by Pain Doc | May 8, 2014 | Uncategorized
Arthritis, which translates to “irritation of a joint,” has the potential to develop into a debilitating condition that can significantly reduce your activities of daily living (ADL) and quality of life. It involves pain, stiffness and understandably a reduced ability to move and engage in exercise. Lack of exercise/ mobility promotes weight gain, which can make the arthritis worse as the joint surfaces bear increased weight.
If the pain is strong enough, sufferers resort to over-the-counter medications such as acetaminophen (Tylenol, Paracetamol), NSAIDs, or non-steroidal anti-inflammatories (Ibuprofen, Naproxen); and if the pain is severe, opioid drugs. All of these drugs have dangerous side effects, which become more significant if they are taken long term. This includes liver damage, gastrointestinal problems, muscle and joint pain, and for opioids, constipation, nausea and drug addiction/dependency.
Today, I will address specifically osteoarthritis, or OA. It is the most common form of arthritis and is the major cause of disability in persons aged 65 and over. Osteoarthritis affects primarily the weight-bearing joints such as the ankles, knees, hips, lower spine and lower neck. It starts out non-inflammatory (unlike rheumatoid arthritis, which is an inflammatory auto-immune form of arthritis) and involves gradual wear and tear of the cartilage surfaces of the ends of the bones that form the joint. In advanced stages, the damaged cartilage triggers mild inflammation (swelling, increased vascularity, increased pain) and the condition is better described as inflammatory osteoarthritis.
Osteoarthritis has systemic risk factors and local risk factors.
Systemic risk factors include age, sex, race, bone density, genetic factors, nutrition and hormonal status (which is related to age).
- Black Americans have a higher incidence of OA than white Americans; however the association may be rooted in demographics/ cultural factors rather than genetics.
- Reduced production of human growth hormone (HGH) and the sex hormones (estrogen, testosterone) are associated with reduced cartilage pliability; i.e. increased brittleness and less thickness.
- Cartilage is thought to be highly vulnerable to oxidative stress (free radical damage, oxidation), and high doses of vitamin C and D are protective against the development of OA. Smoking, pollution and a diet high in processed food are factors that promote oxidative stress.
Local risk factors include obesity, occupation, prior joint injuries, existing joint instability, sports/physical activities and congenital joint abnormalities.
- Obese individuals experience increased pressure in their weight bearing joints when standing or sitting. This can force water content out of the cartilage and lead to small tears which then lead to larger tears and “bone on bone” contact within the joint.
- Occupations that involve repetitious trauma/ forces to the joints increase risk for OA.
- Sports, especially football, basketball, long distance running and gymnastics can result in accelerated cartilage degeneration especially after age 40.
- Prior injuries/ trauma that subluxated or misaligned a joint will predispose it to accelerated OA as the joint loses its normal mechanical function. The joint surfaces may not articulate properly, and weight distribution along the surface may become uneven following trauma.
- Congenital anomalies such as scoliosis and fused vertebral segments can also alter normal joint movement and promote accelerated OA.
- Weak muscles can deprive joints of protection and stability, predisposing them to OA. Weak muscles are related to sedentary lifestyles, whether by choice or secondary to an incapacitating condition like advanced Type 2 diabetes.
The bottom line:
If you have systemic risk factors, think in terms of diet and nutrition to ward of their effects. You can’t control aging, you can’t control your sex and race, but you can control the level of oxidative stress in your body and you can “down-regulate” genes that may predispose you to arthritis by adopting a healthy diet and lifestyle.
If you also have several local risk factors for OA, think in terms of minimizing their effects. Unstable joints from prior injuries can benefit from targeted exercises that strengthen the joint; perhaps some occasional spinal and/or extremity adjustments from a chiropractor or therapist; supports/orthotics as applicable; and avoiding activities which over-stress the affected joint. For example, if you have a spondylolisthesis, it’s best to avoid running and instead do speed walking or use an elliptical machine to get your cardio exercise.
If you are suffering from chronic pain in your muscles and joints, nerves and ligaments, stay tuned for a new multi-media educational course being developed, Get Rid of Pain Forever. To receive notice of its launch, visit here.
by Pain Doc | Apr 24, 2014 | Uncategorized
by Laurie Roth-Donnell, Master Herbalist and Holistic Health Practitioner
There are many alternatives when considering avenues to manage chronic pain. Herbal Therapy is one area that is rapidly growing in popularity. Herbs rarely have an adverse side effect like many pharmaceuticals do and are now easy to access, thanks to the
Internet.
When using herbs for pain management, please be reminded that anti-inflammatory herbs will not heal your condition itself, despite their pain-easing effects. Addressing the cause of chronic inflammation is essential when working your way toward optimal health; inflammation triggers pain and is a major risk factor for chronic diseases like cancer, cardiovascular disease, and diabetes.
Warnings aside, here are five herbs that combat inflammation and are all readily available online and at some health focused stores.
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White Willow Bark—This herb contains salicin, the compound from which commercial aspirin was originally extracted. The analgesic actions of the bark are slower acting than synthetic aspirin, but results last longer. In addition to its pain-relieving properties, it is an anticoagulant, assisting in the prevention of
blood clot formation and thickening of blood that may lead to stroke or heart failure. It has also been credited with the alleviation of acute back and joint pain, as well as osteoarthritis. Native Americans simply chewed the bark from the tree for natural pain relief.
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Boswellia—Sourced from a resin found in the bark of frankincense trees, boswellia has been shown to thwart chemical reactions involved in the creation of inflammation. Practitioners of Ayurvedic medicine have long used boswellia to treat arthritis; the herb may also benefit people with inflammatory bowel disease.
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Bromelain—An enzyme extracted from pineapple stems, bromelain reduces levels of prostaglandins, hormones that induce inflammation. Bromelain may benefit people with arthritis and conditions marked by musculoskeletal tension (such as TMJ syndrome), as well as those suffering trauma-related inflammation. What’s more, the enzyme may promote healing in muscles and connective tissues. Some holistic health practitioners have prescribed patients to eat 8 whole pineapples for 10 days, and they claim their pain was reduced significantly.
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Curcumin—An Ayurvedic remedy known to tame arthritis pain, curcumin is a compound found in the curry spice turmeric. In an animal-based study published in 2007, scientists discovered that curcumin could overpower proinflammatory proteins called cytokines. The compound may also help decrease pain associated with autoimmune disorders and tendonitis. This herbal news is a great reason to eat a little curry! Red Coconut Curry is one of my favorites.
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Ginger—Sipping ginger tea not only helps relieve cold-related congestion, but supplementing with ginger may deliver other long-lasting health effects. Research indicates that ginger may calm arthritis pain by lowering your prostaglandin levels. One 2005 study even suggests that ginger could reduce pain and inflammation more effectively than non-steroidal anti-inflammatory drugs (such as aspirin). Ginger is available in most grocery produce sections, and ginger tea is quick and easy to make. Slice a thumb-sized bulb of fresh ginger, add to 4 cups of water, and boil for 5 minutes. Strain, add honey, lemon or your choice to taste.
If you consider the use of herbs for pain management, please consult a doctor or holistic health professional before you begin the regimen. Some herbs interact with drugs you are receiving for pain or other conditions you may be medicated for and the combination may harm your health when improperly administered.
Sources:
WebMD.com
Secrets of Self Healing by Dr. Ni
by Pain Doc | Apr 4, 2014 | Uncategorized
Neuropathy translates to “nerve disorder.” It can be mechanical in nature, such as the common peripheral neuropathies carpal tunnel syndrome, thoracic outlet syndrome and cervical disc radiculopathy. In these cases, the source of nerve pain is prolonged, direct pressure to the nerve from an abnormal constriction of some sort in the area of the nerve. When nerves are subjected to even the slightest pressure for long durations, morphologic changes occur to the nerve, resulting in permanent symptoms such as pain, tingling, numbness and weakness. The scary thing about peripheral neuropathies is that you don’t feel the constriction to the nerve itself, just the symptoms of the damaged nerve which by that time may be too late to completely resolve.
Neuropathy can be caused by the Herpes virus; i.e. shingles, which does damage to the nerve itself. It can be caused by disease processes; particularly late stage Type II diabetes where peripheral nerves (major nerves of the body responsible for sensing touch, hot, cold and movement) deteriorate from prolonged exposure to diabetic conditions (persistently high blood glucose, vascular disease, high insulin, inflammation). Lyme Disease, inflammatory diseases, autoimmune diseases and toxicity/ poisoning can also cause neuropathy.
But the big thing that can cause you to develop neuropathy is over the counter and prescription medications. There are hundreds of medicines that have side effects that include nerve degradation; whether it be from toxicity or from leaching nutrients the body needs to maintain nerve function. According to pharmacist Suzy Cohen, a leading expert on medications, some classic offenders include antacids, acid blockers, oral contraceptives, hormone replacement therapy, corticosteroids, statin cholesterol reducers, breast cancer drugs and fluoroquinolone antibiotics. She adds that the fluoroquinolones (Cipro, Floxin, Avelox, Levaquin) have a fluoride backbone. Fluoride is known to harm the thyroid gland, reduce thyroid production and cause irreversible damage to the nervous system.
As a side note, I find it amazing that some water districts still add fluoride, a known neurotoxin, to the water supply and that dentists still recommend it for cavities; even for young children– amazing!
If you have a history of taking any of the class of medications mentioned above and you suffer from neuropathy, it is quite possible that you have been inadvertently causing your neuropathy. If this is the case, Suzy recommends the following supplements which may be helpful in reversing the damage (check with your doctor first).
Thiamine — Watch your wine consumption. A glass of wine every night can steal nerve-protective nutrients like vitamin B1 (thiamine). You can also try benfotiamine, a fat-soluble form of thiamine.
Probiotics — Probiotics allow you to make methylcobalamin (vitamin B12), which you need to produce myelin and protect the nerve cells.
My note: it is extremely important that you ensure you maintain a healthy gut microflora. Your gut is where nutrients are transferred from what you eat to your body’s cells. If your microflora is out of balance, you run the risk of malabsorption, Vitamin B12 deficiency, and gut inflammation. Taking probiotics, minimizing antibiotics, avoiding alcohol or drinking in moderation, and including cultured foods (sauerkraut, yogurt, etc.) and raw vegetables in your diet are the key.
Methylcobalamin (B12) — When your body is starved of B12, you lose the myelin sheath and your nerves short circuit. This can cause neuropathy and depression. There are dozens of drug muggers of B12, including the diabetic medications as well as processed foods, sugar, antibiotics, estrogen hormones and acid blockers.
Lipoic Acid — You can buy it as “alpha” at any health food store, or “R” lipoic acid as a more bioavailable form. This antioxidant squashes free radicals that attack your myelin sheath and fray your nerve wiring. It reduces blood sugar, too.
High doses are needed to improve nerve pain, however, if you take high doses, you need to also supplement with a little biotin. The reason is because lipoic acid is a drug mugger of biotin.
Bottom Line: If you take prescription or over the counter medications, carefully read the “side effects;” ask your doctor about them, and research them yourself on Physician’s Desk Reference. Know that a lot of physicians tend to “brush off” the listed side effects of drugs, as drug prescription is one of their main avenues for treating patients, so use your judgment.
Are you experiencing chronic pain? Sign up to me notified of my upcoming Optimal Body System Reverse Chronic Pain multimedia course. Click here to find out more.
by Pain Doc | Mar 27, 2014 | Uncategorized
Musculoskeletal pain sufferers are one of the most difficult types of patients for doctors to treat. An informal survey of MDs and chiropractors indicated that chronic pain patients “are not their favorite” to treat, and it’s not hard to understand why.
When drugs, surgery, physical therapy or chiropractic adjustments fail to resolve pain, the patient keeps coming back, reporting the bad news to the provider. The office visit becomes an emotional outlet for the patient as the patient speaks at length of where it hurts, how it feels, and so on; sometimes getting emotional. And the doctor has to absorb all of this outpouring, which wears him/her down emotionally and physically. It makes the provider feel as though he or she has failed; or feel powerless and ineffective. Without admitting it, the doctors just want these pain patient to “go away.” They do their best to say something, anything to hopefully appease the patient until that dreaded next appointment. By this time, the patient has already gone through prescription meds and did all the things the doctor said to do, so the doctor doesn’t have much left to offer. It leads to frustration for both the patient and doctor.
Some doctors go so far as to discharge (get rid of) the patient against his asking, passing him on to another doctor.
It’s one of those things that is not well known to pain sufferers, but is a reality in hospitals and clinics across the world.
But consider this: when something happens in your life that you initially perceive as “bad,” it can actually be a good thing in disguise. It happens a lot. Such jolting, pivotal moments like being discharged by your doctor are like re-setting a frozen computer: it takes you out of a non-productive cycle and forces you re-assess your situation. It removes the dependency factor and makes you look elsewhere for answers, increasing your chances of finding the right one for you.
So, if you suffer from back pain and haven’t gotten results from medications, it could be a good thing. Explore other avenues that might give you better results, without the toxicity.
I am currently investing a lot of time reviewing the case histories of the thousands of pain patients I have seen over the years and taking note of commonalities; some of which I mentioned in the previous post. While many of them did have degenerative changes in their spine which were not reversible, many also were not at that point yet, but were on their way. I noticed that many lacked knowledge on how to keep their spine flexible and healthy, and/or were of a mindset that ignored the importance of staying active. They believed that work (their job) was a top priority in their life and allowed it to consume most of their waking hours, pushing aside other important, vital things like exercising, removing stressors, resting and relaxation, and eating a healthy diet.
I understand that life is full of difficulties and challenges– we all have them. We convince ourselves that we will get fired if we don’t put in x-amount of hours per day at the job. We convince ourselves that exercising isn’t all that important, and that it feels really uncomfortable and is something to avoid. We convince ourselves that it’s too much effort to research healthy foods and supplements, and that eating the same junk food or highly processed food won’t hurt our health. These are all being generated in the subconscious mind, considered the main driver of behavior and decision-making.
Well, this is a mindset that is common to, in my estimation, over 80% of all the back pain sufferers I have treated. Mindset— your set attitudes and beliefs– is what drives your actions; and much too often it drives actions that are “the path of least resistance.” Yes, it’s human nature, but it’s also the thing that is keeping your body from healing itself.
You may be thinking, “I tried to cure my back pain with exercises but I still have the pain.”
For pain resolution, I believe that it’s not just the exercises themselves that are important; it’s the specific ones and knowing what they do; the sequence in which you do them, the frequency in which you do them and concurrent activities involving nutrition, sleep, meditation, breathing and others that altogether will produce the best results.
This concept describes the upcoming, comprehensive pain relief program I am designing that will help people conquer their pain once and for all, without harmful drugs or surgery. It will be a multi-media course based on video demonstrations of numerous powerful healthy lifestyle strategies, as though you were in my office. I’m really excited about it, because I know that it is going to help millions of people manage and even eradicate their chronic pain problem.
If you wish to get notified when it is released and take advantage of the special launch price, just opt in on the site’s sign up page in the upper right.
by Pain Doc | Sep 25, 2013 | Uncategorized
I’ve been saying for many years that one of the best things you can do to improve your health is to be more active. And one of the ways to do it that is low tech and doesn’t require a heck of a lot of thought is making a conscious effort to stand more than you usually do throughout your day; especially for those who have sedentary desk jobs.
When you stand, you burn more calories because you engage your erector spinae muscles, gluteal muscles and of course leg muscles. You can burn at least 100 more calories a day simply by standing for two hours more. It’s also better for your posture. And get this, other research says that sitting can cause your bad cholesterol levels to rise because it deactivates spinal muscles that prefer to burn fatty acids for energy.
A study just a few years ago revealed a positive correlation between hours spent sitting and premature death. The American Cancer Society study found that women who sit for more than six hours a day were about 40% more likely to die during the course of the study than those who sat fewer than three hours per day. Men were about 20% more likely to die. Now that is a risk factor that can easily be avoided.
If you have a desk job that requires sitting two or more hours straight, or is such that it is easy to get caught up in your work and sit for that amount of time or longer (common for software programmers, researchers, accountants and attorneys to name a few) you need to find a way to remind yourself to stand periodically and ideally do some simple exercises while you are at it, like squats, lunges or doing a couple of laps in your building’s staircase or stair well. Incorporating such a simple routine can have a huge impact on your health, now and in the future.
Lastly, check out this modern concept office workstation by Focus. It is much better for your back than traditional workstations that place max pressure on your lumbar discs, potentially increasing your chances of developing degenerative disc disease. The unique design of the Focus workstation results in much less pressure on your lower back and engages the spinal muscles and leg muscles more than a traditional chair with a back rest. This will allow you to work longer hours without as much risk. But still, it’s better to get off your butt every 20-30 minutes and walk to prevent the bad stuff from happening.
by Pain Doc | Aug 27, 2013 | Uncategorized
Disc bulges, or herniations, come in a variety of presentations. They usually are limited to the lower lumbar spine (L3/4 to L5/S1) and the neck (C4/5-C7/T1). In taking the medical history of patients suffering from disc bulges, there is usually a history of a sedentary office job that requires sitting long hours; a previous injury like a sports, work, or car accident injury; and in rare cases, no significant event or habit that could explain how the disc bulge occurred. In fact, there are studies that indicate that degenerative disc disease, which can include varying degrees of disc bulging, can be hereditary.
A common theoretical model for degenerative discs goes like this: something happens that causes the disc to bear excessive weight, which over time forces fluid out of the disc causing it to dessicate. The outer fibers responsible for keeping the disc intact and the nucleus in place weaken, allowing the center nucleus to bulge outwards. Chiropractors often attribute this scenario to subtle misalignments in the vertebrae caused by minor trauma, prolonged sitting and insufficient support from the abdominal muscles and lumbar muscles. Normally the disc should support 80% of the weight above it and the facet joints (the smaller joints behind the disc) about 20%. But if a physical event changes the orientation of the vertebra, it can force the disc to support 90-100% of the weight, accelerating its demise.
Other models reference calcification of the vertebral end plates,the surfaces of the vertebrae above and below the disc, which then prohibits capillaries from feeding nutrients to the disc causing it to die. Bone calcifies in response to trauma; vertebral end plates can sustain “micro-compression” injuries from activities that place a heavy, axial load (perpendicular) to the disc. Examples include basketball, gymnastics, running, and parachuting.
An acute herniated disc can be extremely debilitating, as it tends to last a lot longer than a typical sprain/strain injury. It hurts, limits movement, can make sleep difficult and restricts you from work and physical activity. If it presses on a nerve root it can send shooting pains down the buttock and leg and cause numbness and weakness. The general recommendation for most cases of non-emergency disc herniations is to manage the pain using physiotherapy (ice, heat, muscle stim, laser), do physical therapy including stretching and strengthening exercises and wait for the disc bulge to self-resolve in 2-3 weeks. Once it heals and the inflammation goes down, the pain usually goes down as well.
If your disc herniation is pressing on a nerve root, the disc may shrink as it heals, removing pressure from the nerve. This is the best scenario obviously, as you avoid surgery and get your life back. At this point, it is prudent to avoid activity that risks re-injury (heavy lifting while turning torso) and do everything you can to strengthen your core muscles and spinal muscles to guard against re-injury. Functional exercises should be emphasized, for this purpose.
The thing that can dramatically increase the chances of full recovery without surgery is healing your insides– reduce systemic inflammation by getting down to a healthy weight and maintaining it; stop smoking, avoid alcohol as best you can, reduce stress, reduce insulin levels, maintain normal blood glucose levels, ensure that your gut micro flora is in balance, and get adequate sleep every day. Eat healthy, decrease your portions, and drink enough water to stay hydrated throughout the day. Exercise consistently, 20-40 minutes each time. This is what a healthy lifestyle routine is made of.
People who are in pain usually are concerned about knocking down the pain first, and ignore the health of the rest of their body. Remember, your entire body is essentially a colony of specialized cells that are interconnected via the bloodstream, nerves, and hormones. When one area is injured, the rest can come to its aid.
If you suffer from disc herniations, joint pain or other musculoskeletal form of pain and are overweight, pay more attention to getting yourself healthy inside; it’s the often ignored self-help method to treat pain.
There are many alternatives when considering avenues to manage chronic pain. Herbal Therapy is one area that is rapidly growing in popularity. Herbs rarely have an adverse side effect like many pharmaceuticals do and are now easy to access, thanks to the
blood clot formation and thickening of blood that may lead to stroke or heart failure. It has also been credited with the alleviation of acute back and joint pain, as well as osteoarthritis. Native Americans simply chewed the bark from the tree for natural pain relief.
Curcumin—An Ayurvedic remedy known to tame arthritis pain, curcumin is a compound found in the curry spice turmeric. In an animal-based study published in 2007, scientists discovered that curcumin could overpower proinflammatory proteins called cytokines. The compound may also help decrease pain associated with autoimmune disorders and tendonitis. This herbal news is a great reason to eat a little curry! Red Coconut Curry is one of my favorites.
I’ve been saying for many years that one of the best things you can do to improve your health is to be more active. And one of the ways to do it that is low tech and doesn’t require a heck of a lot of thought is making a conscious effort to stand more than you usually do throughout your day; especially for those who have sedentary desk jobs.
