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The Science of Pain is Changing Rapidly
Posted by John Coppola on 05 Aug, 20
Pain is a widespread problem today, delivering serious blows to people's health, happiness, and productivity. Chronic pain is one of the most common reasons adults seek medical care. It’s been linked to restrictions in mobility and daily activities, not to mention dependence on opioids and other pain medications. But did you know it could also wreak havoc with your moods? Chronic pain has been shown to increase anxiety, depression, and result in a reduced quality of life.
The experience of pain is highly subjective – each person feels pain differently and at different intensities. The good news is that your pain response is not indelibly hardwired into you. Studies show it's possible to distract or "manipulate" your brain into decreasing its response to pain. Also, by decreasing the amount of toxic overload or accumulated chemicals within your body, this too can decrease your pain response. This is great news if you are a chronic pain sufferer because it means there’s hope beyond simply popping pills.
With a few effective tools, you can manage pain effectively and reduce, if not eliminate, your reliance on painkiller drugs. The importance of this is that these drugs introduce a whole new set of health risks, regardless of whether they are prescription or over-the-counter (OTC).
How Extensive Is the Pain Problem?
According to the Institute of Medicine report1, pain costs society between $560 billion and $635 billion annually—amounting to about $2,000 for every man, woman, and child living in the US.
Part of this cost is lost productivity. Overall, workers lose an average of 4.6 hours per week of productive time due to pain conditions, regardless of age. According to the American Academy of Pain Medicine2, pain affects more Americans than diabetes, heart disease, and cancer combined.
The Risks of Pain Medications
One of the problems with relying on medications to treat pain, especially chronic pain, is that the side effects can sometimes be worse than the condition you're trying to treat. This is even sometimes the case with seemingly "safe" medications like acetaminophen. Acetaminophen is actually the leading cause of acute liver failure in the United States.3 The FDA has even limited the amount of acetaminophen allowed in prescription products and added a ‘Black Box’ warning due to liver toxicity concerns.
Your risk of severe liver injury and/or death related to acetaminophen increases if you:
- Take more than one regular strength (325 mg) acetaminophen when combined with a narcotic analgesic like codeine or hydrocodone
- Take more than the prescribed dose of an acetaminophen-containing product in a 24-hour period
- Take more than one acetaminophen-containing product at the same time. Make sure to read the list of ingredients on any other over-the-counter (OTC) or prescription drug you take in combination.
- Drink alcohol while taking an acetaminophen product. Research suggests that acetaminophen significantly increases your risk of kidney dysfunction if taken with alcohol—even if the amount of alcohol is small.4 Combining alcohol with acetaminophen was found to raise the risk of kidney damage by 123 percent, compared to taking either of them individually.
Each year more than 100,000 instances of acetaminophen overdose result in nearly half of all acute liver failure cases in the US.
Acetaminophen overdoses are also responsible for more than 150 deaths each year in the US.
While acetaminophen is considered safe when taken as recommended, the margin between a safe dose and a potentially lethal one is very small.
Taking 25 percent more than the daily recommended dose (the equivalent of just two extra strength pills per day) can cause liver damage after just a couple of weeks of daily use.5
NSAIDs (non-steroidal anti-inflammatory drugs) are a common class of painkillers available Over The Counter (OTC) and by prescription. They were once thought to be relatively harmless, but now science reveals when used for chronic pain and taken long term, NSAID’s carry a very high risk.
NSAIDs can damage your gut lining, wreck your gut bacteria, and increase your risk of heart attack and stroke. In fact, NSAID’s can increase your risks for heart attacks, stroke or sudden cardiovascular death by two to four times. Aside from this, NSAIDs are linked to serious gastrointestinal risks like bleeding of the digestive tract, ulcers, increased blood pressure, kidney failure and liver failure. In fact, the most common side effect from all NSAIDs is damage to the gastrointestinal tract. Byron Cryer, MD, leading gastroenterologist and spokesperson for the American Gastroenterological Association, states that both OTC and prescription NSAID’s are notorious for causing internal bleeding.
- Aspirin (Bayer, Ecotrin, and St. Joseph)
- Ibuprofen (Advil, Motrin, Nuprin)
- Ketoprofen (Actron, Ordus KT)
- Naproxen sodium (Aleve, Naprosyn)
- Diclofenac sodium (Volataren)
- Celebrex (Celecoxib)
- Mobic (meloxicam)
- Indocin (Indomethacin)
- Diclofenac sodium (Volataren)
- DayPro (oxaprozin)
It has been proven that NSAIDs have been proven are not be the best way to deal with pain or inflammation.
Dangers of Opiods
The U.S. continues to be in the midst of an opioid crisis. In fact, more than 20,000 Americans were killed by prescription opioids in 2017, and it is estimated that over 2 million Americans suffer from opioid addiction. Opioids are highly addictive, in large part because they activate powerful reward centers in your brain.
Researchers have found that taking opioid medications for more than five days increases your risk of long-term use, which increases your risk of addiction. Meanwhile, a study published in the New England Journal of Medicine found that long-term use of opioids actually does little to relieve chronic pain.6 In some cases, they may even make chronic pain worse.
You may find it shocking that, in the midst of this epidemic of opioid overdose deaths, the pharmaceutical industry would be making payments to physicians to prescribe more opioid products, but this is precisely what's occurring.
According to a study published in the American Journal of Public Health7, more than 68,000 physicians received opioid-related payments (not linked to research funding) totaling more than $46 million, between August 2013 and December 2015.
Commonly prescribed Opioids
- Hydrocodone (Vicodin)
- Oxycodone (Oxycontin, Percocet)
- Morphine (Kadian, Avinza)Codeine
Natural Pain Control that Works
If you have a headache, backache, toothache, menstrual cramps or any other type of pain, your first impulse may be to reach for medication, whether it’s from your local pharmacy or a prescription. Many people rely heavily on medications that come with dangerous risks, side effects, drug interactions, and habitual use or addiction. This is not only true for prescription meds but also for OTC medications.
Instead, seek out relief from a variety of natural treatments that have been proven to relieve pain. Alternative medicine treatments have been scientifically proven to be equally effective at treating many different forms of pain without the dangerous risks.
The following lists many non-drug pain therapies that have withstood scientific scrutiny.
According to a study published in the Annals of Internal Medicine8, patients with neck pain who used a chiropractor were more than twice as likely to be pain-free in 12 weeks, compared to those who took medication. Another study published in the same journal even revealed that chiropractic care is often better than medication for treating musculoskeletal pain.
Physical Therapy (PT):
Studies show that physical therapy, occupational therapy and exercise programs can be used to help manage chronic pain because they have benefits such as: improving blood flow/circulation, reducing stiffness and edema and improving the affected body part’s flexibility, strength and function.
Studies have found acupuncture to be more effective for managing chronic pain than drug treatment.9
According to the National Institute of Health (NIH), a number of studies suggest that acupuncture works particularly well on chronic pain such as back and neck pain; osteoarthritis/knee pain; and headache. It often reduces the incidence and severity of tension headaches and may prevent migraines. Therefore, the NIH concludes, “acupuncture appears to be a reasonable option for people with chronic pain to consider.”
Massage releases endorphins, which help relieve pain, induce relaxation, and reduce stress chemicals such as cortisol and noradrenaline. Latest studies two or three 60-minute massages per week may be necessary for pain relief.
Class 3B and class 4 lasers help reduce pain and inflammation and enhance tissue healing—both in hard and soft tissues (muscles, ligaments, and bones). Laser therapy can be especially helpful for acute and chronic pain issues.
Posture, Muscle Strengthening and Stretching:
Poor posture, muscle weakness and tight muscles are some of the top underlying causes of neck, mid back and lower back pain. Try implementing the following exercises and stretches to reduce tension, build strength, and improve posture.
The purpose of pilates is to gain flexibility, strength and body awareness without building bulk. Studies have shown that Pilates-based exercises have a positive effect on reducing pain and improving functional mobility.10 Sessions should last 60 minutes with a frequency of 2 or 3 times per week.
The aim of yoga exercises is to improve physical, emotional, and spiritual health. Yoga, known for promoting flexibility, muscle tone core muscle strength, and good posture has been proven to lower resting heart rate, increase endurance and improve maximum uptake of oxygen, all of which is beneficial if you suffer from chronic pain. Yoga can help reduce pain associated with arthritis, fibromyalgia, migraine, low back pain, and many other types of chronic pain conditions. A study published in Annals of Internal Medicine11 found that among 313 people with chronic low back pain, a weekly yoga class increased mobility more than standard medical care for the condition. A meta-analysis of 17 studies that included more than 1,600 participants concluded that yoga can improve daily function among people with fibromyalgia osteoporosis-related curvature of the spine. Practicing yoga also improved mood and psychosocial well-being.
Underlying emotional issues and unresolved trauma can have an enormous influence on your health, particularly as it relates to physical pain.
The following mind-body approaches have shown good results with decreasing pain levels
Yoga is a mind-body and exercise practice that combines breath control, meditation, and movements to stretch and strengthen muscles. What sets yoga apart from most other exercise programs is that it places as great an emphasis on mental fitness as on physical fitness. Yoga stretches allow the mind to find a positive focus rather than focusing on pain.
Tai chi, often described as "meditation in motion" or "moving meditation," takes your body through a specific set of graceful movements combining breath control and meditation. The slow motion and weight shifting can improve musculoskeletal strength and joint stability, which has been shown in research to reduce chronic pain and the symptoms of depression. Benefits include pain management, improved balance, cognitive function, and sleep.
Some solid research shows that tai chi can benefit people with osteoarthritis, rheumatoid arthritis, fibromyalgia, tension headache, and other ongoing, painful conditions. In one trial, for example, 66 people with fibromyalgia were randomized into two groups: one group took tai chi classes twice a week, the other group attended wellness education and stretching sessions twice a week. After 12 weeks, those in the tai chi group reported less pain, fewer depression symptoms, and better sleep than the group12.
Meditation can be a powerful pain reliever. It can help you reduce stress-induced inflammation. Meditation shifts your focus to something quiet and calm, thereby reducing the amount of stress hormones produced. The process of meditation helps the brain release endorphins, a natural pain reliever, while reducing negative emotions. People with persistent negative thoughts and anxiety are more likely to suffer from chronic pain. Meditation has also been shown to increase pain tolerance.
Emotional Freedom Technique (EFT)
EFT has been found to be an alternative treatment for physical pain and emotional distress. Dr. John Sarno, a psychiatrist who uses mind-body techniques to treat patients with severe low back pain, has experienced more than 80 percent success using EFT.
Herbs and Supplements
CBD has a long history as a natural analgesic.13 Its medicinal qualities are due to high amounts (about 10-20 percent) of cannabidiol (CBD), medicinal terpenes, and flavonoids. As discussed in this previous article, varieties of cannabis exist that are very low in tetrahydrocannabinol (THC)—the psychoactive component of marijuana that makes you feel "stoned"—and high in medicinal CBD. The Journal of Pain,14 a publication by the American Pain Society, has a long list of studies on the pain-relieving effects of cannabis.
A 2014 study found that curcuma extract is as effective as ibuprofen for pain management in the treatment of knee osteoarthritis when a person takes it for 4 weeks.
Turmeric is also a common herbal remedy for reducing inflammation. Several studies have found that turmeric extract (rich in curcuminoids) blocked inflammatory pathways, effectively preventing the overproduction of a protein that triggers swelling and pain.15
Boswellia (Indian frankincense)
Scientific research supports that this herb contains specific active anti-inflammatory agents and can reduce pain by reducing inflammation.16 Boswellia has been found to reduce pain associated with:
- Rheumatoid Arthritis (RA)
- Osteoarthritis (OA)
- Joint pain
- Muscle aches and pain
- Inflammatory Bowel disease (Crohn’s, Ulcerative Colitis)17
- Symptoms of Parkinson’s disease
White Willow Bark
This herb contains powerful anti-inflammatory compounds called flavonoids and is responsible for pain relief and inflammation reduction. Benefits include:
- Relieves menstrual cramps
- Reduces fever
- Decreases pain and inflammation
- Decreases joint pain18
- Alleviates headaches
- Reduces muscle pain
This herb has demonstrated strong anti-oxidant and anti-inflammatory effects. Benefits include:
- Decrease arthritis pain
- Reduce pain associated with gout
- Improves chronic osteoarthritis pain
- Decreases back pain20
DPA decreases pain by blocking the enzymes that break down the body's natural painkillers. Clinical studies suggest DPA may inhibit some types of chronic pain. Certain amino acids have been found to raise pain thresholds and increase tolerance to pain. Benefits include:
- Reduces low back pain
- Reduces chronic pain
- Reduces symptoms of Parkinson’s disease
- Alleviates pain caused by osteoarthritis
- Reduces RA pain
Dealing with pain is never easy. But when the pain comes from a condition that's temporary (the after-effects of surgery, a minor bump on the head, or a mild sprained ankle) at least you know the pain will go away in a short period of time. Unfortunately that’s not the case with chronic pain. Chronic pain may come and go but it always returns making normal day-to-day activities difficult to navigate. As a result, more people search for a remedy in the form of pain pills to restore their quality of life.
After all, most people assume taking a pain pill prescribed by their ‘trusted’ family doctor is safe. But certainly, taking over the counter medications must be completely safe or the FDA would never allow them to be sold over the counter, right? We can see through scientific studies that this is clearly not the case.
We have become a nation that is over reliant upon pain medications. It’s become far too easy for us to pop a pain pill day after day to control back pain, neck pain, arthritis pain, peripheral neuropathy pain and more; all the while losing sight of the long list of side effects and damage that chronic use of these meds do.
Do you know that if you’ve been taking an OTC pain remedy like ibuprofen or naproxen (nsaid’s) daily for long periods, abruptly stopping them can increase your risk for blood clots. So it’s important to wean off of pain pills slowly, even if they’re OTC.
Pain pills, whether OTC or prescribed, DO NOT correct the problem. They only mask the pain allowing the problem to progressively worsen. We have to stop being lulled into a false sense of security we’re sold by the thousands of charismatic commercials on TV peddling pain relief drugs.
It's time to seek out solutions that will correct and/or minimize the source of your pain (as in the case of arthritis sufferers) with proven natural alternatives as mentioned above. People have used herbs, alternative therapies and, essential oils as natural pain relievers for hundreds of years. In the meantime, to control your pain there are safe natural alternatives that you can take to pain medication that don’t come with the high risks and side effects.
9 More Natural Options for Powerful Pain Relief
Below are 9 additional strategies for non-drug alternatives to treat your pain. If you suffer from chronic pain, try these methods first before ever considering prescription pain pills, steroid injections, or surgery.
- Eliminate or radically reduce most grains and sugars from your diet. Avoiding grains and sugars will lower your insulin and leptin levels and decrease insulin and leptin resistance, which is one of the most important reasons why inflammatory prostaglandins are produced. That is why stopping sugar and sweets is so important to controlling your pain and other types of chronic illnesses.
- Take a high-quality, animal-based omega-3 fatty acid. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they manipulate prostaglandins.) Omega-3 fatty acids can reduce inflammation and the pain and swelling accompanied by it.
- Increase vitamin D levels: a simple blood test can tell you if you have optimum vitamin D levels (60-100 ng/mL). Insufficient vitamin D has been linked with back pain, muscle pain and joint pain. Studies have shown that raising vitamin D levels to an optimum status can reduce your pain.
- Astaxanthin is one of the most effective fat-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than anti-inflammatory drugs. Higher doses 8 mg or higher are typically required to decrease inflammation.
- Ginger: This herb has potent anti-inflammatory activity and offers pain relief and stomach-settling properties. Fresh ginger steeped in boiling water as a tea or grated into vegetable juice works well.
- Proteolytic enzymes: These are enzymes produced by the stomach and pancreas and used to break down proteins during the digestive process. However, several studies have shown that proteolytic enzymes are effective at reducing inflammation and symptoms related to inflammatory conditions.
- Evening primrose, black currant, and borage oils: These contain the essential fatty acid gamma linolenic acid (GLA), shown to ease inflammation in the body. These oils can help reduce joint or muscle pain and stiffness.
Essential Oils: Certain essential oils can help manage inflammation and pain. Essential oils proven to be highly effective are:
• Wintergreen + Peppermint – for pain relief
• Marjoram – nerve pain, headaches, migraines, stomach cramps, improves circulation.
• Helichrysum – inflammation, muscle and joint pain, nerve pain
• Lavender – eases pain from muscles, joints, sprains, backaches, headaches, improves circulation
• Oregano – anti-inflammatory, fights infection
• Honey suckle – reduces pain and swelling. Especially effective for arthritis sufferers. Aids digestive dysfunction.
- Far Infrared Heating Pad: Regular electric heating pads use electric heating coils that only heat your skin, can cause burns, and emit high levels of electromagnetic radiation, which is harmful to your health. On the other hand, far infrared heating pads use natural stones, such as jade, amethyst or granite, that when heated produce far infrared rays that can reach as deep as your bones without any risks of burning or side effects.
This blog has been provided by Dr. John Coppola, D.C. and Dr. Valerie Monteiro, D.C. Dr. Coppola and Dr. Monteiro are the founders of the San Antonio Neuropathy Center, and Precision Sport & Spine. They are the leading experts in the field of neuropathy and specifically drug free nerve repair. They are the authors of the critically acclaimed book "Defeat Neuropathy Now .... In Spite of Your Doctor. The doctors have over 25 years of clinical experience.
If you would like to reach the doctors regarding a specific health problem, you may email them at firstname.lastname@example.org.
- Institute of Medicine report: Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research 2011
- American Academy of Pain Medicine
- Hepatology 2004 Jul;40(1):6-9
- 141st annual American Public Health Association Meeting, Online Program
- JAMA July 5, 2006: 296(1); 87-93
- JAMA. 2017;318(17):1661-1667
- Journal of Pain April 2004: 5(3); S52
- Annals of Internal Medicine January 3, 2012
- Arch Intern Med. October 22, 2012
- PMJ/BMJ. /vikyne 95, Issue 1119
- Annals of Internal Medicine: Yoga Similar to Physical therapy in Helping Low-Back Pain in a Diverse Urban Population 2017
- N. Engl. J. Med. August 2010
- Journal of Pain, Cannabis a unique analgesic. 2004; vol.5
- Journal of Pain, Cannabis studies
- Foods. 2017 Oct; 6(10): 92.
- Indian J Pharmacol. 2014
- World J Gastroenterol. 2017
- Nutrition Journal 2015: A commercialized dietary supplement alleviates joint pain in community adults: a double-blind, placebo-controlled community trial
- Current Medicinal Chemistry 2012
- Phytomedicine. 1996
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