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Methods For Managing Pain


Pain is often the primary motivator for people to visit a health care practitioner. How it is treated can vary as much as the reasons for its cause.

Whether its headache, an overuse or weekend warrior injury, most people go to the doctor because of pain. In addition, “one in four adults suffer with inadequately treated chronic pain, so this is one of the most common reasons people seek alternative care,” said Jacob Teitelbaum, MD, medical director of the national Fibromyalgia and Fatigue Centers.

A natural approach means you consider the entire person, he continued, “so some practitioners, such as chiropractors, may recommend a series of physical adjustments in addition to supplementation. Nutritionists would look primarily to the patient’s diet and suggest changes where necessary. Herbalists may recommend whole herb infusions, topical treatments or supplemental extracts. But the one thing each will have in common is to take a holistic view and not isolate and treat just one factor in their patient’s life.” 

Alternative Approach to Inflammation 

“Pain and inflammation is a tough topic; most are taught that they go together. I’m not sure that’s the answer,” said Hal S. Blatman, MD, founder and medical director of the Blatman Pain Clinic in Cincinnati, OH, which offers a holistic approach to diagnosing, treating and managing chronic pain. “We’re taught to use anti-inflammatory drugs and ice to reduce pain after an acute injury. I’m not sure that’s the right idea because inflammation is a part of healing.” 

The clinic provides prolotherapy, which stimulates the body to repair the painful injured area(s) when the body’s natural healing process is not able to do the job on its own. The concept of creating irritation or injury to stimulate healing has been recorded as early as Roman times.

Dr. Blatman said stopping inflammation for the sake of stopping it might be the wrong idea. “To confuse the issue even more, the standard for an acute injury is rest, ice and elevation.With an ankle injury, rest is important. Elevation will keep it from swelling as much; not walking on it will let ligaments heal. So rest and elevation is important,” he said.

“However, ice may take away swelling and take away pain, but it also slows the healing process. I’ve been telling people to apply heat to injury. Those who have the nerve to do it have found that many times the injury will heal faster. It may be uncomfortable the first day, but they’re back to the field of play sooner.” 

Dr. Blatman believes “we’ve ‘powderpuffed’ recovery, so to speak,” and discussed mending an injured tendon. “As long as you don’t take an anti-inflammatory medicine after you play tennis, that shoulder will heal itself,” he said. “At the end of three to four weeks, the body has pretty much done that repair cycle.” However, if it hasn’t and you go to an orthopedic surgeon, he’ll send you to physical therapy, Blatman said. “If you have trouble with the shoulder afterward, they will perform surgery and shorten the tendon by taking out the damaged tendon and reattaching it with a staple to your bone. Now you have a shortened tendon and muscle, and a staple to contend with forever.

“A prolotherapist realizes if the body Isn’t done healing after the three to four weeks, you can re-injure the tendon by poking it with a needle,” Dr. Blatman explained. “That causes enough of an injury to restart healing program. It’s not so much of an injury that the body takes a big step backwards. But rather than cut tendon away, you are sparking that tendon to heal stronger.” 

Supplemental Ideas 

Dr. Teitelbaum agreed inflammation and pain are normal and necessary when an injury, such as a sprained ankle, occurs; “however, chronic inflammation that lasts and lasts is not normal and is, in fact, a disease,” he said. “This type of inflammation is an important part of many serious illnesses, including cancer, heart disease, obesity, diabetes and painful conditions such as arthritis.” 

He recommended omega-3 fatty acids as a foundational nutrient that every individual should be taking. “Omega fatty acids are critical for obtaining optimal health and well-being. They are so beneficial due to their ability to lower the body’s levels of the inflammatory factors, thereby blunting the inflammatory response.”

While omega-3 fatty acids are most typically available in supplemental form as flax or fish oils, there is a more convenient, natural and absorbable source—omega-3s from fish, naturally bound to phospholipids, in a tablet delivery system. Dr. Teitelbaum recommended EurOmega-3, from EuroMedica, which has a level of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) absorption that is much higher than that seen with traditional triglyceride-bound omega-3 products, he noted. The omega-3 fatty acids in EurOmega-3 show intracellular absorption rates 50 times higher than the triglyceride-bound omega-3s found in most fish oils.1 This extraordinary absorption is due to the patented extraction method used to extract omega fatty acids, phospholipids and peptides from salmon.2 The omega-3 fatty acids in EurOmega-3 are extracted from the head of the salmon, where they are naturally bound to phospholipids, not triglycerides.

Dr.Teitelbaum also shared that,“Unlike most over-the-counter pain relievers and prescription drugs, which work by masking symptoms, curcumin and boswellia actually help the body heal. Specifically, curcumin and boswellia fight inflammation, which in turn, reduces pain.” 

Curcumin fights inflammation by suppressing the activation of NF-kB, with regulates the expression of proinflammatory gene products. It also down-regulates COX-2, the enzyme most linked to inflammation. Boswellia is especially potent at reducing pain because it inhibits the inflammatory enzyme, 5-LOX.

“Both of these natural healers also protect cells from free-radical damage and promote healthy cellular replication,” Teitelbaum noted. “Having treated chronic pain for over 30 years, this new combination, when added to DLPA and nattokinase, has simply been a pain relief miracle.” 

Easing Arthritis Pain With Nutrition 

Arthritis is the most common cause of disability in the U.S.,affecting 43 million people and limiting physical activity in almost 19 million every year.3 

New York-based integrated medicine practitioner, Dr. Leo Galland, noted that arthritis medications are among the most highly prescribed drugs in the world, and according to the Centers for Disease Control and Prevention (CDC), NSAIDs account for an estimated 7,600 deaths and 76,000 hospitalizations in the U.S. every year. 4

Rather than relying on NSAIDs, Dr. Galland recommends natural antiinflammatory foods, herbs, spices and supplements that can help with arthritis.

“Foods that help arthritis and supplements are underutilized weapons in the battle against this painful inflammatory condition,” he explained. “First, there are anti-inflammatory supplements like fish oil and borage oil that have been shown to allow reduction of NSAID use in patients with rheumatoid arthritis, one of the most crippling types of arthritis. Fish oil works even better in combination with extra-virgin olive oil to reduce inflammation.

“Second, there are supplements like colostrum and glutamine that have been shown in research studies to help decrease the risk of stomach damage in people taking NSAIDs,” said Dr.Galland.

Detailed research on how these supplements may help protect against NSAID side effects can be found at http://pilladvised.com, Dr. Galland’s free web application.

“Nutrition is another vital tool in fighting inflammatory arthritis,” he added. “Unfortunately, there are a lot of myths about what to eat, and what to not eat, to help arthritis.” 

To help dispel some of these myths and offer proven information, Dr. Galland suggested:

1. Eat at least eight servings of fruits and vegetables every day. Choose those with bright or deep colors like cherries and berries, and sweet potatoes that contain natural anti-inflammatory nutrition. Don’t believe the old saw that citrus fruits and “nightshade” vegetables like tomatoes and peppers cause arthritis. Oranges and tomatoes have been shown to have significant anti-inflammatory effects in some people. NOTE: Food allergies can trigger arthritis for some people.

2. Choose oils wisely. Extra-virgin olive oil has natural anti-inflammatory benefits, whether raw or cooked. Recent research has identified the antioxidant called oleocanthal, which is only found in extra-virgin olive oil. Oleocanthal is a natural anti-inflammatory with potency strikingly similar to that of the drug ibuprofen in inhibiting an enzyme that causes pain and inflammation. Studies have shown that people with inflammatory arthritis experience a decrease in Pain and stiffness of their joints when treated with fish oil. Even better pain management results have been observed when, in addition to fish oil, extra-virgin olive oil is part of the diet.

Flaxseed oil and flaxseed meal (ground flaxseed), also have significant anti-inflammatory effects, but should not be cooked. Other vegetable oils, like corn, safflower or sunflower oils, can increase inflammation and counteract the benefits of anti-inflammatory nutrients in the diet.

3. Eat fish three times a week.

Especially wild salmon, if it’s available and affordable. Consider supplementing your diet with the natural anti-inflammatory, fish oil. The amount of fish oil needed is not fixed; it varies from about a teaspoon (4,000 mg) to a tablespoon (12,000 mg) each day, depending upon what else is in your diet. The more meat, poultry, egg yolk or dairy fat, the greater your need for fish oil, because these foods contain arachidonic acid, a pro-inflammatory omega-6 fatty acid.

4. Avoid sugar and foods with added sugar and refined carbohydrates.

Reduce inflammation by cutting out white flour products, white rice and white potatoes. Several studies have shown that consuming foods of this type aggravates inflammation. Instead, eat high fiber foods like whole grains and legumes. Studies have shown that high fiber diets are anti-inflammatory.

5. Drink tea, black or green. The notion that green tea is healthier than black tea has not been borne out by clinical trials in humans. Green tea may have anti-cancer effects, but black tea has a better track record in fighting inflammation. You need at least three cups a day.

6. Use anti-inflammatory spices in preparing your food. Ginger and turmeric have excellent anti-inflammatory effects, although human clinical trials with these spices are much more limited than for the other principles listed.

Nerve Treatment 

For people suffering from neuropathies, California-based health science company Gilad&Gilad developed AgmaSet supplement based on the company’s discovery of the neuroprotective properties of G-agmatine, a natural amino acid metabolite.

Gad M. Gilad, PhD, CEO of the company, explained that AgmaSet, by providing high dietary G-agmatine, acts like a shotgun targeting multiple molecular mechanisms critical for both neuroprotection and neuropathic pain reduction. These include: modulating several neurotransmitter receptors; providing a blockade of key ion transport channels; regulating nitric oxide (NO) production; inhibiting protein ADPribosylation; modulating polyamine metabolism; inhibiting matrix metalloproteases (MMPs); and blocking advanced glycation end products (AGEs) formation.

According to Dr. Gilad, these mechanisms are compromised not only as a result of nerve compression pathologies, (for example radiculopathies including sciatica), but also as a typical consequence of traumatic injuries, metabolic diseases, chemotherapy-induced neuropathies, infections, trigeminal neuralgia, fibromyalgia, and other peripheral and central neuropathies.

A recent randomized, double-blind, placebo-controlled study demonstrated the safety and effectiveness of G-agmatine in accelerating neuropathic pain recovery and improving health-related quality of life in lumbar disc-related radiculopathy (sciatica).5 “These clinical trials together with extensive scientific evidence serve a ‘proof of concept’ for using AgmaSet in the various neuropathies,” Dr. Gilad added, noting that it is estimated that more than 20 million people in the U.S. alone suffer from various neuropathies.

“Surveys indicate that 75 percent of patients with neuropathic pain are unresponsive to current pain medications,” he said. “Treatment is challenging and many patients pursue complementary treatments including acupuncture, transcutaneous electrical nerve stimulation, cognitive behavioral therapy and supplements. Of the supplements, there is evidence that alpha-lipoic acid may be effective in some cases; B vitamins may be used when there is a specific vitamin deficiency, but otherwise were not proved to be effective.” 

Based on the evidence, AgmaSet has a wide implications for a multitude of people whose need for a dietary supplement to support pain-free nerve functions remained unmet until now, according to Dr. Gilad. AgmaSet can also be used with animals is marketed for veterinary use and for companion animals under the brand name AgmaVet.


1 Comparative in-vitro study of the intestinal permeability and bioaccumulation of omega-3 fatty acids in EurOmega-3™ using the CACO-2 epithelium intestinal model. Rennes, France.

2 Linder M, Fanni J, Parmentier M, Regnault P. Proceed d’obtention d’une huile et d’un hydrolysat de proteins a partir d’une source marine de tissus proteiques et huile et hydrolysat de proteins obtenus par mise en oeuvre de ce proceed. French patent number 2,835,703. August 15, 2003.

3 US Centers for Disease Control and Prevention (www.cdc.gov/chronicdisease/resources/publications/ aag/arthritis.htm). 

4 Robyn Tamblyn, PhD; Laeora Berkson, MD, MHPE, FRCPC; W. Dale Jauphinee, MD, FRCPC; David Gayton, MD, PhD, FRCPC; Roland Grad, MD, Msc; Allen Huang, MD, FRCPC; Lisa Isaac, PhD; Peter McLeod, MD, FRCPC; and Linda Snell, MD, MHPE, FRCPC, “Unnecessary Prescribing of NSAIDs and the Management of NSAID-Related Gastropathy in Medical Practice,” Annals of Internal Medicine (Washington, DC: American College of Physicians, 1997), September 15, 1997, 127:429-438. 

5 Pain Medicine 11: 356–368, 2010.


EuroMedica, (866) 842-7256, www.euromedicausa.com 

Gilad&Gilad, (888) 48-GILAD, www.fornervehealth.com 


Prolotherapy, which stimulates the body to repair the painful injured area(s) when the body’s natural healing process is not able to do the job on its own, has been recorded as early as Roman times.

Curcumin fights inflammation by suppressing the activation of NF-kB, with regulates the expression of pro-inflammatory gene products.

It is a myth that citrus fruits and “nightshade” vegetables like tomatoes and peppers cause arthritis.

Clinical trials demonstrate the safety and effectiveness of Gagmatine in accelerating neuropathic pain recovery.