abrupt discontinuation of many of these medications can be dangerous. Consult your physician! Instead, be especially mindful of those treatments you might be able to add that will help boost your immune system—and possibly help you slowly reduce use of those that are not good for your immune system.

Pain Treatments that Suppress Immunity

Corticosteroids (prednisone, cortisone, etc.)

According to the Cleveland Clinic and many other health authorities, steroids reduce the production of chemicals that cause inflammation. That is why they are commonly used to treat inflammatory conditions such as rheumatoid arthritis and lupus. While suppressing inflammation, corticosteroids also reduce the activity of the immune system by affecting the way white blood cells work. This creates a lowered resistance to infection.


A 2019 review of the evidence of opioid impact on the immune system concluded that both illegal and prescription opioids negatively impacted the immune system in multiple ways. These included suppression of natural killer cell activity, suppression of antibody production and antibody response, depression of T cell mediated adaptive immune responses and more. Studies have shown increased infection rates, particularly for pneumonia, in patients who were taking opioids for long term treatment of pain.[1]


A 2009 study looked at whether non-steroidal anti-inflammatory drugs, including ibuprofen, Tylenol, aspirin and naproxen, reduced immune response. The researchers concluded that these drugs inhibit antibody production in human cells and that “the use of widely available NSAIDs after infection or vaccination may lower host defense”.[2]

Immunosuppressant drugs 

Immunosuppressant drugs are used to treat Lupus, MS, rheumatoid arthritis and other autoimmune diseases. They are also prescribed for patients who have received organ transplants to decrease the chances the organ will be rejected. Immunosuppressant drugs are designed to reduce the strength of the immune system. This leaves the patient’s body more susceptible to infections.[3]

Pain Treatments That Boost Immunity

Things you can do on your own at home


One of my recent blogs was about how meditation boosts the immune system and reduces pain. According to a 2018 literature review of meditation and immune function, many different types of meditation have been shown to enhance the immune system, including Mindfulness Meditation, Transcendental Meditation and Qigong. The common factor in these types of meditation is their relaxation effect. Meditation improves several markers of immune function, including natural killer cell activity, B-lymphocytes, telomerase activity, and CD8+ T-Cells.[4]

There are many apps and YouTube videos that teach meditation at little to no cost. Palouse Mindfulness offers a free online 8 week mindfulness course.  Incorporating a regular meditation/relaxation practice into your life is one of the best things you can do to improve your health. Why not start now?

Want more hands-on guidance? Find mind-body medicine practitioners here.


There’s an old saying, “Laughter is the Best Medicine”. Modern research shows the truth in that statement. Laughter has been shown to improve immunity by increasing production of antibodies, and increasing activation of T-cells, including Natural Killer cells. Laughter also improves mood, decreases stress hormones, lowers bad cholesterol and systolic blood pressure and raises good cholesterol.[5] It also lowers pain.

Another great thing about laughter is that it is so readily available for free. If you live with funny people or pets, great. Even if you don’t there’s plenty of options on the internet, including on YouTube (funny cat videos are very popular!) and on TV. My favorite source for humor is the comedy channels on SiriusXM Radio, a low-cost subscription service you can listen to on any electronic device. They also offer an amazing array of talk and music channels.  They offer a free trial HERE. If you own an Alexa device, you can ask it to tell you a joke. The jokes are pretty corny, but they are funny.


The power of prayer to heal is a very controversial subject in science and medicine. Religious people tend to live longer, healthier and happier lives. Since scientists can’t prove or disprove the existence of God, they are prone to attributing these better health outcomes to a placebo effect or relaxation effect of belief and prayer. What is much harder for scientists to accept is the power of intercessory prayer, that is the power of praying for others. Studies have shown positive effects even when the patients are not aware that they are being prayed for. One of my biofeedback colleagues, the late Dr. Jeffrey Cram, was actually able to measure the physiological effects of prayer when the subjects did not know they were being prayed for and the person praying was 250 miles away. Dr. Cram found that while the subjects were being prayed for there was a decrease in muscle tension around their heart chakra (at T6) that was significant at p<.000008.[6]

The scientific data is mixed on the power of prayer. A 2005 review of the literature concluded that “Religious interventions such as intercessory prayer may improve success rates of in vitro fertilization, decrease length of hospital stay and duration of fever in septic patients, increase immune function, improve rheumatoid arthritis, and reduce anxiety. Frequent attendance at religious services likely improves health behaviors. Moreover, prayer may decrease adverse outcomes in patients with cardiac disease.”[7]

Whether you pray for your own health, or others pray for you, prayer can have many beneficial effects.


A 2019 review of studies of physical activity and immunity found that moderate exercise boosts the immune system and reduces inflammation. Habitual exercise improves immune regulation. Very intensive exercise, such as running a marathon, increases illness risk.[8]

Supplements That Relieve Pain and Boost Immunity

Marijuana and CBD

The impact of marijuana and CBD on the immune system is somewhat controversial. The cannabinoids found in marijuana and CBD interact with the body’s endocannabinoid system, which has a key role in regulating immune response. CBD and THC can act as immunosuppressants that are helpful in autoimmune diseases,[9] but other studies show that regular cannabis use can increase white blood cell counts in immunodeficiency disorders such as HIV, suggesting an immune-boosting effect.[10] A 2017 study also found that CBD decreased the replication of hepatitis C virus.[11]

Marijuana and CBD are well known as effective pain relievers. It now appears that, unlike immunosuppressive drugs, they can reduce the inflammatory response while not harming, and even augmenting, the body’s ability to fight infections.

See our recommended CBD products here


Kratom is a Southeast Asian herb that has been shown to be effective for pain relief. It has been used medicinally for hundreds of years. Its traditional uses included to treat fever and skin infections.[12] Kratom contains many beneficial compounds that can boost the immune system and that have anti-viral properties.[13]

See our recommended Kratom products here


Ginger is best known for its tummy-soothing properties. It is also a powerful anti-inflammatory. Like many other herbs, including marijuana and kratom, it also has immune boosting effects against viruses and other pathogens.[14]

Ginger is a tasty addition to many foods in fresh or powdered form. It can also be consumed as a candy in crystalized form, consumed as a tea or taken as a supplement.


Turmeric is one of the healthiest herbs known, with hundreds of beneficial effects. It’s used as a spice in Indian and other cuisines and is what gives curry powder its yellow color. Its active ingredient is curcumin, which has powerful anti-inflammatory effects that can reduce pain. It also enhances antibody response, which can help fight infections.[15]

You can cook with the spice. Turmeric/Curcumin is also widely available as a supplement.

Omega-3 Fatty Acids

Omega-3 fatty acids have long been known for their anti-inflammatory effects that can be very helpful for pain relief. Recent research has also shown, as it has for many other nutrients and herbs, that omega-3 fatty acids also improve immune response to infections. They are part of the cell membrane of all the immune cells. Omega-3 fatty acids have beneficial effects on microphages that patrol the immune system looking for invading pathogens and on neutrophils that help clear pathogens from the system. They also exert beneficial effects on T-cells.[16]

Omgega-3 fatty acids are found in fatty fish such as salmon, mackerel, herring and sardines, as well as flax seeds, chia seeds, walnuts and soybeans. You can also take them in supplement form.



[1] Eisenstein T. The Role of Opioid Receptors in Immune System Function. Front. Immunol., 20 December 2019 |

[2] Bancos S, Bernard M, Topham D, Phipps R. Ibuprofen and other widely used non-steroidal anti-inflammatory drugs inhibit antibody production in human cells. Cell Immunol. 2009; 258(1)18–28


[4] Thibodeaux N, Rossano M. Meditation and Immune Function: The Impact of Stress Management on the Immune System. OBM Integrative and Complementary Medicine, 2018;3(4).

[5] Body’s response to repetitive laughter is similar to the effect of repetitive exercise, study finds. Science Daily, 2010, April 26.

[6] Cram J. The Psychophysiological Aspects of Prayer. Biofeedback 2001 Fall, p.22.

[7] Ayele C, Mulligan P. Does religious activity improve health outcomes? A critical review of the recent literature. Explore 2005 April 30, 1(3):186-191.

[8] Nieman D, Wentz L. The compelling link between physical activity and the body’sdefense system. Journal of Sport and Health Science, 2019 (8):201-217.

[9] Rieder S, Chuahan A, Singh U, Nagarkatti M, Nagerkathti P. Cannabinoid-induced apoptosis in immune cells as a pathway to immunosuppression. Immunobiology, 2010 Aug. 215(8):598-605.

[10] Molina P et al. Modulation of Gut-Specific Mechanisms by Chronic Δ9-Tetrahydrocannabinol Administration in Male Rhesus Macaques Infected with Simian Immunodeficiency Virus: A Systems Biology Analysis. AIDS Research and Human Retroviruses. 2014 June 1, 30(6), 567-578. 

[11] Tolch, L. Could Medical Marijuana Treat Hepatitis C Virus? Pharmacy Times,2017 Feb 24, 16(06):52.

[12] Brown P, Lund J, Murch S. A botanical, phytochemical and ethnomedicinal review of the genus Mitragyna korth: Implications for products sold as kratom. J Ethnopharmacol. 2017 Apr 18;202:302-325.


[14] Sultan T, Butt M, Qayyu M, Suleria H. Immunity: Plants as Effective Mediators. Crit Rev Food Sci Nutr, 2014, 54(10):1298-308

[15] Jagetia G, Aggarwal B. “Spicing Up” of the Immune System by Curcumin. J Clin Immunol, 2007 Jan 27 (1):19-35

[16] Gutierrez S, Syahn S, Johansson. Effects of Omega-3 Fatty Acids on Immune Cells. Int J Mol Sci. 2019 Oct; 20(20): 5028

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Authored by: Cindy Perlin, LCSW

Cindy Perlin is a Licensed Clinical Social Worker and chronic pain survivor. She is the founder of the Alternative Pain Treatment Directory and the author of The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free.

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More anti opiate propaganda. This article is flat out is irresponsible.

The only one this is remotely true of is steroids.

Pain patients have suffered enough; this needs to stop. Trying to push them off medications that work by spreading fear and false information isn’t going to work. They are on those medications for a reason- because they work.

Do some real work instead of this nonsense.

Please note that in the beginning of the article I specifically say not to go off your meds, but to be aware that they have immune suppressing effects, so people who are on them should add treatments that boost immunity. Also, please note that nothing in the article is my opinion. It is all based on peer-reviewed scientific literature. Each statement has a number next to it which is the reference you will find at the bottom of the article. Most have links so that you can read the research yourself. I spent about 10 hours researching this article because I thought it could be life-saving to many pain patients. It’s up to you whether you choose to use the information I’ve provided.


I have a number of autoimmune disorders – this means that my body attacks my body. Pumping up my immune system means that it will try to kill me. The above seems insane to me and my needs.


Gee, anyone else notice that the “boost immunity” column is all “treatments” that do almost nothing for most people as far as pain treatment? Where’s the column that delineates the impact on the immune system of uncontrolled pain? The incredible physiological stress of constant agony has hideous repercussions on all the body’s systems. See:

“Common sequelae of untreated chronic pain include . . .impaired immunity. . .” [9],[10]. (

Lemme repeat that last bit: untreated pain can CAUSE IMPAIRED IMMUNITY. So this attempt to scare people out of opiate pain meds is BULL, yet another example of someone leaping on a hysteria bandwagon. Opiate pain meds may impair immunity, but someone who is not in constant agony will be much less stressed, much more functional, much more able to live a real life (& want to live), much more able to exercise, & much, much happier. The scales balance out completely on the side of effective pain relief. For those who get that from non-opiate pain meds, congratulations. For the majority of us, opiate pain meds are the ONLY way to achieve quality of life & drastic reduction in life-threatening stress.


Cindy thank you for this information. To the other commenters posting do you really have to be so rude in your responses. Did you see the bottom of the article with all the references? Ive had chronic pain for 20 years and like most of you have tried most everything. When I had pain meds , was practicing gentle yoga and walking, and meditating that was the best I felt. Then I got laid off a 25 year job, lost health insurance, couldnt pay bills and my life went to hell. Out went the yoga, meditation, exercise, and laughter. I was at my worst. Still had my pain meds tho. Developed pneumonia in 2018, it turned into an empyema and had a thoracotomy. Then it was pretty much over for me and ended up on disability. I can attest to some of the suggestions as working for me. They might not work for you but you dont need to bash someone who writes an article about it. I want to get back to those little things that do make a difference. Will they take away my pain, no.. But if it brings it down from a 7 to a 5 its worth it. I been through so much over the past 3 years its hard to get that motivation again but I’ll get there someday.


My vertebrae are rubbing against each other. I guess I’ll just pray the pain away?

This site is truly letting the community down.

Alan Edwards

One cannot trust every article or particular author who has a pro- pain bent. Publishing Liza is far different than publishing a government brainwashed government worker. Thank you for not publishing my comment. The moderator or Ms. Perlin read it but probably misunderstood the humor. Keep posting articles that are anathema to Intractables and Kolodny will cheer when NPR goes under. The flu is of little consequence to a Pain Patient already isolated and non- ambulatory. My Grandparents took codeine in alcohol when the flu hit them and they continued on with daily chores with no flu pain to deal with. I personally think opioids fight the flu far better than a vaccine.

I’m surprised at the censorship and political correctness directed at the comments. Shame..

Pamela Hoard

As an expert in alcohol and other drugs of abuse and addiction, 24 years, I find it very interesting that you choose to omit the most easily available drug of abuse, ALCOHOL
While counseling AIDs patients in the mid 1980’s to mid 1990’s, I learned from an immunologist that alcohol suppresses the immune system quicker than any over the counter drug or illicit drug.
Those of us who can’t get out of bed or walk, have more common sense than you do when it comes to taking prescribed medications as prescribed by an MD. You would do well to acquaint yuh yourself with people who have intractable pain. I have 6 chronic diagnosis that have never gotten better in 42 years. For the first 23 years I took no pain medication other than an NSAID. Now I am allergic to them and 40+ other drugs

Alan Edwards

I’m a doctor and recommend CDC guidance. I use topical pain relievers first. Salonpa*..or a lidocaine patch to please the Dea agents who kill hundreds a year and tase the dog first. Oops..we are armed, have killed a 93 year young woman and the mayor has to fabricate a statement. The dog died. And we killed two citizens on a couch watching tv. Right now we relatives of the innocent victims could care less about the flu.
You forgot about sasafras. A cure for PTSD and its edible raw leaves which are high in vitamin C. Not to mention sasafras root beverages.
It pains me as an intractable who has been pumped full of steroids but would add a trillion to the GNP ( along with ambulatory brethren) if given morphine for life, but am dying in pain, that NPR continues to side with the CDC Guideline and the corrupt government agencies. Alternatives to opioids for severe pain do not compare.
And once again the CDC/FDA designed flu vaccine failed to stop the flu.
By the way, exercise for pain treatment can only be used if one is not in severe pain.. Ms. Perlin study Dr. Frank B. Fisher and Forest Tennant M.D. Also look up the late Florence Nightingale, Siobhan Reynolds who was the greatest pain patient advocate of this century.
Appreciate the flu advice.

Thomas Wayne Kidd

I unfortunately will not be surprised if none of my commentaries are allowed here. Especially those that speak of the evil and God’s judgment.

Thomas Wayne Kidd

I to think this foolishness should never have been allowed on this site. We have enough problems already and the kooks pushing Weed and Kratom which is snake oil medicine to most of us. Once taken off the opioid medication I have been on for most of 30 years I would not survive long. Since 2016 and the evil tappering began my life has been going down hill and continues. Meditation does not work with daily chronic pain. This is not helping to have people write on here who know little to nothing about chronic pain. No we don’t appreciate nor want people writing crazy stuff here. I asked for help on here about a pain advocate almost a month ago but I was ignored. My doctor is considering sending me to a non-existent Methadone or Suboxone clinic, knowing that there is little chance that any clinic would accept me. Thanks to all who have stood up for us and encouraged us. We appreciate you all, but please no more crazy stuff please.

Thomas Wayne Kidd

I have taken Methadone for almost 30.years and I haven’t had a common cold, flu (I don’t take flu shots), pneumonia,. I do have seasonal allergies. This study saying opioid medication caused immune problems is just another way to keep from treating people in chronic pain. It seems those who supposed to know stuff are just being cowardly, afraid they might loose their license. If was a doctor I would be arrested because just like in my walk with my Redeemer I cannot betray my
Lord and my brethren even if it meant jail or death. The oath doctors once took and respected ia no more. The own hide is their main concern this has been proven a certified fact since this evil fake prescription drug crisis(?) Began. Doctors proved it when patients they had for years, who kept their rulls were thrown under the bus to save their own sorry hides. I must speak truth even if it hurts, and I will until may body has been vacated. I, dear friends, have blessed hope and I truly care enough to be truthful with people. Much would return to normal if this evil was stopped. Most will laugh and not believe it but the Coronavirus is a direct effect of the uncaring and foolish policy that has caused deaths and horrible suffering upon innocent decent people who had nothing to do with all the street deaths caused by illegal drugs coming into our country. They, through their foolish evil have brought this upon millions more along with the 50 to 100 million people suffering daily chronic pain. The Scripture says those who who so to the wind will reap the whirl wind. We are about to experience that whirl wind. Praying for my fellow sufferers.


Why are bioenergetic therapies (e.g. PEMF) excluded from the ‘immunity boosting’ section? I support the premise of the article opening conversation of pain therapies and resulting effects in immunity suppressant versus immunity supporting, especially in the current time. However, my opinion, the topic is presented incompletely. Perhaps offering outside references to other publications on the topic could offer the reader opportunity to explore the broader.

This is just the sillest post I have seen here. Why cant we just say it. The NWO like Hitler wants sick peole dead. Most of uds are alrexy gone after 4 years of forced torture. FYI, mj is not allpwed with opiods. Your fake news could lopse someone the meds with need to live. geez louise.

Kratom is also much like Morphine with a difference of only a few molecules. It’s a Stimulant & some believe that Kratom is helping their pain & it probably is.

Reducing pain relievers in patients with SEVERE PAIN will only lower that patients tolerance to fight any illness or injury.

My sister is a LCSW but she’s a lot more educated on Severe Chronic Pain & her opinion is / a sudden reduction of pain medication would be more detrimental vs staying on the medication.


Did anybody actually read the article? It mentioned medications and conditions that can decrease immunity but said in the first sentence not to get off of your meds. It gave suggestions of other options that you can incorporate with your meds to boost your immune system.

Go off my pain medication so I will not get this Virus? Are high ? I can not walk with out my medication! My son must bring it to me in the morning and I must lay in bed for 30 minutes so I can’t attempt o get up . I am self quarantining . That a much better idea for myself . I feel you are ignorant of how some of us in chronic pain are completely reliant on our medication to survive.


Wow. Really? So now we have a LCSW writing articles on Chronic Pain treatment? So, We should All Smoke Marijuana and drink Kratom Tea? Those dealing with Chronic pain face enough “Biased Opinions” and continued Stigma along with shame on a day to day basis already. The author of this article is unqualified to be giving her “Opinion” on this matter as it is completely out of her field of practice and quite honestly could be turned into the board for giving “Medical advice” without proper qualifications. This article can fuel yet even more mis-information and ensue panic among Doctor’s and healthcare providers when enough patients have already been unnecessarily forced off of the only medication’s that made their life tolerable and worth living. Touting we should all smoke Marijuana and Drink Kratom is not only ridiculous, many patients cannot and do not want to use these substances. Shame on National Pain Report for printing this article written by someone completely unqualified to be speaking on this subject.


You are a Lcsw .Exactly the people that fight against anyone using opioids prescribed for pain. This is not your field of study . Chronic pain patients gave been thru hell and back and are still fighting the absurd hysteria . I do not think it fair nor right of you to try and place fear on these patients during this catastrophic worldwide virus .
I personally used opioids “prescribed” heavily for 13 yrs for my pain . I never had the flu ONCE! .I believe in all the natural listings and I’ve seen the “‘POWER OF PRAYER ” .
But using the Covid 19 as an excuse to scare people off there meds is absolutely ridiculous. I DO NOT BELIEVE THERE’S ANY HARD EVIDENCE of being on OPIOIDS lowers ANYONES IMMUNITIES. They may have underlying conditions that may . Honestly, i think you should keep to your field of study and OPIOIDS or PRESCRIBING OF nor HOW THEY EFFECT OUR IMMUNE SYSTEM IS NOT .
Counseling that’s it! Lets be honest . I’m not happy this was ever printed by the national pain report .

Maureen M.

Cindy, Thank you for all of that helpful information and links! I will be reading it all. Knowledge is power!
I want to say, though, that I have Systemic Lupus and am on Plaquenil. I wouldn’t even think of stopping that med. Lupus means having an ‘overactive immune system’ which attacks my organs. Plaquenil slows it down in ‘hope’ of bringing it back to a normal immune level.
But, I also have to be very very careful with using certain ‘immune boosters’. It’s all a fine line with Lupus.
Before I knew I had SLE I was told for a few years that I had FM and so I used a bunch of immune boosters supplements. I was becoming more and more ill over time. Then came my Lupus Dx.!!
I had to stop them all except for my Omega 3’s and gut health supplements.
I eat well and whole, keep as active as possible, use meditation, breathing etc.
I am currently trying Kratom for my pain issues…in hope of eventually ceasing my pain meds, in hope of helping my Lupus fatigue etc. Time will tell…
Keep safe during these trying times!

Linda Olds

This is really helpful–NOT!
Every med that actually helps reduce pain is bad for the immune system, but meditation, yoga, and positive thoughts are good???
I’m sure that being in pain is bad for the body, and I wouldn’t be surprised if that includes decreased immune response.

Gail Honadle

Just remember many antibiotics or other medications that are NEW TO YOU CAUSE HIVES. PREDNISONE, RAISES GLAUCOMA EYE PRESSURES QUITE HIGH, IT ALSO RAISES BLOOD SUGAR LEVELS. I’m a recent Type 2 diagnosed Diabetic. ENDO’s first choice was normal Metformin, I told him since it came from China, had Cancer agent in it I did NOT want it. He gave me Januvia, Which 17 days later, little change in BS, it broke me out in the WORSE case of HIVES. Required Predisone to get rid of them. So my BS stayed way higher than it should. Good thing it’s a short course. ASK for loose pills, NOT the BLISTER pack. Loose cost about $5.00, Blister Pack $50.00. And taste real bad.

Needless to say next script was the one I didn’t want Metformin. I reacted to that too. Going down the list of Type 2 Diabetic medicines I found out quickly THEY ALL HAVE THE SAME SIDE EFFECTS ALMOST TO A T.

I’M SCREWED.. I have GI Diseases, main one Gastropresis…SLOW DIGESTION only diet seems to control it. REGLAN BROKE ME OUT IN HIVES ON 1 PILL. And GP diet is the exact opposite of a Diabetic Diet. 1 is NO FiBER the other is PLENTY of FIBER. They do NOT meet in the Middle.

Pamela Osburn

My Husband asked me to please call my pain management Drs office ,to see if i could skip this monthes visit to my pain clnic .They were nice enough to say ,they would call meds in for me for 1 month .so I did not have to make a 3 in a half hour drive to sit in a room where 30 plus patients go in one day! Im able to stay home without going in or up to portland .To me with a compermizized immune system. This was everything.Thank you to Advanced Pain Managment In Portland Oregon .. Thank you for taking so very much stress off of me very sincerely grateful pamela Osburn.