The treatment of chronic pain

Published 11:40 am Thursday, May 8, 2014

With a large segment of our population reaching “maturity,” I am treating more and more patients who suffer from “chronic pain.”

Chronic pain is becoming an epidemic. According to a 2011 Institute of Medicine Report titled, “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research,” 100 million American adults suffer from some form of chronic pain — more than the total number of individuals dealing with diabetes, heart disease and cancer.

Often defined as pain that has lasted longer than three to six months, chronic pain is poorly understood, poorly treated, and often stigmatized. It can make employment or recreational activities difficult or impossible. At the same time, it can result in social isolation, which can actually serve to increase the pain, causing a vicious cycle for the sufferer.

Many forms of chronic pain, like fibromyalgia, increase overall stress, which can lead to a variety of issues including interrupted sleep, mood swings, phobias and more. This is where we get the term “psychosomatic” in which the brain (psyco) affects the body (somatic) as the chronic picture unfolds. While this term has often meant that “it’s all in your head” (meaning that the symptoms are not real), it is actually true, reflecting the central nervous system’s involvement in the chronic pain sufferer.

Chronic pain is a complex issue, with a variety of causes and factors that contribute to it. It’s important to examine all of these components to better understand chronic pain and how to treat it.

First, there is the biological component, which occurs when unresolved acute strain-sprain injuries, and/or years of over-use and repetitive strains, have caused a breakdown in one or more tissues in the body.

Initially, acute pain is felt as a result of the signals from the nervous system’s nerve endings. These signals are transmitted to the brain, causing you to respond by stopping the stimulus. So, you might take a few days off from the painful activity, use some ice or heat and take some meds to numb the pain.

However, when these injuries aren’t resolved and become repetitive, the unwanted signals persist. The nervous system, in turn, becomes more “sensitized,” and the pain begins to remain even after the stimulus is gone. The result is that a person’s pain threshold is actually lowered over time, so that activities or stimuli that normally would not have hurt, now do.

To make matters worse, our body often compensates to manage an unresolved injury, which can put excessive stress on other parts of the body. For example, if an injury occurs to one’s ankle (a very flexible joint), the knee, (a hinge joint, that is limited in its motion), will then be called upon to ante-up more than its designed mobility. While the body is able to compensate for weaknesses up to a point, eventually, something within the tissues is going to fail and injuries will occur. So when treating chronic pain, we must address the specific injured tissues.

Secondly, there is the metabolic and endocrine component. This involves the correct or adequate processing of nutrients (and hydration!) as well as optimal hormonal activity and adequate sleep.

The body functions best at a slightly alkaline pH level. Some individuals are very sensitive to acidity within their body and can experience inflammation as a result. Dairy, refined (processed) carbohydrates, and meats all tend to make one more acidic, and can compound the pain issue. Similarly, thyroid imbalances can masquerade as pain and parathyroid imbalance can influence muscle activity via calcium shortages.

Finally, there is the psyco-emotional component, which refers to an individual’s emotional response to certain experiences (work, child rearing, parental caregiving, family crises, or being told that your pain is just in your head!). This component can also be triggered by excessive worry and/or negative self talk.

So many people have been emotionally and physically traumatized as a result of these factors, it’s not surprising we see the overuse of prescription medication, alcohol and even illegal drugs as an attempt to manage the issue of chronic pain. Here are a few suggestions on how to begin to break the cycle of chronic pain:

• Balance your diet to become more alkaline. Google “alkaline diet” for a listing of recommended foods. You can also purchase pH test strips at your local health store, pharmacy or online to monitor your levels daily (7-7.5 is optimal). Seek to limit total calories and HYDRATE well!
• Try beginner yoga to stretch and strengthen the core muscles. Breathe deeply by engaging your diaphragm (lie on your back, put your fingers over your tummy and breathe; you should see your fingers rise, and not your chest), and increase activity (walking, elliptical machine, water aerobics) to help take your mind off your symptoms and promote the release of endorphins, your “happy hormones.”
• Get a good night’s sleep. Avoid sugar, caffeine and electronic devices prior to bedtime, as they may not allow you to relax.
• Try chiropractic adjustments to enhance joint mobility and relieve stiffness.
• Consider acupuncture (including needleless laser and Piezo-electric), which generally reduces stress, benefits sleep, lifts and stabilizes moods, and improves energy.

Remember that the more chronic your pain, the lower your pain threshold becomes, meaning it will take less and less to trigger a flare-up. If you would like more guidelines on how to treat chronic pain, please email me at pathwaysth@gmail.com and put “Pain” in the subject line.