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Chronic Pain - Naturopathic Perspectives

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According to Statistics Canada, 1 in 10 individuals between the ages of 12 and 44 experience chronic pain.[1] This can have negative effects on work, school, and social lives, causing the chronic-pain patient to feel a lack of control, and also lead to conditions such as anxiety and depression. Once traditional medicine has been helpful in the acute-pain stage (e.g. first aid, over-the-counter pain killers, heat/ice, etc.), modern medicine may leave individuals feeling lost when it comes to long-term management and reduction of chronic pain. The current ramifications of the opioid crisis, along with this, allow naturopathic medicine to complement other manual therapies (massage therapy, physiotherapy, and others) to both support and empower the chronic-pain patient. So many health conditions cause chronic pain—not just arthritis. Auto-immune conditions, traumatic injuries, migraine/headaches, fibromyalgia, and even anxiety and depression have been linked to increased daily pain. Over time, this not only causes physical distress but also mental distress—it is no surprise that mental-health disorders are commonly linked to chronic pain. Fortunately, many tools are available for chronic-pain sufferers—one of them being herbal/botanical medicine. Using the naturopathic principle “first do no harm,” chronic-pain management can start from the level of nutrition and diet.

Diet and Supplements

Food Rich in Polyphenols (Coffee and Dark Chocolate)
Chronic Pain

A study found that women with fibromyalgia who consumed food rich in polyphenols had improved quality of life. The number of tender points was reduced by coffee intake. Coffee is a very high source of polyphenols and pain-busting caffeine. Overall quality of life was improved by red fruits (cherries, raspberries, cranberries, pomegranate, red grapes) and red wine.[2] Polyphenols are a type of antioxidant found in tea, coffee, and many fruits and vegetables such as grapes, pears, and apples.[3:169]

Traditional Anti-Inflammatory Spices (Turmeric, Ginger)
Research shows that members of the Zingiberaceae family (including turmeric, ginger, and galangal) are clinically effective hypoalgesic (pain-reducing), with a better safety profile than non-steroidal anti-inflammatory drugs (aspirin).[4] Both NSAIDs and Zingiberaceae have been associated with the risk of increased bleeding, though, so caution should be exerted with blood thinners until further research is conducted.

Anti-Inflammatory Omega 3 Fatty Acids (Fish Oil)
A human study found that daily fish oil doses from 1200 mg to 2400 mg essential fatty acids (EFA) reduced chronic-arthritis pain at an equal level as NSAIDs (e.g. aspirin). Some participants even stopped taking their NSAID and continued on with fish oil.[5] Of course, pain reduction is higher by taking a concentrated dose of fish oil, but anti-inflammatory effects can still be gained through dietary intake of fish. Another study using a diet consisting of low omega 6 fatty acid intake (think processed foods) and high omega 3 fatty acid intake lead to major improvements in headaches in those with chronic daily headache.[6][7]

Although this is not an extensive list, some of the top foods/supplements for chronic pain conditions are coffee, dark chocolate, berries, ginger, turmeric, and fish products. So yes, your morning cup of joe may actually be helping your body to dull the way your body responds to pain—although do watch out if coffee causes you digestive issues, anxiety, or insomnia. I am also in support of that daily square of dark chocolate… with perhaps a side of berries? Can’t complain with that! Here’s a pain-fighting drink that you can make straight from your kitchen:

Pain-Fighting Turmeric Ginger Elixir

  • Pain-Fighting Turmeric Ginger Elixir
  • Lemon
  • Honey
  • A pinch of black pepper

Bring the turmeric and ginger to a boil in a medium pot of water. Once a boil is reached, leave the solution on low for 20–30 minutes (depending on how much of a ginger taste you want). Mix in a desired amount of honey and lemon, and add a pinch of black pepper. Black pepper has been proven to amplify the body’s absorption of turmeric. Remove the turmeric and ginger, then enjoy! This recipe can be made with turmeric or ginger powder; however, you will have small amounts of the powder in your drink, which you can strain out.

Herbal Medicine

Botanical/herbals act to quell chronic pain through some main biochemical actions—anti-inflammatory (AI) and analgesic. Anti-inflammatory herbs contain compounds that have been studied to reduce inflammatory chemicals in the body and analgesic actions which have “pain-blocking” abilities—much like a painkiller/sedative medicine would (e.g. taking Tylenol for a headache). Other common actions are antirheumatic, meaning that historically, this herb has been used for rheumatic (joint pain/other pain conditions), and antispasmodic (anticramping).

Turmeric (Curcuma longa)
Chronic Pain

Curcumin polyphenols downregulate NF κB and COX 2, which are anti-inflammatory (AI) molecules in the body.Human studies have shown benefit in rheumatoid arthritis and inflammatory bowel disease. A study of patients with osteoarthritis of the knee found that the group taking Curcuma longa had improved visual analog scales (VAS) and improved oxidative stress biomarker levels.[8]

Ginger (Zingiber officinale)
Gingerol and zingerone are key AI agents in ginger. These AI agents modulate leukotriene and PG synthesis, along with inhibiting NF κB (other compounds regulating inflammation).Zingiberaceae extracts showed significant efficacy in reduce subjective chronic pain, with a linear dose-effect relation.[9]

White Willow (Salix Alba)
The salicylic acid in Salix alba is related to aspirin’s AI and analgesic ability, therefore can be useful for any type of rheumatic or other types of pains.This is actually safer to use than aspirin, because it does not have the same blood-thinning abilities that aspirin has.

Black Cohosh (Cimicifuga racemosa)
Cimicifugides (compounds found in black cohosh) are antispasmodic, antirheumatic. and anti-inflammatory, making this useful for any type of pain, especially cramping pain (e.g. chronic pain as seen in endometriosis and dysmenorrhea).[10]

Marijuana (Cannabis sativa/indica)
Chronic Pain

The endocannibinoid system has been studied for modulating chronic pain conditions. Endocannibinoids are not only limited to cannabis but are impacted by things such as exercising and fish oils. Medical marijuana has been studied for pain conditions such as arthritis, neuralgia, cancer pain, etc. Pain is multifaceted and is affected by various inflammatory systems as well as neurotransmitter and other systems (e.g. the endocannibinoid system in cannabis). The legalization of cannabis will allow for more research into its safety, efficacy, and proper dosing for chronic-pain use.

 

Indian Frankincense (Boswellia serrata)
Chronic Pain

This historic herb is used in Ayurvedic medicine for arthritic conditions and in Western medicine for other inflammatory-related processes (e.g. ulcerative colitis, chronic pains, osteoarthritis, and rheumatoid arthritis). It inhibits leukotrienes just like many of the other AF herbs, which may be one of the reasons it is helpful in chronic pain conditions. A study found that Boswellia serrata changed the baseline level of pain, compared to placebo.[11]

 

Many other herbs are useful for chronic pain, and visiting a naturopathic doctor could help you determine which herbs are useful for you. An advantage of using herbal medicine is that many herbs have other actions that can also treat other coexisting concerns at the same time. For example, ginger is also antiemetic (prevents vomiting/nausea), so it would be useful for someone experiencing chronic pain as well as nausea. Both nutrition and herbal medicine prove to be excellent chronic-pain supports and may help alleviate the burden on the health-care system.