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Natural, Evidence-Based Strategies For Pain Management

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Pain is fact of life. Everyone experiences it at some point or another. Research suggests that up to 50% of the population may be suffering from some kind of chronic pain, with back pain being the most common.1 In many cases the pain signal is from a vicious cycle of structural damage, tissue breakdown and inflammation. This leads to joint painchronic, long term pain that drastically impacts every aspect of a person’s life. Despite the high prevalence of chronic pain, effective treatments are limited in providing lasting relief. Often, frustrated people turn to natural and complementary approaches when they no longer get adequate results from medications. There are many different natural options, making it very confusing in determining what approach would be most beneficial for your specific condition. The goal of this article is to provide a brief overview of natural and complementary approaches to pain management so you can make an educated choice about what will work for you and what is available.

Are you deficient in the sunshine vitamin and magnesium?
There are many vitamins and minerals that a person may be deficient in, but for chronic pain patients the 2 most important are vitamin D and magnesium. Deficient levels of both play such an essential role in nerve function and pain signalling. A study published in November 2012 found that certain types of pain are related to vitamin D deficiency, and replacement of vitamin D showed improvement. The researchers found that 95.4% of the subjects were vitamin D deficient, and 85.5% of the subjects had improvement in pain with vitamin D supplementation.2 This study confirms the findings of a number of other studies that have found the same results.3,4,5 The studies found that vitamin D deficiency may be responsible for generalized, non-specific pain especially if it is resistant to manual and conventional treatments. Vitamin D can be a simple yet very effective therapy for chronic, non-specific pain if you are deficient. To determine if it may be contributing to your pain, have a qualified health care practitioner assess your serum levels and supplement appropriately (with high enough doses) to restore your optimal levels. The biggest mistake people make is that they don’t take high enough doses and fail to monitor levels to see if the vitamin D levels are really going up.
Magnesium is a mineral that is involved in over 300 biochemical processes in the body. One of its most important functions is that it plays a key role in producing energy and maintaining muscle and nerve function. Specifically in chronic pain, magnesium can be helpful for offsetting the effects of too much calcium which causes muscle spasms and tightness. Magnesium acts like a plug in nerve receptors that are over-stimulated. The problem with this essential mineral is that most people do not have sufficient levels for optimal health. People with chronic pain are especially deficient. Various forms of magnesium are available and can make a huge difference on how the mineral is absorbed. For example, magnesium oxide is not well absorbed and can have a laxative effect, while magnesium glycinate is much better tolerated and absorbed. Ask your integrative health care practitioner which form and dose is best for you.

Stop feeding your inflammation
All chronic conditions such as cardiovascular disease, cancer and chronic pain have a strong and persistent link with chronic inflammation. Eating a diet high in refined fats and sugars encourages inflammation, while avoiding refined sugar and eating a balanced diet with unrefined good fats (like omega 3s) and high in nutrient-rich, plant-based foods reduces it.6 Sugar is one of the biggest drivers of inflammation with a key source being refined carbs like bread, pastries and pasta, which are rapidly converted to sugar. Sugar also promotes weight gain and is linked to diabetes. Emerging research is showing that refined foods such as a breakfast sandwich can rapidly increase inflammation right after consumption.7 To break the cycle of inflammation and pain it is paramount to limit foods that promote this damage. On the flip side, culinary spices such as ginger and turmeric are now being intensely studied to quench inflammation right at the cellular level. Speak to a nutrition expert to help you identify which foods to stop and which ones to start eating.

Cut out food sensitivities and allergies
The awareness of food allergies, food intolerances and food sensitivities has been growing rapidly over the past few years. More specifically, people are discovering that certain foods have the power to negatively impact their health. A key concept to understanding why food intolerance has such a powerful and wide ranging effect is the connection of our digestive tract and immune system. Food sensitivities cause chronic irritation and inflammation of our digestive tracts, which causes our immune systems to be over stimulated and become sensitized to normally harmless food particles.8 To identify what specific food intolerances you can either stop eating the most common food allergens and then reintroduce them or get a food allergy blood test, which assesses your immune response to the most commonly allergic foods (dairy, wheat, eggs, soy). For people with chronic pain, migraines, skin conditions, digestive upset, autoimmune disease and IBS assessing food sensitivities is a key step to break the viscous cycle of inflammation.

Block inflammation with herbal extracts
There are many evidence-based herbal extracts that can reduce inflammation. I want to share some of my favourites with the strongest evidence. NOTE: check with your doctor or pharmacist to ensure there are no interactions with your current medications.
Curcumin: The yellow herb found in turmeric. Curcumin has many studies showing its anti-inflammatory effects. What makes curcumin stand out is that it blocks inflammation at multiple levels including right at the DNA, preventing the creation of more inflammatory signals. Clinical studies have also shown it not only reduces joint pain but also lowers cholesterol, and blocks key cancer and Alzheimer’s disease-promoting pathways. The trouble is that curcumin is very poorly absorbed so a fat-soluble extract is needed to maximize absorption. Longvida® is a well-studied curcumin extract developed at UCLA with proven superior absorption over standard extracts and even other “bioavailable” curcumin products. You pay a little extra for it but the powerful anti-inflammatory effects are quickly noticeable and well worth it.
Boswellia seratta: A resin extract from the herb frankincense also reduces a multiple of inflammatory pathways without causing cartilage damage. A number of human clinical trials have found an extract from Boswellia was able to improve joint range of motion and function with the same effectiveness as standard NSAID medications (i.e. Ibuprofen). One study found this effect in as little as 7 days. What makes Boswellia unique is that it also has an affinity for inflammatory pathways in the digestive system and lungs, which can improve conditions like asthma and inflammatory bowel disease.

Get the help of a naturopathic doctor
There are many resources on the internet touting natural and guaranteed pain relief, but it’s impossible to know which ones are actually worth your time or will work for you. One way to take the guessing out your decision is to work with a board-certified naturopathic doctor (ND). Naturopathic Doctors are trained in the art and science of both conventional and alternative medicines. Many chronic pain patients visit an ND after no other doctor or health care practitioner is able to help them or get to the bottom of their symptoms. It’s important to work with a health care practitioner that will help guide you while using natural therapies since there can be interactions with some medications you are currently using.

What are some of YOUR favorite natural pain management strategies? Tell us in the comments below!

Images by © 2014 Rido and © high_resolution via DollarPhotoClub

References

1) Andersson HI, Ejlertsson G, Leden I, Rosenberg C. Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization. Clin J Pain. 1993;9(3):174-82

2) Abbasi M, et al. Is vitamin D deficiency associated with non specific musculoskeletal pain? Glob J Health Sci. 2012;1:107-11.

3) Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain.
Mayo Clin Proc. 2003 Dec;78(12):1463-70.

4) Al Faraj S, Al Mutairi K. Vitamin D deficiency and chronic low back pain in Saudi Arabia. Spine (Phila Pa 1976). 2003 Jan 15;28(2):177-9.

5) Holick MF. Vitamin D deficiency: what a pain it is. Mayo Clin Proc. 2003 Dec;78(12):1457-9.

6) Seaman DR. The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002 Mar-Apr;25(3):168-79.

7) Aljada A, Mohanty P, Ghanim H, Abdo T, Tripathy D, Chaudhuri A, Dandona P Increase in intranuclear nuclear factor kappaB and decrease in inhibitor kappaB in mononuclear cells after a mixed meal: evidence for a proinflammatory effect. Am J Clin Nutr. 2004 Apr;79(4):682-90.

8) Grant EC. Food allergies and migraine. Lancet. 1979 May 5;1(8123):966-9.

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