Pain & Inflammation

 

Pain and inflammation sufferers can greatly benefit from a combination of supplements and dietary/lifestyle changes.

There is no one in the world that is immune from the occasional ache or pain. For some, pain is directly attributable to a specific incident or injury and can be healed in a short amount of time with proper conservative measures. For others, pain is longer lasting and can transition from acute to chronic, making it that much more difficult to relieve. Some medical conditions are also linked to chronic pain, such as pain from fibromyalgia, chronic headaches, arthritis and other inflammatory diseases.

To achieve quick-term relief, many people turn to over-the-counter or prescription medications, the latter of which has triggered a national opioid crisis. The National Institute of Drug Abuse issued a sobering statement earlier this year: more than 130 U.S. residents die each day after overdosing on opioids.

It is thus in the best interest of practitioners and patients alike to seek natural solutions when it comes to pain and inflammation.

Prevalence of Pain

Based on a 2016 National Health Interview Survey, the Centers for Disease Control and Prevention (CDC) released a report last fall estimating that just over 20 percent of adult Americans are living with chronic pain. To put it another way, that is one in five people. The survey also found that 8 percent had “high-impact chronic pain.” The report said that the number of people living with pain correlates with dependence on opioids; anxiety and depression; and limitations in mobility and daily activities. Plus, chronic inflammation, a major pain culprit, is a contributory factor to many serious conditions.

In fact, pointed out Liat Vatary, CEO and founder of Curcumin Wonder, a manufacturer based in New Jersey, “According to the CDC, of the 10 leading causes of death by disease in the United States, chronic low-level inflammation contributes to the onset and progression of at least seven such conditions: heart disease, cancer, chronic lower respiratory disease, stroke, Alzheimer’s disease, diabetes and nephritis.”

Most affected by pain are women, older adults, those living in poverty or rural areas, and those without insurance, added Kristin Chadwick, CEO of Omax Health, a California-based manufacturer.

“Pain affects more Americans than diabetes, heart disease and cancer combined. It is cited as the most common reason that Americans seek health care. As such, it is not surprising that it is also a leading cause of disability and a major contributor to health care costs,” said Madeleine Buchanan, nutrition curriculum researcher with Bauman College in California. Citing a statistic from the National Institute of Health, Buchanan said that chronic pain is the most common cause of long-term disability.

Etiology of Pain

The etiology of pain is multifold and can affect virtually any bodily function or system.

Amy Baxter, MD and CEO of Pain Care Labs, a manufacturer in Georgia, explained the biological trajectory of pain. “After injury or overuse, the web of nerve endings transmits both quick (A-Delta) and slow (C-fiber) ‘nociception’: a pain signal. Instead of heading straight to the brain, we now know that pain signals are moderated in the spine, both by local inhibition at the site of pain (like rubbing a bumped elbow) and by inhibition in the spinal cord from the brain (like when you don’t notice aching knees until you quit dancing). When the balance of pain signals is greater than the local inhibition and the dampening from the brain, you hurt.”

She continued, “The electrical quick or slow pain signal is transmitted to the spine, and if unmodified releases neurotransmitters, particularly glutamate and substance P respectively. This spinal cord release, if transmitted to the brain uninterrupted, is interpreted as pain. At the site of an injury, prostaglandins and cytokines come from damaged cells and make the nerve endings more sensitive; the nerve endings themselves can release like substance P at the injury itself, and growth factors are released. Some of these inflammatory substances are released to begin repair and healing, but when chronically elevated, they make both the injured area more sensitive, and cause the brain to become more attuned to the area’s sensations. When the sensory neurons in the spinal cord are chronically triggered, they too become more likely to send information to the brain, a process called central sensitization.”

Pain is also a component of many chronic conditions. “Chronic disease and pain share an important feature: inflammation. Inflammation is a protective mechanism and a necessary part of the immune system; it is what allows our bodies to deal with injury, infection, and stress. Pain is actually one of the five classic signs of inflammation, and in the short-term it is protective; however, when inflammation becomes chronic, it can cause damage to the body and discomfort,” explained Buchanan.

Vatary agreed that not all inflammation is bad. “When a tissue in your body is going through a trauma like an injury or microbial invasion, acute inflammation is initiated and acts as an essential immune response. Your body will then trigger various compounds and immune cells to treat the injury or deal with the invasion,” she said.

Buchanan said that the lifestyle risks for chronic disease and inflammation overlap. “Dietary, environmental and lifestyle factors are the main causes of inflammation; they also present important opportunities to reduce inflammation,” she said. Dietary factors include processed foods, refined sugars and grains, and food additives; environmental factors include water quality and air pollution; and lifestyle factors include stress, smoking and a sedentary lifestyle.

Other causes, added Vatary, include hormonal imbalances, obesity, poor sleep, smoking and chronic stress. Regarding the latter, for example, she said, “In response to stress, your body secretes various pro-inflammatory cytokines and stress hormones, such as cortisol, which have also been linked to a chronic inflammatory state.”

Chronic vs. Acute Pain

The difference between chronic and acute pain is in the duration. “Acute pain is a short term effect, whereas in some conditions, the body can remain in an over inflammatory state causing long term or chronic pain. Any condition ending in ‘itis’ implies some form of inflammation,” said Natalie Lamb, technical advisor with ADM Protexin, a manufacturer based in Florida.

“Acute inflammation starts suddenly due to a trauma or microbial infection, which induces the process. It starts rapidly, becomes severe in a short time and symptoms may last for a few days. Sub-acute inflammation is the period between acute and chronic inflammation and may last several weeks,” Chadwick added.

“Chronic inflammation is slow, long term inflammation that lasts for several months to years. The extent of the time frame depends on the amount of damage that is inducing the inflammation. Tissue damage due to trauma, microbial invasion or noxious compounds all induce acute inflammation,” she continued.

“Once the pain cascade is elevated, chronic inflammation makes the body more sensitive to pain. They may weaken the immune system, but typically chronic conditions lead to chronic pain and inflammation, not the other way around,” said Dr. Baxter.

Conventional Treatments

For short-term relief of pain symptoms, over-the-counter (OTC) medications, such as NSAIDs (non-steroidal anti-inflammatory meds), are popular with many consumers.

However, OTC medications, as benign as they can seem, can have short-term side effects as well, such as stomach discomfort, internal bleeding, kidney issues, and an increased risk of cardiovascular events. Also, not every incidence of pain responds equally to these pharmaceuticals. To illustrate, Lamb said that many migraine sufferers actually increase their risk of further headaches if NSAIDs are overused.

Other common treatments include topical pain relievers (patches, creams, gels) as well as cold and heat application to the affected areas.

When pain is more chronic, Buchanan said that people sometimes turn to acupuncture, massage, steroid injections or electrical nerve stimulation.

But there is no denying the potentially devastating effects of prescription medications. “As the opioid crisis has reached an all-time high, there is a trend to move away from them as a recommended treatment and instead look for bio-markers of pain and pain management,” said Lamb.

“Individuals, health professionals and governmental agencies are increasingly interested in leveraging non-pharmaceutical modalities to address pain and chronic inflammation. Medication can be costly and cause unpleasant adverse effects and complications, and often cannot be used long-term without complications,” added Buchanan.

Natural Approaches for Pain Management

Depending on the location of the pain and etiology, there are many options for pain-sufferers, often involving a multidisciplinary approach, taking into account lifestyle, diet and exercise, to complement conventional treatments.

Lifestyle changes, including increased exercise, can greatly help work tense muscles and joints; other types of pain can benefit from lower intensity methods, such as rest, yoga, acupuncture and massage therapy.

Diet can also play a big role in reducing inflammation. Anti-inflammatory foods include olive oil, nuts, berries, leafy green vegetables and fatty fish, along with certain herbs and spices; foods to avoid include sugar, red meat, fried food and refined carbohydrates. Certain minerals, such as magnesium, are also known to support muscle function; foods high in magnesium include legumes, leafy greens, dark chocolate and bananas.

The overarching goal, said Buchanan, is to decrease exposure to inflammatory stressors. “An important factor to keep in mind is that dietary and lifestyle changes can take time to show results, but often, they can help us to address the root cause. There is not a single food or lifestyle practice that is going to eliminate pain and inflammation; rather, it is a combination of providing our bodies with quality nutrients and health-supportive lifestyle practices that will have a lasting impact,” she said.

“Balancing blood glucose levels represents another important way to reduce inflammation,” she added.

And getting enough sleep, noted Chadwick, is also a key element.

For an acute injury, ice is beneficial, said Dr. Baxter, as it leads to the cells producing less inflammatory cytokines at the source of injury. But for whole body pain, she said that magnesium is the best-studied supplement.

Natural Supplements for Pain

Natural supplements can have a role in pain and inflammation management, even in conjunction with lifestyle modifications.

Established ingredients that support pain includes magnesium, probiotics, omega-3s, turmeric and curcumin. Newer ingredients like cannabidiol (CBD) are being tested for pain and inflammation solutions.

“Probiotics have been shown to influence microbiota composition and play a key role in maintaining and improving gut barrier function, thereby modulating mucosal immune responses and reducing inflammation,” said Lamb.

ADM Protexin offers five products for the practitioner’s market that address pain. These include, Bio-Kult Advanced Multi-strain formula; Bio-Kult Migrea, Bio-Kult Candea, Bio-Kult Pro-Cyan and Bio-Kult Infants.

“Bio-Kult Advanced Multi-strain formula is a unique probiotic with 14 different strains of beneficial bacteria aimed at maintaining optimal digestive health. As each different probiotic strain has a slightly different beneficial effect within the body, a multi-strain is believed to have more positive benefits overall and therefore be able to help a more diverse range of disorders,” said Lamb.

The company’s Migrea formula is the first of its kind. “A unique triple action, multi-strain probiotic supplement targeting the digestive tract and the head. It is formulated with 14 probiotic strains plus magnesium and vitamin B6, both of which contribute to the normal functioning of the nervous system and the reduction of tiredness and fatigue. B6 also contributes to the regulation of hormonal activity,” said Lamb.

Another ingredient that has been studied for its anti-inflammatory effects is curcumin.

“Curcumin is well known when looking for general systemic support. It is tremendously important to choose a curcumin studied for its bioavailability. Meriva is generally considered to be the most studied bio-available curcumin on the market today,” said Ryan Sensenbrenner, director of marketing at Enzyme Science, a manufacturer headquartered in Florida; Enzyme Science is a division of Enzymedica.

Two products offered by Enzyme Science to support systemic health are MyoMed and (PEA)+. “MyoMend is a comprehensive proteolytic enzyme blend. This product is assisting with proteins in the bloodstream that are dead, damaged or otherwise do not belong. Proteolytic enzyme supplementation is a favorite for many health practitioners,” said Sensenbrenner.

(PEA)+ is a new formula that combines the power of PEA with Meriva, one of the most clinically studied bio-available curcumin extracts available on the market today. (PEA)+ works on similar pathways to CBD. It supports the entire body with a focus on nervous, immune and muscular systems. Unlike other sources of PEA that use solvents in their extraction, this formula is naturally sourced from safflower lecithin,” he added.

Pain Care Labs manufactures VibraCool Elbow/Wrist Easy Fit and VibraCool Knee/Elbow Extended.” We began in 2006 designing a device that combined ice and vibration to block intense pain from needles. After going to market in 2009 with “Buzzy,” patients using our gate control and anti-inflammatory solution for arthritis and Crohn’s injections began using it for hip, knee, elbow and wrist pain. After selling directly to consumers, at the end of 2018 we brought on Performance Health and Meyer WBC to be able to sell the devices to practitioners to sell to their patients,” said Dr. Baxter. The products have been the subject of more than 30 research studies, all of which are made available to practitioners.

Omax Health offers a number of products to alleviate inflammation and support pain relief including: Omax3 Professional Strength Omega-3 Supplements; Omax Clinical Curcumin CoQ10; Omax Sleep & Stress Remedy CBD Supplements; and CryoFreeze CBD Pain Relief Roll-on, which is an arctic blast of cooling relief and includes not only CBD but also menthol. Further, the company’s Curcumin CoQ10 supplement uses a new turmeric extract called BioCurc, which Chadwick said is “…clinically tested to be 400 times more bioavailable than 95 percent curcumin formulas. This ultra bioavailable format of curcumin is effective in fighting cellular inflammation, while supporting heart health.”

Curcumin Wonder manufactures Curcumall, a liquid herbal extract of turmeric and curcumin; specifically, it contains Curcumin C3 Complex, a patented formulation of three main curcuminoides. It also includes herbal extracts of turmeric that contain more than 24 volatile oils. “Curcumall was developed by scientists after five years of experiments to increase the bioavailability of turmeric without causing stomach upset and thus increase the positive health impact of the product. It does not contain piperine that can cause gastrointestinal upset for some patients,” said Vatary.

Practitioner Tips

As patients look for different options to combat their pain and inflammation personalized medicine—treating the whole person versus the one-size fits all approach—is trending. “As part of giving their patients a holistic solution for their chronic inflammation and pain, the practitioner needs not only provide guidelines for an anti-inflammatory diet, but also recommend high-quality supplements to support and boost the patient’s transformation process,” said Vatary.

“As there are more and more supplements entering the market every year, the practitioners have an important role in recommending and supplying the right supplement or the right combination of supplements to patients as part of a wider personalized transformational plan for each patient,” she added.

“Practitioners can help their patients when it comes to pain and inflammation by providing the right resources and guidance to help patients successfully combat inflammatory states. This approach would necessitate the collaboration of a team of professionals including a nutritionist that is well versed in the anti-inflammatory diet,” added Anna Zezon, MD, a rheumatologist in New Jersey.

Practitioners who believe that their patients can benefit from dietary supplements should study the current research to be able to answer patients’ questions and concerns. Many manufacturers make this process easy, providing educational brochures and training for practitioners.

“We supply our practitioner partners with samples and literature for them to give out to their patients; this is a great way for them to introduce their patients to a new product as well as to share with them all the medical research and clinical trials that stand behind our product,” noted Lamb.

Chadwick said that Omax provides sampling, signage and point of purchase displays. But patients also need a pain and inflammation treatment protocol that includes effective products and lifestyle changes. “Provide the protocol in the form of a video, online link or brochure that consumers can read and follow. Sell the products directly to your patients as a package, or provide links direct to Amazon or the manufacturer, she advised.

“Diet and lifestyle are important ways to reduce pain and inflammation. As such, these are important factors for practitioners to bring into conversations with clients. Encouraging clients to eat a “rainbow” of fruits and vegetables with high-quality proteins and fats, as well as booster foods such as ferments, herbs, and spices is a great opportunity to help them address the root causes of pain and inflammation,” mentioned Buchanan. Plus, she added, these approaches avoid negative side effects.

“Give them the ‘what works for pain’ handout and don’t be beholden to any one product. Patients need to have multiple options to try. Make sure they know that it will take time, but they can get their bodies on their side again instead of feeling like age or injury are changing how they see themselves,” concluded Dr. Baxter.

Healthy Take Aways:

• According to the National Institute of Drug Abuse, more than 130 U.S. residents die each day after overdosing on opioids.
• The Centers for Disease Control and Prevention (CDC) released a report estimating that just over 20 percent of adult Americans (one in five) are living with chronic pain.
• When considering supplementation, it is crucial to also talk to patients about lifestyle and dietary changes.

For More Information:

ADM Protexin (Bio-Kult), www.protexin.com
Curcumin Wonder, www.curcumall.com
Enyzmedica, https://enzymedica.com
Omax Health, https://omaxhealth.com
Pain Care Labs, https://paincarelabs.com