Chronic Pain Relief
Pain, Depression and the Serotonin Link
If you have chronic pain, you may have suspected the connection between depression and pain. There IS a connection and the link is serotonin. Derived from tryptophan, serotonin affects our brain function, mood, sleep, memory, and other neurological processes.
Why does serotonin play such an important role between chronic pain and depression? When our body sends a signal to the brain that part of the body is in pain, those pain transmissions travel within our norepinephrine and serotonin pathways. These hormones are quickly used up when pain transmissions are constant, as in the case of chronic pain.
If our supply of serotonin is used up in the modulation of pain, it is no wonder that chronic pain patients struggle with memory, sleep and depression. Some of the anti-depressants commonly prescribed for depression such as SSRI's, can increase the availability of serotonin. This can be very helpful to a good number of people; however it seems more logical to lower the pain transmissions since it is the cause of lower serotonin levels.
Chronic Pain Syndrome
I have lived with chronic pain for nearly two decades and was finally diagnosed with Fibromyalgia and Myofascial Pain Syndrome in 2010. A syndrome, according to Wikipedia is “the association of several recognizable features, signs, symptoms, phenomena or characteristics that often occur together”. In other words, I have a handful of other medical issues that are concurrent with the pain (i.e. depression). Finally, things are starting to make sense.
Chronic Pain Syndrome is another condition marked by persistent pain, often resulting in psychological and/or physiological changes. These changes can include reduced social and physical activities, use or abuse of prescription drugs and alcohol, and workplace limitations and/or disability. Other disorders are common, and most likely a result of the constant pain signals to the brain. Repetitive and ongoing pain transmissions over time will cause changes to the central nervous system- this is very important to keep in mind if you are suffering from any chronic pain condition.
While the prognosis is poor, there are many treatments and pain management remedies available. While complete and permanent relief from pain is unlikely, it is vital to set and maintain clear goals. A goal of as much as 10% decreased pain, as one of my rheumatologists told me, is reasonable. That may sound disheartening to you as much as it did me, but remember that any decrease is better than increased pain!
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1. Liquid Vitamin D
The USDA recommends taking 400 i.u. daily of supplemental vitamin D. More recently however; some nutrition experts are pushing the FDA to increase the recommended amount to 1000 i.u. daily. Doctors are now paying attention to vitamin D deficiencies in their patient’s blood work reports, and prescribe even higher doses on a temporary basis.
Vitamin D is necessary for calcium absorption, plays a role in immune system, weight loss, osteoarthritis prevention, and much more. A deficiency has been linked to chronic pain, and an extra dose is recommended for those with osteoarthritis, rheumatoid arthritis, fibromyalgia, myalgia, diabetic neuropathy, chronic fatigue syndrome, and seasonal affective disorder (http://pain-topics.org/pdf/vitamind-brochure.pdf). My own doctor wants me to take 5000 i.u. daily, and on the days that I remember to take it, my pain is less intense. Vitamin D is affordable too!
2. NSAIDS and Acetaminophen
The most common NSAIDS (non-steroidal anti-inflammatory drugs) are aspirin, ibuprofen and naproxen. The main benefit is they reduce inflammation and are non-narcotic. High doses are not recommended for everyone, with possible side effects including ulcers and other gastrointestinal effects.
If you want to avoid supporting the pharmaceutical industry, try the medicinal herb White Willow Bark. Its history touts it as the “original aspirin” with salicin as its active ingredient. Chemists later developed a synthetic version of salicylic acid to make aspirin- acetylsalicylic acid. White Willow Bark is sold wherever herbal and vitamin supplements are sold. You can use it as an anti-inflammatory, analgesic, fever-reducer and astringent.
Valerian Root is another herbal remedy that is worth mentioning here; however it is not considered an NSAID. Some may compare it to narcotic or sleep aid medications due to its reputation to relieve pain, assist in relaxation and promote sleep without grogginess in the morning. I know many people who take Valerian Root when they get a migraine and it really helps take the edge off the pain and other migraine symptoms.
Acetaminophen (Tylenol) works by raising our pain threshold. There are many chronic pain patients who claim that Tylenol actually increases their pain, which has also been my experience. Narcotics such as Percocet and Vicodin are Tylenol based combined with opiates. Pain transmissions are still sent, but the drug prevents the brain from receiving the message. Narcotics are generally the least favored choice due to their fast tolerance progression, and risk of addiction.
There are hundreds of other prescription medications on the market to treat chronic pain. Their effectiveness varies, yet most people complain that none of them relieves the pain 100%. As with all medications, side effects vary and can be serious when combined with other drugs or supplements. Always keep your doctor informed of every pill you are taking, including all vitamins and herbs.
YMCA- Low Impact Pool Exercise
We hear it every time we see a new doctor or rheumatologist- exercise for additional pain relief. Yet, when pain intensifies the last thing we want to do is exercise. The thing is, when we get active, our brain sends out endorphins. Endorphins are those “feel-good” neurotransmitters that act as opiates. Endorphins are the most ideal pain relief. The great part is that they are free, and we can cause our body to make more by getting active.
Those with limited mobility could try aquatic activity. Join a gym or the YMCA and use their pool. Afterward, maybe you would enjoy a nice soak in the hot tub. Walking is another great alternative that is absolutely free. Don’t let winter stop you from enjoying your walking routine- many schools and malls have walking clubs for people just like us!
Dance is a favorite of mine, because it combines movement with music. Music therapy has in recent years been suggested as another treatment for pain. Macarena does it for me- gets the blood going and I can dance as slow or vigorous as I’m able. Afterward, I find that my energy level and mood are heightened. Those endorphins are truly amazing!
4. Meditation and Relaxation
Muscle spasm is a common symptom of chronic pain. Often where there is inflammation, there is pain and spasm. While there are several effective muscle relaxant medications on the market, they may also cause unwanted side effects such as fatigue and grogginess. Since we already struggle with lack of energy, it may be a very poor option or a last resort at best. Anti-spasmodic and anti-seizure medications are being considered also.
5. Face Your Pain
When a doctor explains that you must learn to live with your pain, meditation can help you do just that. There are some great guided meditation techniques on the internet, books, and CD's that teach you how to pinpoint your pain and face it. In a way, it is like facing a fear- face your pain so that it cannot have power over you. This can be very effective in reducing stress associated with the pain, and more importantly it can force relaxation in muscle spasm.
Imagine someone that you care about telling you that they had a very stressful day. Maybe you would suggest that they soak in a nice hot bath, while listening to some soothing music in candlelight. Maybe follow it up with a little massage using essential oils? What a nice way to pamper someone, show them we care and help make their day a little better! I’d say that’s just what the doctor ordered!
You don’t need to wait for a really stressful day to be kind to yourself in this way. When you live with pain every day of your life, you deserve this kind of special treatment. If you are alone and can’t ask someone for a massage, keep in mind that essential oils still provide their medicinal benefits when applied alone. My all-time favorite essential oil for pain relief is lavender due to its anti-inflammatory, anti-spasmodic, and sedative properties. Other favorites include sandalwood, chamomile, vetiver, jasmine, and ylang-ylang.
Guaifenesin and Elimination Diet
Earlier I mentioned that I would provide information about some strategies, alluding to the idea that they are not included in my list of "easy" remedies.
Guaifenesin is an over the counter expectorant medication that is believed to treat fibromyalgia by removing excess phosphate from the body. Dr. St. Amand states in his book, “What Your Doctor May Not Tell You About Fibromyalgia” that guaifenesin is effective only if the patient eliminates all salicylates from the diet including all topical products such as creams with salicylates. Salicylates are chemical compounds that plants produce to avoid soil bacteria.
The guaifenesin protocol is very intriguing, and apparently has caused marked improvement in many fibromyalgia patients. However, avoiding salicylates presents a difficult challenge. Not only must all plants be avoided, but also synthetic salicylates such as aspirin. Smokers inhale salicylates every time they light up. Women who wear makeup apply salicylates to their skin. Even mouthwash and dish soap contains this compound. A serious commitment though could lead to reversal of the disease, and is worth consideration.
The Elimination Diet is a technique to discover if any food allergies or intolerances are associated with symptoms. It is recommended to strictly follow the diet for a period of one month, keeping a food and symptom diary. Suspect foods are added into the diet one at a time as provocation to see if symptoms return.
Initially the most common food allergies are eliminated. These include dairy products, egg products, most of the common animal proteins, grains, citrus, some vegetables, coffee, tea, alcohol, soda, sugar, msg, food coloring and additives, preservatives, etc.
For more information about the Elimination Diet, go to this link: http://www.drcranton.com/elimination_diet.htm
As you can see, both of these rely on very strict diets that would pose a challenge to anyone. But if it is true that we are what we eat, these methods could be the cure to what ails us.
The medical information provided in this article is of a general nature, and cannot substitute for the advice of a medical professional. Nothing in this article should be construed as an attempt to offer or render a medical opinion or otherwise engage in the practice of medicine.