First Things First Relieving Pain With Natural Medicine
A General Guide to Pain Relief Without Drugs
By Dr. Heather Fox Ph.D. ÂŠ 2005
$19.50 CAN $16.25 USA
Pain Relief With Natural Medicine • • • •
At least one member of almost half of Canada’s households (43 percent) suffers from chronic pain due to a specific illness or medical condition. A survey released in April of 2005 revealed that as many as nine out of 10 people suffer some sort of pain on a monthly or more frequent basis. Never take another aspirin again! Learn which herb contains levels of nature’s aspirin. The old adage that the best therapy is a good laugh could well be true. Several studies have shown that good belly laughter can reduce stress hormones, decrease pain, lower blood pressure, and even boost the immune system. Learn which herb provides migraine relief, as well as relief of symptoms from allergies and hayfever and now available in Canada. Enjoy Pain Free Living with an Anti-Inflammatory Diet and Recipes found inside. ISBN 0-9738739 -1-4
First Things First Relieving Pain With Natural Medicine A General Guide to Pain Relief Without Drugs
Dr. Heather Fox Ph.D. ÂŠ 2005 Revised 2nd Edition Choice Solutions 1168 Albert Street Regina, Saskatchewan S4R 2R1 ISBN 0 973839 1 4 Published 08/2005 Copyright ÂŠ 2005 by Heather Fox
All rights reserved, which includes the right to reproduce this book or portions thereof in any form whatsoever except as provided by Canadian Copyright Law. For further information contact Choice Solutions. Published in Canada 2005
TABLE OF CONTENTS
FIRST THINGS FIRST – RELIEVING PAIN
DRUGS FOR PAIN RELIEF
THE THERAPY OF MOTION - YOGA
MASSAGE AND BODY THERAPIES
SPIRITUALITY AND PAIN RELIEF
NUTRITION AND DIET
FIRST THINGS FIRST RELIEVING PAIN Pain is arguably the most common reason why patients seek treatment. A survey released by the Merck Corporation in April of 2005, for example, revealed that as many as nine out of 10 Americans suffer some sort of pain on a monthly or more frequent basis. No matter what other steps a person who is unwell faces in recovering a sense of health and well-being, pain relief must be considered first and foremost. Pain can overwhelm even the ‘strongest’ person if left un-treated. All pain is first and foremost mediated by the brain. Whether an individual is experiencing pain with physiological issues at its root or from a physiological source, the experience of pain is mediated by the brain. The relief of pain must be given immediate attention regardless of its root condition. Many people feel an overwhelming sense of powerlessness when confronted with pain. It is as though the pain is something that ‘happens’ to them beyond their control, 7
consequently attempts to gain control over pain become the immediate concern. This experience of loss of control is central to feelings of despair and must be addressed in order to overcome those feelings. Loss of control, loss of the ability to regain a sense of well-being in the absence of pain is tantamount to feelings of hopelessness for many, particularly with no hope of pain relief on the immediate horizon. Pain can, in fact, become far more engulfing when there is no end of it in sight. Again, this applies to both physical and emotional/psychological pain. For those who have a chronic or other serious physical condition such as cancer, fibromyalgia or arthritis, pain may be a steady companion. Similarly, those who suffer from clinical depression, bipolar disorder, grief or other conditions which result in feelings of despair may also struggle with feelings of powerlessness in the attempt to cope with deep and constant pain. The brain response is reflexive and largely autonomic (reflexive and reactive) and produces a variety of responses within the whole organism. Instinctively, we move in a well orchestrated reaction to protect ourselves from whatever it is we perceive is causing the pain we experience. Certainly, there is a complex biophysical process at work on an organic level. Nerve pathways convey messages which are interpreted by the brain as pain stimulus. Chemical processes such as the production of endorphin come in to play in the attempt to mediate the experience of pain.
We also have a complex gating mechanism within our psychological framework that steps in to protect us in the face of emotional pain. We may distract ourselves, sleep, and in the most traumatic of painful situations even our memory becomes protectively selective allowing us to experience no more than what we are able to integrate at any given moment. In fact, the experience of pain itself is fundamental to our survival and keeps us out of â€˜hot waterâ€™ so to speak.
ENDORPHINS Endorphins belong to a class of biochemicals commonly referred to as neurohormones. Neurohormones act by modifying the way in which nerve cells respond to transmitters. The discovery of this class of biochemicals has an unusual and interesting history. In the 1960s, medical researchers studying the causes and effects of opium addiction detected what they suspected were "opiate receptors" in brain tissue. It seemed unlikely that the human body would contain a specific receptor designed for a chemical derived from the poppy plant. So researchers focused their attention on biochemicals that might be manufactured in the brain itself. Early in the 1970s, several small peptides (many hormones, and other compounds that participate in life processes are peptides) were isolated that appeared to possess natural analgesic or pain killing properties, and these were collectively termed enkephalins and endorphins. The changes we see in neural transmissions by these biochemicals now appear to be 9
responsible for the insensitivity to pain that is experienced by individuals under conditions of great stress or shock. The effectiveness of drugs that are opiate derivatives such as opium, morphine, and heroin is an accidental side effect that stems from the ability of these substances to bind to the brainâ€™s natural neurohormone receptors despite their very different structure.
Four distinct groups of endorphins have been identified to date. Researchers have been investigating alpha-endorphin since the 1970s, but are still not sure exactly how the polypeptide works or how it specifically affects the body. It is known, however, that alpha-endorphin contains 16 amino acids, only one less than gamma-endorphin, from which it may be formed. 10
Scientists have suggested that alpha-endorphin may stimulate the brain in a manner similar to amphetamines, while others indicate that gamma-endorphin originates at times from cells of the stomach and may help treat anaphylactic shock and similar conditions.
beta-Endorphin Beta-endorphin is produced by the pituitary gland and reportedly produces a greater sense of exhilaration, or â€œhigh,â€? than all of the other endorphin types. This polypeptide contains 31 amino acids, a significantly greater number than either alpha- or gamma-endorphins. Beta-endorphin has the ability to breakdown into either of the alpha or gamma endorphins. Beta-endorphin provides significant natural pain relief and has been heavily researched in recent years. Scientists believe that it is the significant production of this substance during times of stress that prevent a person that has suddenly lost a leg or undergone a similar event from immediately feeling pain. 11
Endorphins are most heavily released during stressful events and in moments of great pain. The flood of endorphins into the system at such times is often felt as a mild nausea or fluttery uncomfortable feeling in the stomach. In addition to stress and pain, endorphin secretion may be triggered by the consumption of certain foods, such as dark chocolate and certain peppers such as chilli and cayenne. The increase in endorphin levels caused by chocolate is believed to play a significant role in its often being turned to as a comfort food in times of stress. The endorphin release associated with chilli peppers accounts for the success in using them in a variety of medical treatments, especially as part of therapy for chronic pain. They have even been considered an aphrodisiac. Physical activity has also been associated with endorphin secretion in recent years. Massage therapy or acupuncture may in part be successful in pain management in part due to the stimulation of endorphin release. Endorphins acting as a natural painkiller are no doubt a factor in what athletes refer to as "runner's high" and an "adrenaline rush."
gamma-Endorphin Gamma-endorphin is a polypeptide that is characterized by the presence of 17 amino acids, only one more than alphaendorphin. Research focusing upon gamma-endorphin has been ongoing since its discovery in the 1970s. This important polypeptide may have an antipsychotic effect on a certain category of patients suffering from schizophrenia. Some studies also suggest that gamma-endorphin may act to help regulate blood pressure.
LAUGHTER One surprise contrary to the understanding we have that endorphins are produced in response to pain and stress is the fact that they are also secreted when a person is laughing! Several studies have shown that good belly laughter can reduce stress hormones, decrease pain, lower blood pressure, 13
and even boost the immune system. The old adage that the best therapy is a good laugh could well be true. Medical research has discovered remarkable impacts on our hormonal levels, in response to laughter. Laughter has been shown to shut down the "stress" hormones like cortisol, dopamine, adrenaline, and growth hormone, keeping them at lower healthier levels. Such hormones are released when we are tense, working hard, worried, or afraid. It is all part of the fight or flight reaction built into all of us, enabling us to either overcome an attacker or dash away to safety. The endorphin protein seems to remain constant in laughter, even as the stress hormones are being shut down. Virtually all of us learn to laugh at four months of age, something which requires the action of fifteen facial muscles and changes in breathing. When we laugh, at first the heart rate increases as does our rate of breathing. After our laughter ceases, there is a period of relaxation, easing muscle tension and useful in breaking the muscle spasm in some neuralgias and rheumatism.
WOMEN AND PAIN TOLERANCE From the intensity of their pain to the way they deal with it, men and women are different, suggests a growing body of evidence. A woman's tolerance of pain may have more to do with the power of her reproductive hormones than the strength of her muscles. Fluctuations in hormone levels might contribute to variations in the severity of women's 14
pain symptoms across the menstrual cycle, during pregnancy and immediately after delivery, and during and after menopause. The key to pain response in women may be the hormone estrogen. When estrogen levels are high, the brain's natural pain chemicals, the endorphins or enkephalins are much more potent. Likewise, when estrogen levels are low so is the response of the endorphins. Pregnancy is a good example of this brain chemistry in motion. He speculates that one of the reasons women can tolerate the pain of childbirth is that just before they deliver, estrogen levels are extremely elevated. According to research this hormone activity increases the number of receptor sites in the brain where natural painrelieving chemicals such as endorphins can â€˜dockâ€™. The more receptor ports there are available to receive endorphins, the greater the ability of the brain to control the pain response, and ultimately the less pain a woman feels. Under high estrogen conditions, the number of brain receptors available to receive endorphins increased dramatically, compared to the low estrogen conditions. During high estrogen times women tend to have a significant ability to release endorphins and activate the receptor sites. On a variety of studies women reported less pain when estrogen levels were high, even though the level of pain 15
inflicted was the same as it was during their low estrogen cycle. The data, now being confirmed in larger studies, hints at the powerful effects of female hormones on the pain and stress response.
DRUGS FOR PAIN RELIEF ASA, acetaminophen and non-aspirin nonsteroidal antiinflammatory drugs (NSAIDs)
Chronic pain costs the U.S. approximately 100 billion dollars annually, making it the number-one cause for health care spending, and leads to approximately 515 million lost workdays. Aspirin and nonaspirin nonsteroidal antiinflammatory drugs (NSAIDs) are among the most commonly used medications. In 1993, prescriptions for nonaspirin NSAIDs alone totalled 6 million. Prescription use of NSAIDs in the United States appears to be stabilizing, but nonprescription over-the-counter, (OTC) drug use is growing. Sales of ibuprofen in forms such as Advil, Motrin IB, etc. have more than tripled since the analgesic was approved for OTC sales nearly a decade ago.
Approximately 16,500 Americans died last year from bleeding stomach ulcers brought on by common medications known as non-steroidal anti-inflammatory drugs, (NSAIDs). If these deaths were the result of a disease we would call it an epidemic. To be clear, this was close to the number of deaths resulting from AIDS. Unfortunately, those most at risk are those most likely to use the drug, including people with severe arthritis and those over 65 years of age.
Drug companies are taking advantage of the trend toward health and wellness. They are relatively unconcerned with the interest in consumer alternatives and have responded with a shift in their emphasis in sales. Prevention is the concept behind the development of a whole new trend in drugs. More and more drug companies are pushing drug use not just for treatment of â€˜diseaseâ€™ but increasingly for use before any problems arise as a preventative. This mass marketing shift has paid off as prescriptions for drugs went up 400 million from 1993 to 1997, up to an astounding 2.4 billion prescriptions being dispensed in 1997. This new approach markets drugs with the promise to prevent such things as heart attacks, cancer, osteoporosis, diabetes and impotence. The single most frequent severe adverse drug reaction is seen in gastrointestinal complications caused by NSAIDs. The U. S. Food and Drug Administration estimates that the incidence of symptomatic ulcers and potentially life-threatening ulcer complications in patients taking NSAIDs is 2-4% per year. More than 100 million prescriptions are filled for NSAIDs each 18
year, and many more patients are taking over the counter, nonprescription products, resulting in over 200,000 hospitalizations and 10,000 to 20,000 deaths due to NSAIDinduced complications each year. A study, from researchers at the Oregon Health Sciences University in Portland, finds that between 5 and 10 percent of all people in the US with kidney disease had sustained that damage through excessive and habitual use of aspirin and other over the counter pain killers. The researchers said that there is no doubt that aspirin, taken over a long period of time in a cumulative dose of more than two kilograms, can cause permanent kidney damage requiring dialysis or trans-plants. One kilogram is roughly 3,000 aspirins so to translate the figure of two kilograms; this means that three regular dose tablets a day for three years would produce a harmful dosage. In addition to aspirin, other pain killers are also suspected of causing kidney damage. It is not uncommon for people to take over the counter pain killers in the danger-level amounts, despite package label warnings against doing so. 95% of acetaminophen is passed through the body and out through the urine. The remaining 5% attaches itself to features in the liver and reduces the liver's ability to function properly. Most people have no difficulty recovering from this effect. Five percent might sound like a small and even insignificant number but there groups of individuals for whom this could be very important information. Any person whose liver is not within the normal levels of 19
function is especially at risk. These individuals would include those who consume alcohol at amounts of more than a couple of drinks per week and those who already have a liver problem such as hepatitis or other liver disease. For these peoples, acetaminophen can cause a temporary or a permanent shutdown of liver function. This can actually lead to hepatitis or even death. Complete and permanent liver shutdown can occur in some individuals who overdose on acetaminophen and do not receive prompt specific treatment. There is another important issue with acetaminophen which doesn't get a level of attention equal to its seriousness. We know not to give aspirin to a young child with a fever due to the risk of Ryeâ€™s Syndrome. Instead we have been giving children a liquid formulation of acetaminophen. The liquid formulation is. Children have suffered serious liver damage and death from liver failure due to their parent's overdosing them on acetaminophen. And from another study Alcohol and Tylenol - DON'T MIX! "A former White House aide who claims that ordinary doses of Tylenol destroyed his liver has been awarded more than $8.8 million in a federal court suit against the manufacturer of the popular pain-reliever. "I had the flu and then I wake up with my liver gone," Antonio Benedi said. "They ruined my life." The 20
drug's manufacturer, McNeil Consumers Products Co., denied that Tylenol had any thing to do with Benedi's liver disorder and said it would appeal Thursday's decision by a federal court jury in suburban Alexandria, Va.â€? Antonio Benedi was a former special assistant to President Bush Sr. who claimed in a law suit that his liver had been "sensitized" to react to Tylenol by his habit of drinking wine with dinner every day. Benedi took the drug for several days to combat the flu and eventually lapsed into a coma and was hospitalized. In the law suit Benedi's attorney argued that McNeil Consumer Products knew of the danger of mixing the habitual use of alcohol with the acetaminophen but had taken no action to warn the public. After hearing four days of testimony in U.S. District Court, a six-member jury awarded Benedi $7.8 million in compensatory damages and $1 million in punitive damages. Benedi ultimately required a liver transplant and then went on to face damage to his kidneys due to the anti-rejection drugs. During the trial the Court heard testimony from experts who claimed that ordinary doses of Tylenol can cause a toxic reaction in the liver of someone who regularly drinks alcohol. A Food and Drug Administration advisory panel recommended last year that Tylenol and several other types of over thecounter pain relievers carry alcohol warning labels.
Survey on Drug Abuse showed that approximately 9% of the U.S. population has used pain relievers illegally in their lifetime. While narcotics have an important use in cases of sudden and extreme pain and the benefit to being able to access these drugs is important to remember, long term use should be avoided due to their extremely addictive nature. The longer a person uses a narcotic the less sensitive they become to the pain relieving benefits and it is common to want to take more rather than less at the critical point where addiction becomes a risk factor. It is important to be clear that narcotic use should be avoided in anything other than emergency situations. When a person must use narcotics it is critical to be very clear from the onset that it is to be a temporary solution while making plans for longer term pain relief strategies that are less dangerous.
Did You Know... â€˘ â€˘
At least one member of almost half of Canadaâ€™s households (43 percent) suffers from chronic pain due to a specific illness or medical condition. In a survey 48 percent experienced pain related to skeletal problems, which include back pain, as well as problems with the knees, neck, shoulder/arm, ankle/foot, joints, bones, hips and bursitis; and other sources, such as arthritis, headaches, nerve problems, 24
surgical/post-operative and traumatic injury. 80 percent of patients surveyed believed their pain was a normal part of their medical condition and something they must live with. For one third of sufferers, their chronic pain was so severe and debilitating, they felt they were unable to function as normal people and sometimes is so bad they want to die. Some 40 percent of sufferers are uncomfortable discussing their pain and 37 percent say it can leave them feeling very alone. One-third of sufferers do not believe people understand how much pain they are in and one-quarter say their family is tired of hearing about their pain, do not understand how it affects them and feel inadequate as a spouse/partner because of it. Fifty-six percent of patients suffering from severe pain feel that their pain interferes with sleeping, that pain affects their overall mood, ability to drive , to have sexual relations, and even to feed themselves. Those not completely happy with their physician cited unsuccessful treatment of their pain as the main reason for dissatisfaction. Patients in chronic pain are so dissatisfied with the effectiveness of their prescription and over-the-counter pain control medications that 78 percent are willing to try new treatments and 43 percent would spend all their money on treatment if they knew it would work. Many patients have been suffering for years, with more than half of sufferers (62 percent) having experienced 25
Perhaps one of the most important therapeutic alternatives for treating any condition of acute physical pain is Acupuncture. Originating in China over five thousand years ago, acupuncture is a system developed to enhance health, relieve pain and 27
restore a balanced flow of life energy - qui or chi - along pathways or meridians present in the body. These energy pathways correspond to different organs and body systems. Needles are placed very concisely along these meridians at specific ‘acupoints’. Chinese medicine maintains that the more than 2,000 acupuncture points on the human body connect with 12 main and eight secondary “meridians” or channels. Pain and disease are the result of these channels becoming blocked. By placing needles at one end of the channel or the other, healthy energy can be restored. Western medicine’s view is that the placement of acupuncture needles at specific pain points releases endorphins and opioids, the body’s natural painkillers, and perhaps immune system cells as well as neurotransmitters and neurohormones in the brain. Research has shown that glucose and other bloodstream chemicals become elevated after acupuncture. According to the National Institutes of Health’s National Center for Complementary and Alternative Medicine, there is also evidence that stimulating acupuncture points enables electromagnetic signals to be relayed at a greater rate than under normal conditions. This may increase the flow of healing or pain-killing natural chemicals to injured areas.
In a study in 1960 by a team of researchers in Korea, evidence was documented that there is a series of very small, ‘duct-like’ 28
GUIDED IMAGERY ‘The imagination is probably a person’s least utilized health resource. It can be used to remember and recreate the past, develop insight into the present, influence physical health, enhance creativity and inspiration, and anticipate possible futures.’ Martin L. Rossman M.D. Co-founder of the Academy for Guided Imagery
Dr. Rossman calls images the ‘language of the emotions and the interface between mind and body’. What makes personal imagery so powerful? It is our personal imagery, the way we see ourselves and the world around us which is so powerful. Our ability to imagine something vividly, to put ourselves into that situation can have both positive and negative effects. An average person has literally thousands of thoughts or images flashing through their mind each day. At least half of 38
those thoughts may be negative due the numerous day to day stresses we encounter. These may be job related anxiety, money worries, family stresses and more. A steady dose of worry and other negative images can alter your physiology – the way your body functions - and make you more susceptible to a variety of ailments, ranging from acne to arthritis, headaches to heart disease, ulcers to urinary tract infections and many other diseases. Your thoughts have a direct influence on the way you feel and on the way you act and react in life. If your attitude or belief is that your job is enough to give you a headache no doubt that’s exactly what you will end up with at the end of the day. When you expect the best from a situation, that’s often what you get. Likewise, when you expect the worst you often get the worst. Most often our expectations, what we believe or think about any situation are exactly what we get. This is just another clear example of the power the mind exerts over the body. If you can learn to direct and control the images in your head, you can help your body heal itself. If you learn to use your imagination in a way that is purposeful and directed, it can be a tremendously powerful tool to get you where you want to go, including to better health. Your imagination can be a powerful tool to help you combat stress, tension, and anxiety. You can use visualization to direct your imagination. Visualization or Guided Imagery does not need to be time consuming or complicated. Most people find they are able, with a little practice, to visualize two or three 39
THE THERAPY OF MOTION YOGA Yoga is an ancient practice developed in India almost 4,000 years ago and is a scientific methodology aimed at uniting the mind, body, and spirit. Yoga has become increasingly popular in North America, and currently more than 15 million people in Canada and the United Stated do yoga. . Generally in the US, yoga classes consist of a combination of physical exercises, breathing exercises, and meditation. The most commonly practiced form of yoga is called Hatha yoga. Hatha yoga incorporates a series of poses called Asanas while promoting a breathing technique referred to as Pranayama. Yoga has been used for thousands of years to promote health and prevent disease, and many people with back problems have found yoga to provide several benefits, including: 54
• • • •
Relieving pain Increasing strength and flexibility Posture, balance and body alignment Teaching relaxation and calm
In recent years, researchers have determined through studies that effects of yoga on many medical conditions as varied as heart disease, carpal tunnel syndrome, epilepsy, asthma, addiction, and many neck and back problems are positive. Although no one treatment works for everyone, many aspects of yoga make it ideal for treating back pain and neck pain as well as the stress associated with pain. Those who practice yoga for as little as twice a week for 8 weeks have made significant gains in strength, flexibility, and endurance, which is a basic goal in most rehabilitation programs for back pain or neck pain. Fibromyalgia is another condition that can greatly benefit from the practice of Yoga. Fibromyalgia comes from the Latin fibro, meaning connective tissue such as tendons and ligaments, myo meaning muscular, and algia, meaning pain. The breathing and meditation aspects of yoga induce a level of deep relaxation that has been found in many studies to assist people in decreasing their pain. Significantly, Yoga has also been found to be helpful in the treatment of depression and anxiety that often accompany pain problems.
MASSAGE AND BODY THERAPIES
There are several therapeutic styles of touch which can bring about a profound relief of pain as well as to help restore an overall sense of health, comfort and well being. These styles can range from techniques such as Therapeutic Touch (R), 59
Rolfing (R), Reflexology, several schools of Therapeutic Massage, Shiatsu and Acupressure. All are valuable and may be selected as a therapeutic style according to the specific needs of the client. In general, body therapy can help with a number of conditions. It can improve circulation of the blood and also lymphatic circulation. It helps restore mobility and can reduce swelling of painful joints. Muscle spasms as a result of overuse or a chronic condition can be relaxed causing great relief in discomfort, particularly where compression of nerves has resulted from muscle spasm... Relaxation of stress, tense muscles permits better elimination of toxins by the body. A study on massage and back pain conducted at the Touch Research Institute at the University of Miami in 2001 and reported in the International Journal of Neuroscience found that: “Massage lessened lower back pain, depression and anxiety, and improved sleep. The massage therapy group also showed improved range of motion and their serotonin and dopamine levels were higher.” Muscles that are in spasm are often painful. The pain is caused by ischemic muscle tissue. Ischemia means the muscle is lacking proper blood flow, usually due to the muscle spasm. This in turn creates the following undesirable process: • When muscle is not receiving enough blood it is also not receiving enough oxygen • Lack of oxygen causes the muscle to produce lactic acid 60
SPIRITUALTY AND PAIN RELIEF Results of a recent poll revealed 58 percent of us have tried prayer to deal with pain, about as many as have taken prescription drugs. Furthermore, among those who have turned to prayer, half have said it has worked very well for them in terms of pain relief â€” tying it again with prescription drugs as the top ranking approach. The survey was sponsored by Stanford University Medical Center, ABC News and USA Today in April of 2005. And as with other remedies, prayer works best on easier problems. Among people with acute pain, 61 percent say praying for relief worked very well for them; among those with chronic pain, many fewer, 37 percent, say prayer works. Women are more apt than men to have prayed for pain relief: Sixty-six percent of women have done it (62 percent of women under 50, rising to 71 percent of women age 50 and over). That compares with 49 percent of men (with no difference by age). 68
One possible explanation for the popularity of prayer as pain relief could be that prayer allows for a deeply thoughtful time on introspection ad the individual struggles to understand the meaning of pain in their lives as a part of the human condition and their own spiritual growth. Western religious tradition includes Judaism, Christianity and Islam. The Eastern religious tradition includes Buddhism, Taoism and Hinduism. Each religious system is based on a core of beliefs, often articulated through a set of ancient texts that are considered authoritative and sacred. These bodies of literature incorporate that religion's values and teachings, providing the source of answers to many profound human questions. Some Buddhists, for instance, may believe that suffering is part of life, to be expected, and that if a person experiences pain calmly, without becoming emotionally distressed, he or she can attain greater states of consciousness Quiet reflection is one of the most important practices for Buddhists. Comfort can be found in the pictures of religious leaders or ancestors, prayer beads, and flowers. Having a quiet and private place to focus on these things can help the individual manage pain. Chanting is another ritualized form of prayer or meditation for many people, and involves quietly repeating specific prayers or mantras. This practice can be done in solitude or along with other members of the religious. There is evidence of many associations between religious experience and pain. However one defines religion and 69
however one defines pain, these two stand in a close and complex relation to one another. A life-threatening disease such as cancer, or any state of illness that results in intense or prolonged states of pain confronts us with trying to understand the realities and questions that prompt us to step back from our day to day lives and reflect on the meaning and implications of the condition. Our perspective is based on our religious, spiritual or philosophical beliefs and experiences. Our experience or way of understanding the significance of pain or illness in our lives influences how we experience the illness--its meaning, how we feel about it and how well we come to terms with it. A religious perspective can help us as we grapple with these issues and seek to keep our perspective through the mental and emotional distress much experience. There are often important spiritual questions that arise during painful illness. Many people have asked "Why did this have to happen to me?'' Of course, the answer is that it did not have to happen, it just did. But there is often an emotional poignancy to this issue that cannot easily be dismissed. In fact, depending on your life perspective it can be easy to become swallowed up by this question. It is not uncommon for patients to wonder whether the illness is a punishment for certain wrongs or failings of character. The Bible teaches that disease and death are the result of sin. Of 70
ELECTROTHERAPY What is Electrotherapy? The use of electricity for the relief of pain goes back many thousands of years - the ancient Egyptians used electric fish. By the mid-1800s, physicians and dentists were beginning to use electrical stimulation as an analgesic. Electrotherapy is a physical therapeutic treatment whereby electrical stimulation is applied to nerves and muscle-motor fibres via electro-pads placed on the skin. Electrotherapeutic programs, utilizing prescribed variations in electrical frequencies and intensities, serve to interrupt, alter or induce specific electrical impulses in order to affect the perception of pain and/or facilitate in wound healing and muscle rehabilitation. These effects are achieved by reducing localized inflammation, increasing blood flow, stimulating muscles, and triggering the release of endorphins, hormones that act as the body's natural analgesic. Electrotherapeutic medical include analogue, digital and/or programmable transcutaneous electronic nerve stimulation 76
(TENS) devices, E.M.S. devices. TENS sends small electrical impulses through the skin to the nerves. The impulses are carefully controlled and are not harmful in any way. Since the brain can only pay attention to one stimulus at a time, the pulses take priority over pain signals. TENS may induce the nervous system to release endorphins such as dopamine which also minimize pain signals from reaching the brain. Electrodes are placed on the skin and joined to the T.E.N.S. unit with wires. Electric signals are then sent to the nerve endings, blocking pain signals before they reach the brain. It is believed that this signals may also stimulate the production of endorphins, the body's natural pain killers. T.E.N.S. therapy is not considered painful, although some people report feelings of mild discomfort. Pain relief from T.E.N.S. therapy can be long-or-short-term in nature. Because the treatments are safe and have no known side effects, they can be repeated as necessary. The electrodes are usually placed near the painful area (often on either side), over a main nerve leading to the painful area, on the spine one or two segments above the spinal nerve receiving the pain, or at acupuncture points. Treatments are typically given 3 to 4 times per day for 30 to 40 minutes a session. Electrotherapy can be used for any type of localized physical pain, although it is most commonly advocated for arthritis, sciatica, neuralgia, and chronic back pain. It is sometimes used after knee, hip, or lower back surgery (usually in combination with other analgesic treatments). And it has also been used for 77
Ginger Botanical or Herbal medicine is still highly resisted by many conventional allopathic medical practitioners despite its traditional acceptance and growing trend of popularity. Generally, this is due to two main factors. The first is a mainly political-economic factor. Herbal medicine cannot be patented and as a result, no pharmaceutical company can hold any kind of exclusive right to the marketing of herbal products. There is little motivation, 84
due to the lack of monetary incentive, to engage in research of herbal medicinal properties. Secondly, due to the unreliability of nature (and to some extent human) determined growing conditions as well as the conditions of harvest and preparation of herbal products, there is legitimate concern with the standardization of quality of herbal preparations. Herbal remedies may be prepared from any part of a plant. That may mean the root, bark, seed, leaf, flower, or any part. The principle difference between herbal medicine and todayâ€™s pharmaceutical drugs is that the active ingredient found within a herb is not taken in a purified or isolated state. It is taken in the context of the many other chemical compounds which naturally coexist in the whole state the plant is found in. Pharmaceutical drugs are based on the isolation of certain active ingredients and are then purified for a more potent dose of that chemical. Herbal medicine may not offer the same level of immediate result as what the pharmaceutical drugs offer, but often arenâ€™t as much of a jolt to the system either. It would be as foolish to attempt to provide a prescription for herbal medication as would be to prescribe a pharmaceutical medication that would be appropriate for all conditions. However, as Aspirin and Tylenol have become common place and over the counter remedies for headache and fever, so have certain herbs become commonplace and safe for certain conditions with minimal contraindications for the average person. Many herbs should be taken in consultation with a 85
Passionflower, Chamomile and Skullcap.
Valerian Valerian is also used as a popular day time sedative without typical complications that occur with barbiturate use. If symptoms of headaches, chest tightness, abdominal pain, and tremor of the hands and feet are experienced use of Valerian root should be discontinued immediately. Willow Bark Willow Bark is another non-narcotic used to treat conditions of pain. It contains derivatives of salicylate â€“ natureâ€™s aspirin but in minor quantities so that a great deal of the rather bitter 88
trials. There is a body of evidence well supporting the medical value of cannabis for glaucoma patients, cancer and AIDS patients, those who suffer from chronic pain and much anecdotal research on the use of the drug with other conditions such as bipolar disorder. Curcumin (from the spice turmeric) Curcumin is a root that is used to add the golden colour and flavour to curry and other foods. It has beneficial antiinflammatory properties. Curcumin has been used to combat the pain and swelling of arthritis. Some researchers think that curcumin is as powerful an anti-inflammatory as prescription cortisone. There may be additional benefits to taking Curcumin. It may also help to lower cholesterol, reduce the risk of heart disease and stroke by thinning the blood to prevent unnecessary blood clots, lower blood sugar in diabetics, and help the body to counteract carcinogens. Chinese Medicine has a history or using the herb to treat colic, menstrual cramping, and shoulder pain. Curcumin has been shown to be as effective as cortisone and phenylbutazone in decreasing inflammation. In one study with men who had surgery-related hernia, this compound reduced tenderness much more than the drug or a placebo. Like cayenne, curcumin contains pain relievers that stop the neurotransmitter substance P from sending its pain signals to the brain. It also works in several ways to decrease inflammationâ€”by reducing prostaglandin activity. Researchers also believe that curcumin increases cortisone's antiinflammatory action by making the body more sensitive to this 92
NUTRITION AND DIET
Nutrition and diet are vital considerations in the treatment of any condition. Food sensitivity and allergy as well as certain nutritional deficiencies can be key factors in the experience of 105
physical discomfort, certain diseases which are becoming more frequently seen throughout our population such as colitis, gall bladder disease, hypertension, diabetes and hyper-insulinemia, and also in the experience of clinical depression and certain other psycho/physiologic conditions. The scientific study of nutrition is not as new as many have thought. The study of medicine based on the bodies need for nutrients and indeed the use of nutrients as treatment for disease is often referred to as Orthomolecular Medicine. Science has provided us with answers and as with many other aspects of alternative medicine, there is much traditional knowledge with regards to diet and personalized eating styles which we have the benefit of drawing on when assessing personal and individual needs. For most of us, the question of what we eat is also intimately tied to our cultural influences in life and for many us also includes ties to our definition of spirituality. For example, there are those who are vegetarian because they believe is simply a healthier way of eating for them. There are others who chose vegetarianism out of a deep sense of spiritual connectedness to other living animals and feel is spiritually â€˜wrongâ€™ to eat meat. Eating pumpkin pie for Thanksgiving is an example of food that has a cultural context, a spiritual context, appeals to the pleasure principle because it tastes so good, and may also reflect the all important economic factors that determine what we eat. Abundance of certain foods at certain times of the year 106
and other. There are also, specifically, a whole host of food additives that are especially toxic and especially neurotoxic for many. These include additives such as aspartame and MSG. Switching to a highly nutritious, low-fat, low-glycemic diet has helped many patients reduce or banish their pain, helping them to reduce or eliminate the need for their drugs as well. In general, pain patients should. The significance of low glycemic food seems to lie in the reduction of carbohydrates that tend to ‘feed’ many inflammatory conditions.
Rules for Pain Safe Foods •
Eat a wide variety of foods (the more variety, the better) because each food contains a unique formula of nutrients. Although there is no perfect food, a diet based on many fresh vegetables and fruits, plus a variety of whole grains, comes close to perfection.
Eat as much real food as possible. Take a look at your shopping cart as you roll it up to the checkout stand. Is it filled with boxes and cans or do you see mostly fresh foods? Fresh foods should predominate.
Avoid food additives that are mostly found in packaged foods. When you do select packaged foods, compare labels carefully and look for those with the fewest additives.
Keep sugar consumption low. Excess sugar consumption makes the body have to work harder to ‘clean up’. A little added sugar will not be harmful to most of us, but a lot will hurt many of us.
As much as possible, eat meals at home where you have control over food intake.
Eat small amounts frequently, snacking on low-fat foods to dull your appetite so that you will not overeat at the dinner table. Snacking also helps to keep your blood sugar reasonably stable throughout the day. Fruits, nuts and vegetables make ideal snacks and finger food that can be enjoyed throughout the day.
Avoid large meals within several hours of going to sleep. Eating a large meal close to bedtime is not healthy and more of the food eaten will be stored as fat.
Eat slowly. Enjoy your food. It’s important to give your appetite control centre enough time to tell you that you have had enough before you have eaten too much. Put down your fork or spoon while you are chewing. Do not overeat. Eat until you are comfortably full (but not stuffed) and then stop. If you are not hungry, do not eat. Let your stomach be your guide, not the clock.
Nutrients That Fight Pain
work as rapidly as many drugs or other pain treatments and its effectiveness increases over time. This is because, as discussed earlier, the amino acid helps to increase the body's supply of endorphins, rather than attacking pain directly. It would not be an ideal first choice for acute pain such as headache and migraine, pain due to sprains etc... It is an ideal choice however, for chronic pain. The suggested dose of phenylalanine is 500 mg taken 2-3 times daily. Glucosamine is another amino acid especially. helpful in treating arthritis pain because it stimulates connective tissue such as cartilage, helping it to repair itself. Glucosamine protects the chondrocytes that are found in large quantities in the joints. Glucosamine is made in the body from glucose (sugar) and an amino acid called glutamine. Thus its name Glucosamine reflects its origins. It serves as a building block of mucopolysaccharides (MPS) which are important for the development of cartilage, bone, ligaments, nails, hair, and skin. We can find glucosamine in fish, meat, and other foods. We can also get glucosamine from nutritional supplements. The bodyâ€™s production of glucosamine declines with age or with injury contrary to what one might expect. Taking glucosamine as a supplement gives the body a boost in having the material it needs to help repair damaged cartilage. It often works best when taken with the fatty acids GLA, DHA, and 121
EPA; chondroitin sulfate; manganese; and vitamins C and E. As with most supplements recognizing the co-factors, the synergy of other nutrients that aid in the best use by the body of what it needs is important. Many studies conducted at research centres in Europe have shown strong evidence that supplemental glucosamine reduces joint pain, tenderness, and swelling, making joints that had been frozen or locked in with pain and inflammation usable again People with rotator cuff injury to their shoulders and other injury to joints who experience â€˜frozenâ€™ joints can especially benefit from glucosamine. Again, like phenylalanine, glucosamine does not work as fast as some standard pain medications or treatments such as acupuncture for more immediate relief. However, it does provide relief without the serious side effects associated with drugs. Many informed practitioners in European countries give glucosamine to their osteoarthritis patients as a first response treatment. A recent study done at King's College in London, and published in March, 2002, in the British Journal of Community Nursing, compared the effectiveness of glucosamine with ibuprofen for relief of joint pain. The study found that glucosamine can be used as an alternative to anti-inflammatory drugs and analgesics or as a useful adjunct to standard analgesic therapy. The study indicated that glucosamine's painrelieving effects might be due to its cartilage-rebuilding properties, which is a significant bonus you certainly don't get 122
Anti Inflammatory Cooking For Pain Free Living There is much awareness today of the role of inflammation in many health conditions ranging from arthritis to heart disease. Inflammation however, is one of our body's key defence mechanisms against infections and aids in the healing process. You can see beneficial and healthy inflammation in action when you get a small cut for instance. The area gets warm and red, and maybe a little swollen. Those are all signs that your immune system is working to repair the damage to your tissue â€“ in this case your skin. This type of inflammatory response can happen around your heart as well. If some cholesterol begins to deposit into your arterial walls and plaque develops an inflammatory reaction is provoked. The critical point, however, is when inflammation stops being useful and part of a healing process and begins to be harmful. When the inflammatory response continues beyond that point of usefulness it progresses into chronic low-grade inflammation in the body. Inflammation can be one of the main antagonists resulting in pain. 135
There are several steps can take to prevent chronic inflammation and to aid in the healing process through the food you eat, and don’t eat! Eating a healthy diet with an emphasis on foods high in antioxidants and anti-inflammatory phytonutrients can help keep you healthy and prevent heart disease, diabetes, arthritis, certain cancers, and Alzheimer's disease. It is also an important component of pain relief with healthy diet. You should try to emphasize the healthful foods listed in the charts, but continue to keep in mind that all fruits, vegetables, and whole grains.
The Do's and Don'ts of Inflammation •
Don't smoke. Each cigarette is an oxidative attack on your body and oxidation elicits an inflammatory response from your immune system. Smoking, like high blood pressure, causes damage to blood vessel walls and sets the stage for inflammation. Don't carry excess weight. Being overweight directly increases your risk of heart disease and diabetes. Also, the presence of abundant fat cells may indirectly encourage the release of inflammation-causing hormones. Losing weight has been shown to reduce harmful inflammation inside the body, as well as reduce C-Reactive Protein (CRP), cholesterol, and blood sugar levels. Don't eat pro-inflammatory foods. Many processed 136
RECIPES Appetizers Almond Mushroom Pate 2 tablespoons butter 2-3 cloves garlic chopped fine 1/2 teaspoon tarragon 1 tablespoon fresh squeezed lemon juice 1 dash cayenne pepper 1 small onion, chopped fine 1 1/2 cups sliced fresh mushrooms 1 cup whole almonds 2 teaspoons tamari soy sauce 2 tablespoons cream cheese or yogurt 4 servings â€˘
In a large skillet, melt butter. 141
SOUPS Ginger Lentil Soup Tasty, healthy lentil and sweet potato soup with ginger. 2 tablespoons butter 2 carrots, chopped 1 onion, chopped 2 tablespoons finely grated fresh ginger 4 cloves garlic, minced 1 1/2 teaspoons ground cumin 1/4 teaspoon cayenne pepper 1/8 teaspoon ground allspice 8 cups water 1 cup red lentils, rinsed 1/2 cup brown rice 3/4 lb sweet potatoes, peeled and cut into chunks 1 teaspoon salt 1 cup fresh, finely chopped spinach 6 servings • • • •
Heat the butter in a large pan over medium heat. Add the carrots and onion and cook for 6 minutes or until softened. Add the ginger, garlic, cumin, pepper, and allspice, and cook, stirring, for 1 minute. Add the water, lentils, and rice, and bring to a boil over high heat. 151
• • • •
Reduce the heat to low, cover, and simmer for 1 hour, or until the lentils and rice are tender. Stir in the sweet potatoes and salt. Cover, and simmer for 20 minutes, or until the sweet potatoes are tender. Stir in the spinach, and cook for 5 minutes.
Spicy Coconut & Red Lentil Soup This is a another great soup for a cold evening. Its great served with your favourite bread and salad. 2 tablespoons butter 2 red onions, chopped fine 3 cloves garlic, chopped 1 cup red lentils, rinsed 1 cup of sweet potato diced 1 teaspoon ground coriander 1 teaspoon Hungarian paprika 1 2/3 cups coconut milk 3 3/4 cups water 1 lime, juice of 3 1/2 scallions or green onions chopped 1 cup cilantro, finely chopped (optional) salt & fresh ground pepper 4 servings 152
Preview pages from the book First Things First - Relieving Pain with Natural Medicine. The entire book is 191 pages.