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Pain Management Pain Management
Longevity By Nature

Discomfort is wide-ranging for people of all ages and shapes. Here’s how to help ease the pain.

A cute and still funny joke went like this: “So, I go to my doctor and tell him it hurts when I do this. The doctor said, ‘Then stop doing that.’” If only managing discomfort and lessening aches were that easy.

According to Robert Kachko, ND, LAc, there are hundreds of causes of pain, but that sensation may be classified into three overall categories—nociceptive, neuropathic (nerve) or mixed. Further, approximately 100 million Americans have some type of chronic pain. Some of the most common conditions that contribute to pain and cause people to see a physician are chronic low back pain, migraines, arthritis and neck/face pain. “Pain is a common endpoint because it is a signal of damage and thus something which should be avoided to protect ourselves,” he commented. “Understanding the root cause of the pain, as well as addressing psychosocial components of that pain, is essential for appropriate treatment.”

Jamie Langston, BSN, RN, CCRP, at Texas-based LifeSeasons sees two significant types of pain situations—systemic muscle pain and acute muscle pain, which is more common. Acute muscle pain arises from tension/stress, muscle overuse (over exercising) and minor injuries, and is usually localized. Natural practitioners are likely seeing an increase in these complaints as more Americans try to fit more into their lives, including improper or over-zealous workouts.

Best-selling author and leading integrative medical authority Jacob Teitelbaum, MD, said that the standardly prescribed NSAIDs (non steroidal anti-inflammatory drugs) cause 30,000 to 50,000 preventable U.S. deaths each year (a 40 percent increased risk of heart attack and stroke in a major meta-analysis and 4,000 to 16,500 deaths annually from bleeding ulcers). “Meanwhile, we are seeing 15,000 overdose deaths a year from prescribed narcotics,” he emphasized, adding, “Despite this, the prevalence of major discomfort has increased over the last 15 years.”

The Opioid Debate

Opioid abuse has continued to garner red-alert headlines in the mass media and has been the impetus for overhaul and even, dramatically, lawsuits against the makers. Yet many still see their need in some severe cases and instances, notably post-surgery or severe trauma.

Opioids have an important role to play in medicine, Dr. Kachko agreed. The current situation has roots in the mid-1990s when physicians believed that opioids were the most successful pain-reduction medications, and the idea of widespread addiction was not well known. When irrefutable addiction statistics surfaced, showing increased dependence, physicians shrank back, and are now unwilling to prescribe opioids for those who have been relying on specific (often high) doses for many years.

“This over correction is but a symptom of an impaired view of how we should treat chronic pain in the first place,” he asserted. “Pain must be addressed from a biopsychosocial standpoint if it is to be sustainably ameliorated. In addition to appropriate medications and medical procedures, this involves changing people’s relationship with their pain,” he explained. This is accomplished through a variety of actions such as teaching more adaptive coping responses, reducing fear, improving exercise and sleep, and consuming an anti-inflammatory diet. Social support is also essential to helping alleviate chronic pain. Dr. Kachko just launched TribeRx (www.TribeRx.com), to help physicians treat their patients for pain using biopsychosocial principles.

According to a PubMed Pain Physicians abstract, although the U.S. holds only 4.6 percent of the world’s population, we consume 80 percent of its opioids. “Opiophobia, or the fear of opioids, is very common when it comes to pain management solutions,” Langston observed. Most people are very afraid of addiction, not to mention potential side effects. And, he noted, a key challenge in the medical community is that physicians receive minimal training in chronic pain management, and many have turned to frequently prescribing opioids.

However, he said in 2016, the CDC (Centers for Disease Control and Prevention) published the current standard for treatment of chronic pain, which recommend behavioral interventions as the first action before prescribing medication. “There are many noninvasive, non-medication treatments to help with pain management, such as muscle stimulation, acupuncture, therapeutic massage and physical therapy. There are also numerous scientifically researched herbs that help to nourish, calm and soothe the nervous system which can help relieve aches and discomforts.”

Shailinder Sodhi, BAMS, ND, president of Washington-based Ayush Herbs, Inc. and a practitioner at the Ayurvedic and Naturopathic Medical Clinic stated that “every drug has its place and in special cases, opioids are necessary. However, sustained opioid use is not wise as it does not improve the inflammatory response or causes of injury.” He explained that botanicals such as Boswellia serrata and Curcuma longa address both inflammation and assisting in the detox of accumulated waste.

Dr. Teitelbaum said he advises his patients that when used properly, opioids “are less toxic than chronic pain. It isn’t my goal to get my patients off of opioids rather it is to get them to be pain-free. And we can usually do so without using opioids by using the best of natural and standard medical treatments.”

Answering the Ache

More specifically, Dr. Teitelbaum added that patients with widespread achiness and head discomfort (as well as fatigue and severe insomnia) may benefit by his SHINE (sleep, hormones, immunity/infections, nutrition and exercise) Protocol. He explained that when the muscle discomfort is localized, SHINE also addresses the biochemistry needed for the muscles to release, and structural issues that are stressing the specific muscles also need to be looked at. Further, when the discomfort is at the base of the skull or across the forehead, these are usually coming from muscle tension, and the principles in the SHINE Protocol along with massage apply. “For those associated with nausea and light and sound sensitivity, adding vitamin B2 400 mg a day and magnesium decreases the frequency by over 67 percent after six weeks.”

Renovating diet is key, according to Dr. Kachko, who stated that patients/clients should always first attempt to obtain what they need from food; in this case, those that lessen systemic inflammation. Some supplements are particularly useful for reducing inflammation and addressing discomfort, including omega-3 EFAs, magnesium, antioxidants and curcumin.

Curcumin is prominent in both Curaphen and Curaphen Extra Strength, from Wisconsin-based EuroMedica. According to Cheryl Myers, chief of scientific affairs and education, both provide clinically studied curcumin (BCM-95) that is blended with turmeric essential oil for enhanced absorption, blood retention, and to add turmerones. “Curcumin (turmeric polyphenol) reduces inflammation and protects against oxidative stress,” she said.

Both formulas also contain BosPure boswellia, a widely used medicinal plant in India that reduces pain by inhibiting the inflammatory enzyme 5-lipoxegenase (5-LOX). Myers explained, “Boswellia needs to be standardized for low beta-boswellic acid content (which interferes with beneficial activity) and higher levels of acetyl-11-keto-β-boswellic acid (AKBA) to ensure the best potential and effectiveness of the extract. Both the curcumin and boswellia have been clinically studied in a human clinical trial of osteoarthritis,” she stated.

Curaphen and Curaphen Extra Strength also provide DLPA (DL-Phenylalanine), which Myers explained helps prevent the breakdown of one of the brain’s natural pain-killing substances, enkephalins, which are in the same family as endorphins. Curaphen Extra Strength has higher levels of curcumin and boswellia, for more concentrated relief. And, noted Myers, the need for fewer doses may increase compliance.

Bowellia is also offered by Ayush Herbs as BoswelyaPlus, which supports a healthy inflammatory response and helps to regulate proper joint and cartilage function, according to Dr. Sodhi. The supplement also contains herbs Zingiber officinale and Curcuma longa to provide to support the joints, and Withania somnifera to assist in modulating nervous system components, reducing pain sensation. Additionally, this product contains glucosamine sulfate and chondroitin, nutrients shown to support joint structure and function.

Ayush Herbs’ CoCurcumin is a blend of turmeric, coconut oil, and trikatu. “Many studies show that curcuminoids are best absorbed when consumed with fat and black pepper, found in trikatu,” said Dr. Sodhi. “Turmeric is an all-around must when people are feeling joint and muscle discomfort.

He reported that a study of a formulation of boswellia extracts and curcuminoids in the management of knee osteoarthritis was compared to celecoxib, a widely prescribed COX-inhibitor. Participants were given 500 mg of Boswellia serrata and Curcumin longum twice a day and another group consumed 100 mg twice a day of celecoxib for 12 weeks. At the end of the trial, the group using the herbs reported more comfort and range in motion than those taking the pharmaceutical and relief was noticed much sooner in the 12-week trial. “Furthermore, blood results showed significant reduction in liver and kidney stress in the herbal compound groups as evidenced by decreased serum glutamic pyruvic transaminase and C-reactive protein,” he pointed out.

LifeSeasons’ Pain Bloc-R, said Thomas Leatherwood, vice president of business development, includes five scientifically researched ingredients to help ease discomfort, relax muscles and calm the nervous system. These five ingredients include: White willow bark, used for centuries to help ease discomforts; L-theanine, an amino acid-like compound that’s been shown to calm stress, boost mood and cognitive performance; angelica root, an anti-inflammatory herb; benfotiamine, a synthetic derivative of vitamin B-1 (thiamine) to support the cardiovascular system and as an antioxidant to promote healthy cell and tissue function; and L-tetrahydropalmatine (THP), an alkaloid found in several plants and is an important part of traditional Chinese medicine.

Pain is … well, a pain to have. These and other related supplements can help your clients/patients feel better and without any side effects. That in itself lessens the pain!


Is Knee Pain Linked to Depression?

In the U.S., approximately 13 percent of women and 10 percent of men aged 60 or older have knee pain due to osteoarthritis (OA). Osteoarthritis occurs when a joint becomes inflamed, usually because the protective cartilage and other tissues that cushion joints like the knee become damaged and worn over time. Knee pain from OA can make it harder to take care of yourself, which can damage your quality of life. In turn, that can lead to depression.

According to researchers, knee OA affects some 55 percent of people over age 40 in Japan. A research team from the country recently published a study in the Journal of the American Geriatrics Society examining the effects of knee pain on depression since, until now, few studies have focused on how knee pain and impaired knee function relate to depression.

To learn more, the researchers examined information from 573 people aged 65 or older who participated in the Kurabuchi Study, an ongoing look at the health of older adults living in central Japan. When the study began (between 2005 and 2006) none of the participants had symptoms of depression. Two years later, nearly all of them completed follow-up interviews. The participants answered questions about their knee pain and were evaluated for symptoms of depression.

Nearly 12 percent of the participants had developed symptoms of depression. People who experienced knee pain at night while in bed, while putting on socks or while getting in or out of a car were more likely to report having symptoms of depression, noted the researchers.

The researchers concluded that asking older adults with knee pain whether they have pain at night in bed, when putting on socks, or while getting in or out of a car could be useful for helping to screen people at risk for developing depression.

For more information, visit www.americangeriatrics.org.

*Side-bar end

Healthy Take Aways:

• Pain is classified into three overall categories: nociceptive, neuropathic (nerve), or mixed.
• NSAIDs cause 30,000 to 50,000 preventable U.S. deaths each year.
• In 2016, the CDC published the current standard for treatment of chronic pain, which recommend behavioral interventions as the first action before prescribing medication.
• Sustained opioid use does not improve the inflammatory response or causes of injury.

For More Information:

Ayush Herbs, www.ayush.com
EuroMedica, www.euromedicausa.com
LifeSeasons, www.lifeseasons.com