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Writer's pictureDr. Cassie Irwin, ND

Stop Pain at the Source

Buddhist philosophy posits that pain is inevitable, but suffering is optional. Suffering is a state of the mind. Understanding the anatomical cause of your pain can help you cater your diet, lifestyle and supplement routines to minimize unneeded pain and maximize a life fully lived.



Nociceptive Pain Within the layers of your skin and muscles are nerve cells called “nociceptors,” whose sole purpose is to register potential threats to your body. These threats come in the form of inflammation, chemical buildup, and physical trauma such as injury. The brain receives this information, and then sends us the message of pain to deter us from the activity or situation that caused the threat, such as stepping on a nail. This physiological process is helpful to avoid further harm, but when pain becomes chronic, it can cause more suffering than benefit.


Inflammation around joints, as in rheumatoid arthritis, is a form of nociceptive pain.

Rheumatoid arthritis can benefit from an anti-inflammatory diet, low in grains, dairy, sugar and nightshade vegetables such as bell peppers and eggplant, but high in most other vegetables and healthy fats such as fish and avocado. Incorporating anti-inflammatory supplements such as fish oil and curcumin can also be helpful. One 2017 study found improvements in subjective reports of pain among rheumatoid arthritis patients taking curcumin (Amalraj, 2017).


Osteoarthritis is also considered a form of nociceptive pain, and it too can benefit from anti-inflammatory herbs. Boswellia is a herb that has been studied for osteoarthritis of the knee, and in a 2008 trial it was shown to reduce pain and improve physical functioning by reducing the degradation of joint cartilage (Sengupta, 2008). Even more, combining boswellia with curcumin shows a greater benefit than curcumin alone in regard to joint pain, morning stiffness and physical function, according to a new study (Haroyan, 2018). This suggests that taking a supplement that combines turmeric (the source of curcumin) and boswellia, may have a greater effect than taking turmeric alone.


Neuropathic Pain Neuropathic pain arises from damage to the nerves in particular. Physical disruptions such as fixated joints in the spine or tight musculature can impinge nerves and cause tingling, burning or pain. Thoracic Outlet Syndrome is a common example, wherein tight muscles in the neck impinge on the brachial plexus and cause pain and tingling in the arms and upper body. Likewise, sciatica occurs due to a herniated disc in the spine, compressing on the sciatic nerve and radiating pain down the back of the leg. These physical causes of neuropathic pain are most often soothed through physical modalities such as acupuncture and Bowen Therapy.


Diabetic neuropathy is another example of neuropathic pain, which arises due to ongoing nerve damage from high blood glucose. A 2018 study found that the methylcobalamin form of vitamin B12 and alpha-lipoid acid (ALA) are beneficial in the treatment of diabetic neuropathy (Han, 2018). Complying to medications, eating a balanced diet high in fibre and vegetables, and exercising regularly all improve outcomes in diabetic patients.


Visceral Pain Unlike the nociceptive pain you can point to, like a puncture wound from stepping barefoot on a nail, visceral pain is felt in a general rather than a specific area. This can be caused by a dysfunction deep within the organs, in which the pain is radiated to a superficial location on the body. One of the most widely-known examples is the pain radiated to the left arm and jaw during a heart attack. This symptom, either alone or accompanied by shortness of breath, sweating and/or anxiety, warrants a visit to the ER. Likewise, pain in the lower abdomen may indicate appendicitis, which also requires urgent medical care. Vaginal bleeding and intense low abdominal pain may indicate ectopic pregnancy and warrants emergent care at the ER.


Not all visceral pain is emergent, however, and is common in myriad conditions ranging from functional dyspepsia (indigestion) to menstrual cramping. These conditions and many others can be improved with diet and supplement recommendations made specifically for you by your naturopathic doctor or other healthcare provider.


Vascular Pain This pain is associated with the cardiovascular system and is caused by the narrowing of blood vessels from insufficient blood supply to an area. Symptoms can include edema, cold hands and feet, and discoloured skin. This commonly occurs from longstanding atherosclerosis and/or cardiovascular disease, which has progressed to peripheral vascular disease. Regular exercise 3-4 times per week can improve blood flow to the extremities, providing fresh oxygen and nutrients. Adopting a Mediterranean diet rich in fish, vegetables, extra-virgin olive oil, and low in meats and grains, has been shown to improve cardiovascular health. And who doesn’t want to live like they’re in the Mediterranean?


Originally written for Healthy Directions magazine.


Resources:


Amalraj, A., Varma, K., Jacob, J., et al. A Novel Highly Bioavailable Curcumin Formulation Improves Symptoms and Diagnostic Indicators in Rheumatoid Arthritis Patients: A Randomized, Double-Blind, Placebo-Controlled, Two-Dose, Three-Arm, and Parallel-Group Study. J Med Food. 2017 Oct;20(10):1022-1030. doi: 10.1089/jmf.2017.3930. Epub 2017 Aug 29.


Han, Y., Wang, M., Shen, J., et al. Differential efficacy of methylcobalamin and alpha-lipoic acid treatment on symptoms of diabetic peripheral neuropathy. Minerva Endocrinol. 2018 Mar;43(1):11-18. doi: 10.23736/S0391-1977.


Haroyan, A., Mukuchyan, V., Mkrtchyan, N., et al. Efficacy and safety of curcumin and its combination with boswellic acid in osteoarthritis: a comparative, randomized, double-blind, placebo-controlled study. BMC Complement Altern Med. 2018 Jan 9;18(1):7. doi: 10.1186/s12906-017-2062-z.


Sengupta, K., Alluri, KV., Satish, AR., et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee. Arthritis Res Ther. 2008;10(4):R85. doi: 10.1186/ar2461. Epub 2008 Jul 30.

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