Heather Bedard, C.H.E.
About 51 million Americans suffer from chronic pain and about 17 million of them suffer from high impact chronic pain, which is pain that restricts daily activities.[1] With 1 out of every 5 people dealing with what can sometimes be debilitating pain, it would do us well to investigate possible causes and treatment. Educating yourself on options before there is a situation or emergency can help tremendously in avoiding unwanted side effects of pain medication.
In the case of chronic pain, patients should be aware that there is a connection between emotions and the experience of pain. Dr. David Hanscom is a spinal surgeon, and he says that anxiety and anger are the root cause of almost every chronic pain case. The reason for this is that both anxiety and anger release adrenaline which can cause nerve sensitivity. When those emotions are addressed, the chemistry of the body changes and with it, the feelings of pain. The incredible thing is that resolving the root of the pain like this avoids the necessity of drugs since the pain is greatly reduced or resolved.
The really fascinating thing is that pain is not always an accurate indicator of there something being wrong with the body’s structure. A study that looked at the lumbar spine of people with and without back pain found that 25% of people who have back pain actually have a herniated disc and 60% of the people that didn’t have back pain had degenerative changes in their spine. Interesting![2] A similar study that looked at meniscal tears found that out of 991 people, meniscal tears were just as common in those without pain as those with pain.[3]
Furthermore, just removing pain symptoms with surgery doesn’t always work. If the root is emotional, you may remove the pain of the area that seems to be of concern only to have to pop up in other pain or joints as the brain shifts to another symptom to relieve the emotions. Emotions play a much bigger role in our physicality than we give them credit for! Many patients have found relief by trying cognitive behavioral therapy which can help people to address these issues and deal with them in a relatively short period of time.
There are other more natural ways of dealing with pain than traditional pharmaceuticals or opioids; many of which appear to be equally as effective.
Turmeric is a plant that is related to the ginger family. It contains curcumin which is used in Chinese and Ayurvedic medicine for a multitude of conditions including skin and liver diseases, inflammation and pain. Most turmeric extracts that are used for this are composed of 80-90% curcuminoids; and most of that is curcumin. If you have a musculoskeletal condition, curcumin is a safe alternative for pain relief.[4] It doesn’t inhibit pain signals but rather reduces pro-inflammatory cytokines such as interleukin.[5] One study that included 107 patients with knee osteoarthritis found that over 6 weeks, curcumin was as effective as ibuprofen for reducing pain.[6] Another study, which was a double-blind crossover study, randomized rheumatoid arthritis patients to take an NSAID or curcumin, and found that curcumin was just as effective in reducing joint swelling with no adverse side effects.[7]
Clinical trials have confirmed that curcuminoids are safe even at doses up to 12,000mg[8] and are considered to be generally recognized as safe by the FDA.[9] This means that even though the FDA has not directly approved it, a board of “experts” have done their own testing and submitted it to the FDA as safe. This is welcome news considering that NSAIDS and other drugs for pain have serious gastrointestinal and cardiovascular side effects.
As with all things pain related, it is important to remember that taking medications for pain does not relieve the root of the issue and should only be used to increase comfort while finding the real cause of the pain itself.
Other modalities that can help with pain include strength training and acupuncture. For rheumatoid arthritis patients, strength training can reduce systemic inflammation pain and improve muscle strength.[10] Along with that, exercise regimens that include the practice of yoga improves both function and mental state for patients that have rheumatoid arthritis.[11] Studies that look at acupuncture and pain are very promising. Patients that visited the emergency room for acute musculoskeletal pain with no evidence of fracture or dislocation, ankle and knee sprains, shoulder and elbow tendonitis, and low-back pain were randomized to be given morphine or acupuncture. The group receiving acupuncture had 92% experiencing resolution vs 78% with morphine. Pain relief was much quicker as well. The risk of side effects was equally as impressive with 2.6% in the acupuncture group experiencing side effects vs 56.6% in the morphine group.[12]
As you can see, there is much more to understand about pain management than just resolving symptoms, and there are often other options to relieving symptoms than what you may be given. As always, you can speak with your doctor or licensed nutritionist about more options.
Your body is a phenomenal creation and can provide you with so much insight if you take the time to listen.
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[1] https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm [2] Jensen M, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. “Magnetic Resonance Imaging if the Lumbar Spine in People Without Back Pain.” NEJM 1994 Jul;331(2):69-73 [3] Englund M, Geurmazi A, Gale D et al. “Incidental Meniscal Findings on Knee MRI in Middle-Aged Elderly Persons.” NEJM 2008 Sep;35(11):1108-1115 [4] Peddaka KV, Peddaka KV, Shukla SK, Mishra A, Verma V. “Role of Curcumin in Common Musculoskeletal Disorders: a Review of Current a, Translational, and Clinical Data.” Orthop Surg 2015 Aug;7(3):222-231 [5] Appelboom, T, Maes N, Albert A. “A new curcuma extract (flexofytol) in osteoarthritis: results from a belgian real-life experience.” Open Rheumatol J 2014 Oct;8:77-81 [6] Kuptnirasaikul V, thanakhumtorn S, Chinswangwatanakul P, Wattanamongkonsil L, Thamlikitkul V. “Efficacy and safety ot Curcuma domestica extracts I patients with knee osteoarthritis.” J Altern Complement Med 2009 Aug;15(8):891-897 [7] Deodhar SD, Sethi R, Srimal RC. “Preliminary study on antirheumatic activity of curcumin (diferuloyl methane)” Indian J Med Res. 1980 Apr;71:632–634. [8] Lao CD, Ruffin Mt 4th, Normelle D et al. “Dose escalation of a curcuminoid formulation.” BMC Complement Altern Med 2006 Mar;6:10 [9]https://www.accessdata.fda.gov/scripts/fdcc/index.cfm?set=GrASNotices&sort=Date_of_closure&order=ASC&showAll=true&type=basic&search= [10] Häkkinen A, Sokka T, Kotaniemi A, Hannonen P. “A randomized two-year study of the effects of dynamic strength training on muscle strength, disease activity, functional capacity, and bone mineral density in early rheumatoid arthritis.” Arthritis and Rheumatism. 2001;44(3):515–522 [11] Telles S, Singh N. “Is yoga a suitable treatment for rheumatoid arthritis: current opinion.” J Sports Med 2012;3:81-87 [12] Grissa M, Baccouche H, Boubaker H et al. “Acupuncture vs intravenous morphine in the management of acute pain in the ED.” Am J Emerg Med. 2016 Nov;34(11):2112-2116.
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