Chronic pain can often be helped, better than you expect.Everyone's different, colour of hair and chronic pain tolerance included.Variations of one gene on chromosome 22 were found to affect experimental pain, in experiments at the University of Michigan1. Our genes do different things in different circumstances, and changing the supply of nutrients can alter their action. My naturopath mentor was mostly able to relieve peoples' pain this way. I didn't learn enough from him, to do this. Most naturopaths cannot, but it is possible. Pain management always needs much more than nutrients. There's room for everything here, as long as expectations are reasonable and everyone concerned is honest. I've seen quite convincing home movies of a Filipino psychic surgeon doing operations with bare hands. I've personally benefited from Reiki hands-on healing. One of my dogs benefited from absent healing without meeting the healer (and without my knowing the healing was to be sent.) Cherche le Guérisseur - every place has its' local healers. The medical approachI'm an idealist and a pragmatist. I sometimes admit defeat, accept peoples' condition as chronic and incurable, and maintain them on long term analgesics.Long term treatment with any drug is dangerous2 to some degree, and chronic analgesic prescribing is a bit like walking a tight rope. One is not aiming at total pain relief. I was quite surprised when I first heard pain management specialists say they aimed for 30-50% relief of pain. I would have thought it would be more like 80% Their reason for limiting to this, is that experience has shown aiming for more relief causes too many side effects. Even with my particular interest in pain, I would dearly love to have more access to help and advice from pain specialists. Such specialists are few and far between however, with long waiting times before someone is seen. If you suffer from chronic pain, you will probably have experienced unsatisfactory relief at times. When you have the energy, consider lobbying your government representatives for higher priority for this area. Its' overall cost to society is second only to cardiovascular disease, and greater than cancer. The small number of doctors in this field, have little political clout. This needs large numbers of people to have any effect, so please consider adding your voice.
Analgesic drugs in chronic non-cancer painTrial and error, or suck it and see - any new treatment of any sort is always an experiment. The massive advances in the field of genomics will reduce this uncertainty in the future, but for now it is just give it a go and see if you feel better.No one drug works in everyone. One way to express this is by the number of people needed to be treated, to achieve one useful result. Similarly one can express safety or otherwise by a number needed to harm. Here are some results (figures rounded)... Tricyclic antidepressants (eg amitriptyline) In this study5, NNT was for >50% pain relief and NNH was for people who withdrew from the trial because of side effects. Common practices which cause problems include... Using short acting painkillers and waiting for pain to become bad before taking them. This means one is in pain a lot, waiting to take the dose or waiting for the dose to work. Short acting opiods are inappropriate for long term treatment of persistent pain. Taking a mixture of different drugs may be a problem. Sometimes it causes undesireable drug interactions with unexpected ill effects.
Australian figures4 discount this worry. The prevalence of any mental disorder in the surveyed people with MSK conditions was 25%, and of this substance abuse contributed only 5%.
I've not put this after the drugs as an indication of preference, just so you see what the nutrients are alternatives to.Instead of benzodiazepines (block NMDA) - consider magnesium supplements. Antidepressants (correct monoamine deficiency) - perhaps 5-hydroxytryptophan etc supplementation. Correction of local and systemic acidosis, by improving tissue oxygenation and 80% alkaline forming food diet. Correcting dehydration or oedema improves tissue oxygenation, as can elevation of a dependant part of the body and gently exercise. Hyperventilation can reduce oxgen getting to tissues as haemoglobin in our red blood cells holds the oxgen more tightly.
The journal "Pain Medicine" published a study on this, by Turner et al, in November 2008.Vitamin D deficient pain sufferers needed twice the dose of opiate medications, and had needed this for nearly twice as long. They felt less well and functioned less well. It's hard to know which came first, the chicken or the egg. People in chronic pain probably don't get out in the sun as much. Despite this uncertainty, it's very sensible to get your vitamin D tested and to take it if indicated. If this improves your pain, write in and tell everyone. Self management is essential - this should be at the top of this pageThe Calgary patient lecture on this3 is a very straightforward "What to do" exposition.State your intention to yourself, that you will take control over what happens to your body. Search out and listen to advice, then withdraw and quietly consider what you feel best doing. Have A helpful tip to share, or an experience others can learn from?
You can have your own page on this site, be anonymous if you prefer, and help other people or get useful opinions from other readers. It's very quick and easy References1. Jon-Kar Zubieta et al Science 299 (5610) pp 1240-1242 21st Feb 2003 COMT val158mete Genotype affects Opioid Neurotransmitter Responses to a Pain Stressor.2. http://www.doctorsaredangerous.com/ 3. www.calgaryhealthregion.ca/programs/rpp/pdf/cpc.english.handbook.pdf 4. AIHW analysis of ABS 2007 Survey of Mental Health and Wellbeing, reported in AIHW bulletin 80, September 2010 5. Finnerup et al Pain 2005 118(3) pp289-305
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