Pain Management

 

The Pain Dilemma

Are you experiencing chronic pain? Do your joints ache?  If so, you may or may not know the cause. One thing is for sure, you’re in pain, and you want it to go away. You may have tried prescription medications to ease the symptoms, but the side-effects make them a difficult choice for daily use. Now, if we asked you to point out your level of discomfort using a physician’s facial expression chart, it would most likely be one of the frowning faces at the end of the scale.

A pain measurement scale used by doctors to help a patient point out their symptoms using emoji faces that go from happy to in pain–the color of the emoji face changing from happy green, no hurt, to tan, yellow and red to convey hurts worst.

You’re not alone. It’s estimated that 76 million adults or one in every four Americans suffer from chronic pain. The conventional approach to treating chronic pain falls short and comes with dangerous side-effects.  Modern research has been able to identify the body’s pain pathways. This is good because when we know the cause, we can locate a cure. Scientists studying the pain pathway have found that chronic pain increases our sensitivity to pain.

 

An image of someone's foot highlighted red to indicate inflammation.

 

To get a better picture, think about dropping something heavy like a dictionary on your foot. Each time you attempt to walk on the foot that received the blow your reflexes kick in, and you begin to limp. Now imagine that hyperactive pain response occurring throughout the body. Chronic pain is easy to diagnose but hard to treat. 

What causes pain?

Pain is caused when tissues become injured and inflamed. This can be from either physical trauma or age-related wear and tear. No matter the cause, the processing of pain is the same. Signals from inflamed tissues are sent to the brain and processed as painful sensations. Recent studies have found changes to the body’s inflammation response contributes to chronic pain. Inflammation is often diet-related and can be fixed by eating healthier foods. 

 

An overhead picture of healthy food such as apples, broccoli, and celery next to unhealthy fast food like burgers, fries, and pizza on a wooden table.

Alternative Therapies

“Alternative Therapy” is a concept that describes any medical treatment or strategy that takes the place of conventional medicine. For example, instead of using a prescription drug to treat a chronic condition such as pain, an alternative treatment can include the use of anti-inflammatory herbs. Other natural interventions primarily based on traditional healing systems like Traditional Chinese Medicine incorporate herbs, massage, yoga, and acupuncture.

Herbs are hanging to dry on a wooden pole against a pure white background.

 

Herbal Therapies 

The prescription drugs used to treat pain and inflammation has changed little in the last few thousand years. Pain medicines have their ancient origins with the use of opiate-based medications. The danger with this course of treatment is the effects opiates have on the body’s autonomic functions such as breathing. A safer and time-tested remedy to naturally promote a healthy inflammation response is the use of therapeutic herbs. Herbal formulas are a healthier choice because they work with the body to reduce the symptoms of chronic pain.

Turmeric powder in a wooden spoon with fresh turmeric roots next to a bowl full of more turmeric powder on a wooden table.

Turmeric

Modern research on Turmeric has demonstrated its role as a powerful antioxidant. It’s estimated that each of our 34 trillion cells gets hit with roughly 10,000 free-radical strikes each day. Turmeric inhibits chronic pain by naturally shifting the body into an anti-inflammatory state.

Dried Boswellia granules in and around a white mortar and pestle on a glass table.

Boswellia

Is a natural tree resin used for over millennia in India and China for the treatment of asthma, edema, and inflammatory diseases. The first reference of the use of Boswellia as a medicine dates back to 1500 BC Egypt on papyrus scrolls. Boswellia prevents the enzymatic destruction of joint tissues and blocks the action of enzymes that promote inflammation. 

Fresh sliced ginger root on a pure white background.

Ginger

Is a pungent, warming medicinal that has been used for over 5,000 years for treating digestive ailments, cold extremities, and inflammation. Ginger can be taken by itself or combined with other herbs to increase their bioavailability. Ginger is related to Turmeric, and in Ayurvedic tonic formulas, the two are often combined to combat infections, support gastrointestinal health, quench pain and inflammation of arthritic joints and sore muscles.

Someone with just there hands showing holding out an eyedropper of CBD oil which is suspended over tiny hemp leaves.

CBD

Is able to activate TRPV1 Vanilloid receptors which play an essential role in pain perception, body temperature, and inflammation. Activation of TRPV1 desensitizes/fatigues pain processing neurons leading to pain relief. Learn more

Massage Therapy 

A young woman laying on a toweled table on her stomach is smiling as she's getting a massage from a masseuse whose hands are just visible in the shot.

Massage therapy is a centuries-old technique for relieving tension and pain in the body. A qualified massage therapist can release pressure on joints and nerves by relaxing tight muscles and fascia. There are several techniques used, such as:

 Longitudinal Gliding is an effective massage technique that helps reduce inflammation and swelling by increasing blood flow to injured areas generating pain. Fresh blood flow delivers nutrients and stem cells to speed recovery and healing.

Kneading applies pressure to the surface of the body using thumb and palm in an intermittent movement with the goal to quickly ease tension in soft tissues. This is a very common technique practitioner's often employ to remove knots in tight muscles.

Myofascial Release is used by massage therapists to stretch the fascia, which is the “breathable” connective tissue that covers and connects the organs, muscles, and skeletal structures. Stress and physical trauma often restrict fascia, and the purpose of myofascial release is to restore tissue function by releasing the impeded fascia.

Trigger Point Therapy is the most common massage strategy that involves applying pressure to tight muscles that get “knotted” from stress caused by anxiety and bodily injuries.

Swedish Massage is a simplified approach that includes several techniques to release tension, reduce stiffness, and eliminate pain. The method incorporates gentle kneading, tapping, vibration, and firm broad strokes in the direction of blood flowing to the heart.

Yoga

A woman wearing a yoga outfit in the foreground and a woman in a yoga outfit in the background are sitting in meditative poses–neither of their faces is visible.   

Yoga is one of the oldest techniques for concentrating physical energies to promote health and wellbeing. Yoga is a series of poses or asanas that transcend ordinary postures, appearing to project the body onto a spiritual plane. One of the most famous asanas is of the Buddha sitting with legs intertwined holding both hands out with thumb and forefinger turned upward in what is known as the lotus position. The health & wellbeing of the body, mind, and spirit underlie the central tenets of Yoga.

A woman's hand is visible in a meditative pose on a wooden porch with the morning sun taking up most of the shot.

 

Benefits of Yoga

Asanas promote flexibility, stimulate blood and oxygen flow while activating parasympathetic functions which calm the body & mind. Hatha Yoga is a safe and effective treatment for chronic pain as it supports full range of movement. Hatha Yoga is performed at many different levels that often begin with some basic poses such as chair pose which allows a beginner to learn breathing exercises known as pranayama (breath control) while in a comfortable position.  

Top 3 Benefits for Chronic Pain

  • Hatha Yoga is a way to activate the body’s “relaxation response.” increasing pain thresholds.
  • Hatha Yoga resets the physical and emotional feedback systems restoring healthy inflammatory levels and emotional wellbeing.
  • Hatha Yoga improves cerebral blood flow, which prevents age-related cognitive decline.

 Basic Yoga asanas:

 

An infographic of yoga poses and text describing the different poses.

 

Acupuncture
A woman is lying on her stomach with acupuncture needles in her skin and an acupuncturist behind her applying a needle.

Acupuncture is a Traditional Chinese procedure for relieving pain and restoring mobility to the body. The Chinese saw the mind-body as one unit composed of an invisible bioelectric meridian system that unites the internal organs and surface of the body with a life-force energy. When an injury or illness disrupts the flow of energy through the 12 meridians it results in the symptoms of disease like pain. Acupuncture uses sterilized needles that a certified practitioner inserts at specific points on the surface of the body based on the anatomical positioning of the meridian system discovered thousands of years ago. The purpose is to remove the blockage that prevents the life-force energy from flowing into the injured tissue or organ for healing. A meta-analysis by the Journal of Pain found significant evidence for the use of Acupuncture as an alternative therapy for treating chronic pain symptoms.

 

A woman is lying in a supine position receiving energetic healing from a reiki practitioner standing over her with hands hovering her head with light added to convey visible energy.

What can I expect? 

Treatment begins with an initial appointment that introduces you to the medical philosophy of acupuncture and establishes your complete medical history. The acupuncturists ask you questions about your diet, stress levels, sleep routine, to establish a baseline which may need adjustment or change depending on your state of health. The whole person is treated, not just the disease. A blockage of life-force energy to an area of the body is not the main issue, but the entire picture of your life. It’s what you do outside of acupuncture that is important.

A young woman wearing a white top with just her head and shoulders visible is holding out her tongue against a pure white background.


An average acupuncture session lasts between 45 mins to an hour. A certified acupuncturist starts by examining your biomarkers such as pulse, then proceeds to check your tongue, which reflects the condition of your organs and indicates any blockage in the meridian system.

The acupuncturist will use about 15 needles in one treatment and leave them in for 10 to 20 minutes. A single needle at the beginning is used to gauge your level of comfort.

Additional techniques may be used depending on your condition, including: 

Cupping. Glass or rubber cups are applied to the surface of the body utilizing a suction effect that pulls the skin into the vacuum. The theory indicates cupping to ease tension in soft tissues by allowing blood to flow freely into an area.

Moxibustion. Is used when acupuncture is not alleviating the symptoms of pain and weakness. Moxa sticks made of paper are filled with the herb mugwort which is smoked and held 1cm above the skin over acupressure points. Moxibustion is known to deeply penetrate into the body restoring the flow of energy in the meridian channels.

Laser acupuncture. This is more of a modern method of acupuncture that some people prefer because it uses concentrated light instead of needles.  

  

References

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  3. Chung, Hae Young, Matteo Cesari, Stephen Anton, Emanuele Marzetti, Silvia Giovannini, Arnold Young Seo, Christy Carter, Byung Pal Yu, and Christiaan Leeuwenburgh. "Molecular Inflammation: Underpinnings of Aging and Age-related Diseases." Ageing Research Reviews 8, no. 1 (2009): 18-30. doi:10.1016/j.arr.2008.07.002
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  5. Itokawa H, Shi Q, Akiyama T, Morris-Natschke SL, Lee KH. (2008). Recent advances in the investigation of curcuminoids. Chin Med.
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  7. Krishnaraju V Alluri, Andey Rama Satish, Simanchala Mishra, Trimurtulu Golakoti, Kadainti VS Sarma, Dipak Dey, and Siba P Raychaudhuri. "A Double-Blind, Randomized, Placebo-Controlled Study of the Efficacy and Safety of 5-Loxin ® for Treatment of Osteoarthritis of the Knee." Arthritis Research & Therapy. July 30, 2008.

  8. "Safety and Toxicological Evaluation of a Novel, Standardized 3-O-Acetyl-11-keto-β-Boswellic Acid (AKBA)-Enriched Boswellia Serrata Extract (5-Loxin®)." Taylor and Francis Online.
  9. Semwal RB, e. (2018). Gingerols and shogaols: Important nutraceutical principles from ginger. - PubMed - NCBI. [online] Ncbi.nlm.nih.gov.

  10. Nafiseh Shokri Mashhadi, M. (2018). Anti-Oxidative and Anti-Inflammatory Effects of Ginger in Health and Physical Activity: Review of Current Evidence. [online] PubMed Central (PMC).
  11. Nagarkatti, Prakash, Rupal Pandey, Sadiye Amcaoglu Rieder, Venkatesh L. Hegde, and Mitzi Nagarkatti. "Cannabinoids as Novel Anti-inflammatory Drugs." Future Medicinal Chemistry 1, no. 7 (2009): 1333-349. doi:10.4155/fmc.09.93.
  12. Maione, Sabatino, Fabiana Piscitelli, Luisa Gatta, Daniela Vita, Luciano De Petrocellis, Enza Palazzo, Vito De Novellis, and Vincenzo Di Marzo. "Non-psychoactive Cannabinoids Modulate the Descending Pathway of Antinociception in Anaesthetized Rats through Several Mechanisms of Action." British Journal of Pharmacology 162, no. 3 (2011): 584-96. doi:10.1111/j.1476-5381.2010.01063.x.
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  15. Yoga eases moderate to severe chronic low back pain. (2017, July 11). Retrieved from https://www.nih.gov/news-events/nih-research-matters/yoga-eases-moderate-severe-chronic-low-back-pain
  16. Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., … Linde, K. (2018). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The Journal of Pain, 19(5), 455-474. doi:10.1016/j.jpain.2017.11.005