Pain

(Is more than a four-letter word)

The Problem

Pain is one of the most costly health problems in North America. Estimated costs including direct medical expenses, lost income, lost productivity, compensation and legal fee’s are approximately $90 billion per year. Here a few statistics.

• 48 million Americans suffer from chronic pain.
• Over 21 million Americans regularly take prescription painkillers and also spend over $3 billion on over the counter painkillers.
• Over 13 million Americans cannot perform routine activities due to chronic pain.
• Fourteen percent of employees take time off from work from chronic pain.
• Up to 45 million Americans have chronic, severe headaches that can be disabling.
• Arthritis pain affects more than 40 million Americans each year.

Please keep in mind these figures don’t t represent the number of people (I call the walking wounded, so elegantly phrased by the brilliant Dr Jeffrey Bland PhD) that suffer from fibromyalgia, low back pain, myositis, gout, bursitis, carpel tunnel syndrome, etc.

While acute pain is like a sprained ankle or that a broken bone warns us that something is wrong, chronic pain is an entirely different problem. Researchers now suspect that chronic pain is completely separate from acute pain and is a non-ending feedback loop of chemicals produced inside our bodies that is not a helpful response to our environment.

To end chronic pain we must figure out how to interrupt the misery producing feed back loop. Some of the most effective approaches are multi-disciplinary. This usually includes certain medications if indicated to help get the problem under control so the bodies own system natural products will work.

But it is not only the actual pain that is the only problem; it is also the side effects of chronic pain-illnesses caused by sedentary lifestyle, seclusion, immune suppression, hormonal imbalances, depression and in many cases addiction to prescription pain killers. All of these side effects can be as devastating as the actual pain itself.

One cannot measure the value of quality of life. It is very hard for someone to try and give justice to the amount of chronic pain people endure on a daily basis. Pain affects more than just the nerve endings or the emotional health of people in pain. Pain affects every aspect of life. How we deal with pain is our choice. There are options available to try, but remember, there is no magic bullet and there is not one specific therapy that works for everyone. Pain management is the ability to educate oneself on the treatments available.

Conventional pain treatment often covers up the cause or underlying factors and treats only symptoms. But if you have suffered from chronic pain, you would welcome any relief. The key is to manage pain with minimizing the side affects of the drug or the pain itself. There is currently more and more information available on the nutrient depletions and interactions of most prescription drugs. This is a valuable tool because if you or someone you know and care about suffers from chronic pain.

Chronic Pain

There is a familiar pattern that is seen with persons diagnosed with chronic pain. If it is from an accident, trauma, physical or emotional, environmental or caused by poor lifestyle habits, the treatment is many times the same.

All pain, whether chronic or acute, physical or emotional is recognized, interrupted and acted on by the brain. Pain that lasts longer than three months is generally considered chronic pain. If you or anyone you know has suffered from chronic pain you have learned that it affects families and friends.

Chronic pain drains energy. Not only physical energy but mental energy. This is why a multi-disciplinary approach is necessary. There is not one pill, exercise or treatment plan that will work every time for every one because each approach needs to be individualized. We also know that certain approaches are helpful across the board. The following is information that seems to be accurate in many cases of people that suffer from chronic pain.

There are numerous chemicals that cause pain. The Eicosanoids are hormones that play a major role in pain and inflammation. Both non-steroidal and steroid medications work by inhibiting both the eicosanoids and platelet-aggregating factor.

The eicosanoids are subdivided into prostaglandin’s, leukotrienes and thromboxanes that influence inflammation as well as being responsible for many other biochemical actions. Certain enzymes have been shown to assist our body in regulating inflammation. The most common are the Cox-1 and Cox-2 enzymes. Cox-1 is present in our tissues under everyday conditions. It produces prostaglandins that regulate our normal bodily functions. Cox-2 is not present under normal conditions and is present only at sites of inflammation.

Nature has provided certain herbs that only inhibit Cox-2 that are very effective with out any side effects. Several companies have developed good natural combination products to address this inflammation pathway.

Chronic Inflammation

More and more information is piling up to the fact that chronic inflammation is the culprit in most all chronic pain and degenerative diseases as well as aging. There are a number of factors to take into consideration when trying to address inflammation. There are many causes of inflammation in the body. Infection, injury and stress are just a few causes of inflammation.

One blood test that your physician can do is what’s called a C-R-P test or C-reactive protein. This blood test looks at a protein in the blood that is associated with inflammation. This valuable test can help assess risk factors for heart disease, diabetes and cancer.

Chronic Fatigue

Chronic Fatigue goes hand in hand with chronic pain. This is pretty straightforward; a consistent stressor on the body will eventually wear down our metabolic systems and bodily functions. Many practitioners will look at and test how well adrenal health is when addressing chronic fatigue and chronic health conditions. Chronic pain and chronic fatigue is like pulling an overloaded trailer up-hill for a very long time. It wears down the machinery. Our bodies get worn down biochemical and emotionally.

Once again, chronic fatigue affects more than one function of the body. There may be a predominant problem such as infection or metabolic imbalances, the goal is to look at the big picture or the whole body and treat it appropriately through diet, exercise and lifestyle changes.

Depression

One very common problem associated with chronic pain is depression. The way I look at this scenario is this way; if a person hurts all the time, which wouldn’t be depressed. There are many well-documented biochemical and physiological changes that occur when the body is under the consistent stress of chronic pain.

Many conventional approaches to chronic pain are to prescribe anti-depressants. This may help short term or may be needed long term but it generally does not address the underlying deficiencies or excesses.

A more natural approach is to look at the body as a whole and support it as a whole, not a symptom. Proper nutrition, gastrointestinal health, liver function, proper balance of hormones and blood sugar may many times help alleviate depression. Some of the nutrients listed below have also been studied and proven effective with certain types of depression. Again, the ideal situation is to be tested or work with an experienced practitioner to help you develop a plan specifically for you.

Conventional Pain Treatments

Almost every home medicine cabinet has at least one type of over the counter pain medication. A few of the most popular pain medicines are as follows.

Aspirin

Aspirin is an inexpensive drug that is used by millions for pain and inflammation. Long term use taken in high dose has potential side effects that include; heartburn, nausea, vomiting, ringing in the ears, hearing loss, hives, itching and in some cases, bleeding.

Aspirin can also displace certain drugs from their binding sites on protein, making them less effective. Certain medication should not be taken with aspirin. Check with a qualified practitioner to identify these.

Another interesting fact is that continued use of aspirin compound has been shown to actually inhibit the production of the building blocks that form connective tissue.

Acetaminophen

Acetaminophen (Tylenol) is used for moderate pain and fever, but is not effective for inflammation, swelling or redness. Inhibits prostaglandin production in the central nervous system.

NSAIDS (aspirin) or non-steroidal anti-inflammatory drugs are used for pain, stiffness and swelling of the joints. These compounds affect pain by blocking the formation of prostaglandin’s.

Potential side effects include stomach aches, gastritis, peptic ulcers, gastrointestinal bleeding, headaches, nausea, dizziness, depression, drowsiness, ringing in the ears, vomiting, diarrhea, cramps, convulsions, blood in the urine and stools, chest tightness, rapid heartbeat, fainting and chills.

 

A Natural Approach

We do know that overall diet is critical in the management of chronic pain because when we are under the continual stress of chronic pain, this stressor affects our overall health.

1. Food as Medicine

This is very important to remember, as it is very true. We must keep in mind that certain foods aggravate pain and inflammation and set up roadblocks for the body to heal itself while others act as natural anti-inflammatory. The key is to balance these foods and incorporate the beneficial foods and eliminate the offending foods.

There are several foods that have been shown to aggravate pain and may increase inflammation. These foods produce arachadonic acid from prostaglandid PGE2. These include red meat, dairy products, peanuts, high glycemic index foods, processed foods and sugar. The other two main regulating prostaglandins are PGE1 and PGE3. Foods that have an anti-inflammatory effect that feed these hormones include fish oil, organic fruits and vegetables, essential fatty acids from flax oil or extra virgin olive oil. Also, check for food allergy or sensitivities

2. Food Allergies and Food Sensitivities

See additional handout

3. Detoxification

See additional handout

4. Protect Liver and Gastrointestinal Function

These is critical as part of therapy for people in chronic pain because most people that suffer from pain, usually are or have been taking medications to control pain, inflammation or mood. These medications all have a side effect. Some more serious than others, but there are a number of natural substances that can be used to help protect and rebuild liver and gastrointestinal function.

NAC                                                   Milk Thistle                      SAMe

Zinc/Carnosine                                PhosCholine                     Artichoke

NAG                                                   Larex                               Probiotics

Prebiotics                                          Dandelion                        Oregon grape

Burdock                                             Fringe Tree                      Gentian

Red Root                                            Ginger                               Turmeric

SeaCure                                             Slippery Elm                     L-Glutamine

Aloe Vera                                          Marshmallow                    vitamin C

5. Support Adrenal Function

The adrenal glands are responsible for assisting in regulating our body’s response to stress. A hormone called cortisol is secreted under times of stress. Elevations of cortisal are associated with inflammation. The problem is that too many of us are always in a state of stress, thus producing too much cortisol and weakening adrenal response. There are several good books available  on this subject

• Nutrients to Support Adrenal Function Include:

vitamin C with bioflavonoid,         B5       B6       Holy basil      Ashwaganda

Bacopa          magnesium             Relora              Rhodiola              licorice

zinc

(adrenal glandular as synergistic glandular such as  hypothalamus, pituitary

and thyroid).

6. Support Immune Function

Persons under any chronic conditions have a lowered immune response. Diet is important to maintain a healthy immune system as is a healthy gastrointestinal tract as up to 70% of our immune system is developed in the GI tract.

• Foods to Support Immune Function Include:

Fresh vegetables                           Fermented Foods (Kim Chi, sauerkraut, Kefir)

Essential Fatty Acids                   Fresh Organic Vegetables

• Nutrients to Support Immune Health Include:

Vitamin C               astragalus             thymus peptides              bioflavanoids

quercitin                Larex                    medicinal mushrooms      Lactoferin

Zinc                       melatonin               Nat-Stim                          DHEA

OPC’s                    whey protein          trace elements               colostrums

Andrographis        boneset                  elderberry                       noni

• Foods that Suppress Immune Function Include:

Sugar                                        Deep Fried Foods              Food Additives

High Glycemic Foods              Processed Foods               Food Colorings

7. Balance Acid/Alkaline

See additional handout

8. Get Restorative Sleep

This is one of the most common and consistent problems encountered by persons with chronic pain. Many health practitioners agree to break the cycle of chronic pain, one must get restorative sleep. This is considered to be at least 7-8 hours per night, every night.

There are several approaches one can use. Herbal and nutrient therapy has been effective for many. We also have to consider what was eaten throughout the day as some foods can be stimulating and cause a person not to get into a restorative pattern. The biggest offender is caffeine, as it can be hidden in numerous foods.

Supplements that help with inducing or increasing sleep include; passionflower, valerian, wild lettuce, hops, inosital, GABA, 5-HTP, L-Tryptophan, California Poppy, melatonin and magnesium citrate.

9. Supplements to Control Pain and Inflammation (please do some research on which products may fit your need best, it is always recommended to work on the diet in conjunction with any supplement program)

• DLPA Protects the body from enzymes that render our own pain killing ability, less effective.

• Wobenzyme of Vitylzyme These are one of the most effective natural compounds

• EPA/DHA This is found primarily in fish oil. Other oils also contain the

• Systemic Enzyme Therapy The brand names that have many studies behind them include Wobenzyme and Vitylzyme.

• DMSO Originally used as a solvent. Very effective in reducing scar tissue and decreasing inflammation.
• Zyflamed (Cox-2 Inhibitor) This product by New Chapter is the subject of a number of clinical trails. It is a very effective, natural COX-2 inhibitor supplement.
• Trace Mineral Research This liquid mineral/trace element is a favorite. It assimilates extremely well and results can be seen or felt in a few days.
• MSM Also know as dietary sulfur. Has been shown effective in cleaning out
• L-Tryptophan L-Tryptophan is converted into Serotonin with the help of a number of nutrients and hormones. Low levels of Serotonin have been associated with chronic pain.
• D-Phenylalalnine….D-Phenylalanine is the dextrorotory form of the amino acid phenylalanine. The L forms are ones that are bioavailable for protein synthesis and regulatory function. The D form is not absorbed in the body but acts as an inhibiting agent to the enzymes that are responsible for the breakdown of endorphins and enkephalins that control pain perception.

Low levels of endorphins and enkelphalins have been shown to be present with persons suffering from chronic pain.

• Lyprinol Lyprinol is the lipid extract from the Green Lipid Mussel that has outperformed ibuprofen as well as many of the omega 3 & 6 fatty acids. The fatty acids in the New Zealand Green Lipid Mussel modulate the abnormal cell membrane chemistry of pain and inflammation. In addition to its anti-inflammatory effects, un-like
• Magnesium & Malic Acid Most persons that suffer from chronic pain or other chronic conditions are deficient in magnesium. Magnesium also inhibits IL-6. This mineral is used up under stress by the adrenal glands.
• Borage Oil Borage Oil is high in a fat GLA gamma linoleic acid. This is a healthy fat found in different plants
• Nattokinase is a very effective anti-inflammatory enzyme found from soy. Many years of clinical research has shown this to be very effective in chronic pain and inflammatory conditions.
• Glucosamine/Chondrotin Numerous studies have proven the benefit of glucosamine/chondrotin supplements in chronic joint pain. It generally takes 4-6 weeks to become very effective.
• Serratiopeptidase A premier proteolytic enzyme to support joint and tissue repair. Very quick acting in many cases for pain relief with over 40 years of clinical testing in Europe and Asia.
• Turmeric (Curcumin) inhibits the breakdown of arachidonic acid, a potent pro-inflammatory fat.
• Quercetin This powerful antioxidant inhibits the pro-inflammatory cytokine IL
• Boswellia This gum resin inhibits the Cox enzyme pathway and reduces the pro-inflammatory pathway.
• Microlactin Is derived from milk, acts quickly and usually effective with arthritis.
• Hylaronic Acid Helps rebuild the synovial fluid in the joint. Acts as a cushion.

There are many nutritional supplements that are used to either help control pain and inflammation. The ones listed above have been used and studied for many years.

 

Additional Helpful Factors for Controlling Chronic Pain

Laughter

Norman Cousins landmark book “Antimony of an Illness” showed that laughter is medicine. It is hard sometimes to laugh when experiencing chronic pain. The key is to try and find some lighter side of your situation. There are studies that show that a good “deep belly” laugh produces a lot of pain fighting chemicals.

Exercise

Exercise can be helpful in the management of pain but if you overdo it, you increase the pain. Find and exercise that works for you. One of the healthiest exercises is SWIMMING.

Acupuncture

Much literature is written on the benefit of acupuncture and pain. Many health plans are recognizing the health benefit of this ancient treatment. It helps to break pain cycles by balancing energy.

Chiropractic

Regular quality chiropractic care usually provides people with some relief. Long-term management of chronic pain usually includes some type of chiropractic care.

Massage Therapy

Mark Norman is a Certified Nutritionist in private practice in offices in Minnesota and Wisconsin. He is available for private consultations as well as group lectures. He has developed a lifestyle program called “Practical Steps Toward Optimal Health” and teaches this across Minnesota and Wisconsin.

Products discussed are available at Tailor Made Nutrition or on-line at www.tailormadenutrition.com

Email: mknorman2003@yahoo.com