From slight annoying twinges of discomfort to disabling, all-consuming agony, pain is an integral part of human existence and experience. Sometimes, pain gives us a clear signal that something, potentially life-threatening, is wrong. It triggers the avoidance reflex, which clearly has survival roots. It sends us the imperative message that we need to attend to this RIGHT NOW! And many times, we can indeed take steps to effectively address both the cause of the pain, and the pain itself. At other times, the injury, wound or process keeps loudly telling us that something is still wrong or needs attention, but the treatment or remedy simply takes time, or is not actually fixable. Think childbirth! We are doing all we can do in the moment, and have to find other ways to manage the discomfort or pain.
And then there is chronic pain. Chronic pain persists even when there is no overt damage. Chronic pain is mediated by other processes in the brain and is often the result of a perfect storm of genetic vulnerabilities, nutrient deficiencies, brain wiring issues, neuroinflammation and a series of physical and emotional insults that lead to what one researcher call “the tipping point syndrome”. (Dr. Kaplan, DO: Total Recovery, Solving the Mystery of Chronic Pain and Depression). Since chronic pain is a complex problem, or rather, a complex of problems, it requires a multi-faceted approach, addressing all 3 legs of the stool, biochemical/nutritional-psycho/social and spiritual, to overcome it.
This article will focus on the biochemical/nutritional tools we have available to us. We will explore ways to reduce inflammation, decrease pain awareness, improve pain tolerance or resilience, speed up tissue healing, and even positively impact impaired neural pathways.
RELAX THOSE MUSCLES!!
Let’s start by addressing the pain and discomfort that can come from tight, tense or spasming muscles. The primary goal here is to relax those muscles. Tight muscles can be caused by a lack of the neurotransmitter GABA, along with insufficient magnesium. Thus, taking a low dose of GABA, starting with 100 mg, and then increasing the dose until relief is experienced may be very effective. Too much GABA can cause rebound anxiety, so titrate the dose upward in small increments. Valerian can support the GABA pathway and has been used as a muscle relaxer as well as being a sleep aid. (Can Valerian Root Alleviate Muscle Spasms? – Brandon Orthopedics) Like GABA, occasionally valerian can cause a paradoxical reaction, so start with a small dose and build up.
Magnesium may be dosed up to about 1,000 mg/day. There are several different magnesium formulations, but it is best to avoid magnesium carbonate as it is not very absorbable, and be cautious with magnesium citrate, as too much may cause loose stools. Aromatic oils, such as Wintergreen, have been used in massage setting to support the relaxation of tight muscles. Lower intestinal spasms have been known to be helped by enteric coated peppermint oil. Menstrual cramps have several different causes which are beyond the scope of this article. However, magnesium may be helpful here, along with GLA from Evening Primrose Oil or Borage oil, to support production of the brain anti-inflammatory chemical PGE1. The herb, Cramp Bark, Viburnum Opulus, has traditionally been used to help relieve cramps as well. (Cramp Bark (Viburnum opulus) (herbalremediesadvice.org)
Migraines are an often complex, debilitating condition, affecting at least 4 million people a year. Fully exploring them is also beyond the scope of this article. However, there are some useful starting points. Magnesium, Vitamin B2, and use of the herb Feverfew may bring significant relief. People who are sensitive to Tyramine, a natural chemical found in some foods such as red wine, citrus, aged cheeses, cured meats or smoked fish do better when avoiding those foods (Web MD – Migraine Guide). Likewise, a histamine intolerance can also manifest with migraines upon exposure to high-histamine foods. Avoiding these foods, or adding the enzyme DAO may help. Migraines have also been associated with low levels of serotonin, one of our mood-mediating neurotransmitter chemicals. When this is the case, often adding the precursor amino acid 5htp at the appropriate dose, helps tremendously, by allowing the brain to actually make more serotonin.
DOUSING THE FIRE OF INFLAMMATION
Neuroinflammation often can cause migraines and other types of headaches. Thus, anti-inflammatory nutrients such as PEA (palmitoylethanolamide) and the Omega 3 fatty acids may reduce neuroinflammation as well as platelet aggregation. (https://pubmed.ncbi.nlm.nih.gov/28727699; National Center for Biotechnology Information, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500919).
Inflammation can cause or contribute to other types of pain as well. The inflammation which can cause pain can be both localized to the site of injury or stress, or be systemic. Inflammation has a number of purposes. It is a defense mechanism designed to protect and promote health by attacking or sequestering bacteria and viruses, and initiating the healing process of damaged tissue. It is mediated by a large number of inflammatory chemicals which rush to the scene of injury and cause heat, swelling and pain. Pain can be caused by the damaged tissue itself and by the pressure of swelling on non-damaged tissue or nerves. Thus, inflammation can also cause nerve pain.
What to do?
Proteolytic enzymes, such as found in Wobenzyme N, or Vitalzyme, have been shown to effectively reduce acute and chronic inflammation, especially when taken between meals.
- Reducing the swelling of mucous membranes
- Decreasing capillary permeability
- Dissolving blood clot-forming fibrin deposits and microthrombi
- Reducing the viscosity (thickness) of the blood, improving circulation
- Reducing levels of substances that drive inflammation in the body, including prostaglandins and pro-inflammatory cytokines
- Dissolving excess fibrin that forms scar tissue, adhesion’s, and growths that create inflammation and slow down the circulatory system
- Normalizing inflammatory response
- Providing support during muscle recovery
As mentioned above, the Omega 3 fatty acids, both DHA and EPA, are powerfully anti-inflammatory because they convert to the anti-inflammatory brain chemicals, Prostaglandin E3 (PGE3). Other herbs such as Boswellia, Turmeric (curcumin) and Ginger have pain relieving and anti-inflammatory effects as well, through various pathways. The homeopathic remedy Arnica Montana, at various potencies, may help to relieve post-operative pain from swelling and bruising, as well as sprains and strains from over-exercising. CBD oil has also been used to reduce a variety of painful conditions through its anti-inflammatory properties, and activation of the endocannabinoid system. Robust research on CBD, THC and the Endocannabinoid system is on-going. When I was first introduced to MSM (methylsulfonylmethane) years ago, I read that it reduced Substance P and was often used by athletes to keep functioning in spite of injury. However, when I looked around for research just now, the emphasis seems to be on its anti-inflammatory actions. (MSM (methylsulfonylmethane) health benefits: Joint pain and more (medicalnewstoday.com) ).
REDUCE PAIN AWARENESS
Finally, simply reducing pain awareness can reduce suffering. There are a variety of mechanisms to achieve this, but we will start by discussing role depleted neurotransmitter systems play in pain sensitivity and awareness.. The endorphins and enkephalins are our endogenous opioids, and are much more potent than morphine, molecule by molecule. They are cleaved off a mother molecule, POMC, and are large proteins, made up of many different amino acids. Therefore, maintaining a high protein diet of approximately 90 grams per day, can boost or protect endorphin production. This can be challenging for chronically ill people but is still an important goal to aim for, as a high protein diet also promotes the production of our other pain and stress relieving neurotransmitters, Dopamine, GABA and Serotonin. However, there are some shortcuts available to us over-the-counter or online.
D-phenylalanine, available online, is a synthetic amino acid, created by a Chicago Medical School professor, Seymour Ehrenpreis, PhD to reduce the amount of post-operative morphine needed. It inhibits the action of certain enzymes which degrade endorphins and enkephalins in the synapse, allowing them to remain active longer. Both emotional and physical pain relief may begin within minutes of taking a dose of DPA as low as 500 mg. but typical doses for chronic pain is 500 mg – 2000 mg two to four times a day. It can also be found over-the-counter mixed with the dopamine precursor L-phenylalanine, as DLPA.(Nutritional Supplements in Pain Practice (practicalpainmanagement.com))
Low serotonin levels also appear to sensitize us to increased pain awareness, so increasing serotonin levels with the precursor amino acids l-tryptophan or 5htp may help with pain resilience. The traditional herb, St. John’s Wort, often used for its serotonin supporting antidepressant effects, has also been researched as an effective reducer of neuropathic pain. (St. John’s Wort reduces neuropathic pain through a hypericin-mediated inhibition of the protein kinase Cgamma and epsilon activity – PubMed (nih.gov)). Homeopathic St. John’s Wort, along with other homeopathic remedies may also be very useful for a number of nerve pain conditions. (Homeopathic Remedies for Nerve Damage – DrHomeo Homeopathy)
Finally, capsaicin has a well-researched history of depleting Substance P, one of the chemicals which transmit pain signals to the brain and has been shown to reduce a wide variety of pain conditions. Capsaicin Benefits and How to Use – Dr. Axe (draxe.com).