According to the Ministry of Health, one in five New Zealander’s suffer from chronic pain, resulting from an array of causes from sports injury, osteoarthritis, nerve pain, migraine to fibromyalgia, Rheumatoid arthritis and other pain syndromes.
The dangers of medication
The majority suffering from chronic pain will use medication sometimes on a daily basis, however these only provide temporary relief and don’t deal with the underlying cause. Common medications include:
- Opioids, are usually used to relieve moderate to severe acute pain in acute situations, not so much for chronic pain unless in malignancy, due to concerns over the long-term efficacy, adverse drug effects and the risk of misue and addiction. (BPAC, 2014)
- Non-steroidal anti-inflammatory drugs (NSAIDs), these are probably the most widely used as they are easy to get and affordable. Most believe they are harmless but they do have side effects. Gastro-intestinal bleeding and ulceration can occur with NSAID, all NSAIDs have been associated with the development of acute kidney injury especially with those who have cardiovasular disease and the elderly. NSAID use can, to varying degrees, be associated with a small increased risk of thrombotic events (e.g. myocardial infarction and stroke) independent of baseline cardiovascular risk factors or duration of NSAID use; however, the greatest risk may be in those receiving high doses long term. Most manufacturers advise avoiding the use of NSAIDs during pregnancy or avoiding them unless the potential benefit outweighs the risk. NSAIDs should be avoided during the third trimester because use is associated with a risk of closure of fetal ductus arteriosus in utero and possibly persistent pulmonary hypertension of the newborn. In addition, the onset of labour may be delayed and its duration may be increased. (NZ Formulary, 2017; Koffeman, et al, 2014)
- Paracetamol, commonly used for mild to moderate pain, but has no anti-inflammatory effect. Paracetamol doesn’t cause the gastric irritability that NSAID’s do however overdosage with paracetamol is particularly dangerous as it may cause hepatic damage which is sometimes not apparent for 4 to 6 days. (NZ Formulary, 2017)
- Antidepressant medicines, used in the treatment of a variety of chronic pain states, especially those of neuropathic origin (nerve pain). Tricyclic and Serotonin–norepinephrine-reuptake inhibitors have been shown to help with diabetic neuropathy and fibromyalgia. However there are many adverse effects from these medications and are prescription only. (NZ Formulary, 2017).
Naturopathic Treatment for Chronic Pain
In naturopathy we address the underlying mental – emotional, chemical and physical stressors that are causing the chronic inflammation and pain, this process takes time, deep introspection and commitment from the patient. Some naturopathic treatments that have been shown to be of benefit in treating pain and inflammation without any harmful side effects include:
- Turmeric, ginger and boswelia, these anti-inflammatory herbs have been thoroughly studied and shown to dramatically reduce pain, swelling and inflammation. (Aggarwal, Gupta, & Sung, 2013; Gupta, Patchva, & Aggarwal, 2013)
- Omega-3 fatty acids from oily fish, flaxseed oil and grass fed meat and eggs, reduce inflammation. Especially of benefit in brain inflammation, or brain injury. (Maroon & Bost, 2006; Murray, Pizzorno & Pizzorno,2005)
- Probiotics, digestive issues, such as leaky gut can lead to inflammation and joint pain, as well as the onset of arthritis. Eating fermented foods, prebiotic fibres and limiting our intake of processed foods help keep the gut microbiome healthy and reduce systemic inflammation. (Diamanti et al, 2016, Maeda et al, 2016)
- Methylsulfonylmethane (MSM) a naturally occurring organosulfur compoundand and sulfur-rich foods such as, onions, garlic, chives, scallions, cruciferous vegetable family help reduce inflammation(Butawan, Benjamin & Bloomer, 2017; Murray, Pizzorno & Pizzorno,2005)
- Diet, eating well, i.e. getting a variety of organic whole foods, ensures that we get adeaquate magnesium, b-vitamins and other minerals involved in metabolism and general wellbeing. Eating foods that are highly acidic and inflammatory will, over time, contribute to chronic pain. (Murray, Pizzorno & Pizzorno,2005)
Other Natural Therapies for Chronic Pain
Along with naturopathic approaches incorporating these other modalities, depending on the source of your pain, will provide a more holistic approach to treatment.
- Exercise – Yoga, Pilates, Tai Chi
- Cognitive behavioural therapy (CBT)
If you are suffering with chronic pain, please come and see us in clinic, and let us help.
Koffeman, A. R., Valkhoff, V. E., Çelik, S., Jong, G. W. ’t, Sturkenboom, M. C., Bindels, P. J., … Bierma-Zeinstra, S. M. (2014). High-risk use of over-the-counter non-steroidal anti-inflammatory drugs: a population-based cross-sectional study. The British Journal of General Practice, 64(621), e191–e198. http://doi.org/10.3399/bjgp14X677815
Shah, A. D., Wood, D. M., & Dargan, P. I. (2011). Understanding lactic acidosis in paracetamol (acetaminophen) poisoning. British Journal of Clinical Pharmacology, 71(1), 20–28. http://doi.org/10.1111/j.1365-2125.2010.03765.x
Ji, R.-R., Xu, Z.-Z., & Gao, Y.-J. (2014). Emerging targets in neuroinflammation-driven chronic pain. Nature Reviews. Drug Discovery, 13(7), 533–548. http://doi.org/10.1038/nrd4334
Aggarwal, B. B., Gupta, S. C., & Sung, B. (2013). Curcumin: an orally bioavailable blocker of TNF and other pro-inflammatory biomarkers. British Journal of Pharmacology, 169(8), 1672–1692. http://doi.org/10.1111/bph.12131
Gupta, S. C., Patchva, S., & Aggarwal, B. B. (2013). Therapeutic Roles of Curcumin: Lessons Learned from Clinical Trials. The AAPS Journal, 15(1), 195–218. http://doi.org/10.1208/s12248-012-9432-8
Maroon, J., & Bost, J. (2006) Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical Neurology , 65 (4), 326 – 331.
Murray, M., Pizzorno, J., & Pizzorno, L. (2005). The encylopidea of healing foods. New York: Atria books.
Diamanti, A. P., Manuela Rosado, M., Laganà, B., & D’Amelio, R. (2016). Microbiota and chronic inflammatory arthritis: an interwoven link. Journal of Translational Medicine, 14, 233. http://doi.org/10.1186/s12967-016-0989-3
Maeda, Y., Kurakawa, T., Umemoto, E., Motooka, D., Ito, Y., Gotoh, K., Hirota, K., Matsushita, M., et al. (2016).Dysbiosis contributes to Arthritis development via activation of autoreactive T Cells in the intestine. Arthritis Rheumatol, 68(11), 2646-2661.
Butawan, M., Benjamin, R. L., & Bloomer, R. J. (2017). Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement. Nutrients, 9(3), 290. http://doi.org/10.3390/nu9030290
VanDenKerkhof, E. G., Macdonald, H. M., Jones, G. T., Power, C., & Macfarlane, G. J. (2011). Diet, lifestyle and chronic widespread pain: Results from the 1958 British Birth Cohort Study. Pain Research & Management : The Journal of the Canadian Pain Society, 16(2), 87–92.