path to freedom

NATURAL ALTERNATIVES FOR CHRONIC PAIN

Chronic pain can be one of the most destabilizing conditions a person can experience. It gnaws away at you-body and spirit. An otherwise positive, happy and thoughtful individual can become a cranky, snarling, hopeless victim.

I know about chronic pain. In 1992, I was in my last year of naturopathic medical school. Every joint in my body was inflamed. Even the joints between the bones in my skull hurt! It was exhausting, depressing and unremitting.

More than 12 years later, I have minor, rare occasions of pain and feel no connection with the autoimmune label placed on me-or its grim prognosis. I'm active, healthy and pharmaceutical-free!

With the safety of Vioxx and other NSAIDs (nonsteroidal anti-inflammatory drugs) being questioned, people are looking for safe and effective natural alternatives for chronic pain.

My first suggestion: Find a knowledgeable practitioner to work with. That's what I did in 1992. You can be educated about a subject, but, when it's you with the problem, it's often difficult to navigate through the myriad options. It's comforting to have a guide, and it allows you the space to experience and truly heal from your condition. Besides, sometimes relinquishing control can be therapeutic.

Conditions with chronic pain and inflammation as their primary symptoms usually have a multitude of causes. It's important to identify as many of these as possible and make the appropriate lifestyle changes. Lifestyle changes are my favorite therapies to work on with a patient. They are generally inexpensive and allow the patient to take an active role in healing.

Diet & Exercise

Begin by examining your diet. Numerous studies have found that decreasing animal fats will decrease inflammation. The fats in animal products break down into arachidonic acid, a pro-inflammatory fatty acid. Arachidonic acid encourages inflammation with the help of the COX (cyclooxygenase) enzymes. Vioxx and other NSAIDs inhibit these enzymes, thereby decreasing potential inflammation. However, if pro-inflammatory foods are replaced with anti-inflammatory foods such as fish, whole grains, legumes, nuts, fruits and vegetables, the need for the COX inhibitors is decreased.

Next, identify potential food allergens that could be exacerbating inflammation. A 2002 article in Rheumatology (Oxford) concluded that "dietary modification may be of clinical benefit for certain RA [rheumatoid arthritis] patients." The most common food intolerances are wheat or gluten, dairy, corn, soy, eggs and peanuts.

The best way to find out if you react adversely to any of these foods is to avoid all of them for 3 weeks, and then reintroduce them one by one with a "washout" period of 4 days in between each one. This is called a food "challenge." On the day that you "challenge" each food, consume that food at every meal. If you're testing dairy, test cheese, milk and ice cream on separate days. During the "washout" period, notice if the consumption of that food makes your symptoms worse.

Other dietary guidelines include abstaining from alcohol except on special occasions, drinking at least 64 ounces of water per day, replacing coffee with green tea, and eating mostly organic nonprocessed food.

Exercise is important as well. In the December 2004 issue of Arthritis and Rheumatism, a study concluded that individuals with fibromyalgia who had 23 weeks of supervised aerobic exercise showed improved "physical function, mood, symptom severity, and aspects of self efficacy for at least 12 months" after starting the exercise regimen. The results are similar in studies of people with rheumatoid and osteoarthritis.

Natural Remedies

People who are considering alternative therapies often get overwhelmed. The news reports are often conflicting, and at the health food store, there are rows and rows of bottles! This is when it's ideal to have a health professional guiding you. The best therapy is the one tailored to your individual case.

However, I do have some general guidelines. The first is to keep it simple. Don't buy everything that you've read about. Start with a high-quality multivitamin and mineral supplements. You will find these in a health food store, not in a warehouse supermarket or in most drug stores. Don't choose your multivitamin by the lowest price. In the supplement world, you get what you pay for, and the cheaper brands tend to be less absorbable. I prefer capsules rather than the harder-to-digest tablets, and those that are taken with every meal rather than once a day.

Fish oils are the next supplement I recommend. Fish oils are a source of omega-3 fatty acids, which counteract pro-inflammatory arachidonic, acid. When buying fish oils, look for those that are free of contaminants such as PCBs, mercury and other heavy metals. Most contain about 300 milligrams (mg) of EPA and 200 mg of DHA per capsule. I recommend 2-3 capsules two times per day with meals.

There are a number of herbal products that can help ease pain and inflammation. Look for a product that contains turmeric, bromelain, boswellia, ginger and Devil's Claw. These are the herbs that I have found are most efficacious, especially in terms of arthritis pain. Use them in combination rather than individually. They each attack inflammation differently, and they work synergistically. The exact close will vary depending on manufacturer, but 2-3 capsules twice a day between meals is fairly standard.

One of my favorite products to use for pain is Wobenzyme, a proteolytic enzyme. It is the most reliable product I know of for pain relief. For chronic conditions, start with 2-4 tablets two to four times per day between meals. Wobenzyme is available in most health food stores.

If your pain is clue to osteoarthritis, a mixture of glucosamine sulfate, chondroitin and MSM works better than any of these agents alone. If you don't find relief at the recommended dose of 1,500 mg/day of glucosamine, try increasing it to 2,000 mg/day. It is still safe, and I find many people need that extra 500 mg. Theoretically, chondroitin molecules are too big to be absorbed through the wall of the gastrointestinal system. Clinically, however, it works, especially with glucosamine. I find that the combination of these three is hard to beat!

These recommendations should be generally helpful. However, there is no substitute for an individualized plan formulated by you and your savvy health professional. It has worked for over a decade to keep me pain- and pharmaceutical-free. I know it can work for you, too!

[Sidebar]

the best therapy is the one tailored to your individual case

[Author Affiliation]

by Nancy Welliver, ND

[Author Affiliation]

Nancy Welliver, ND, has been a practicing naturopathic physician for the past 12 years, and is currently on faculty at Bastyr University. She has a private practice in Mountlake Terrace, Washington.