Story at-a-glance
- Chronic pain impacts about 100 million US adults, which is more than the number impacted by diabetes, heart disease, and cancer combined
- In many cases, there is no initial event (such as a back injury, infection, arthritis, or cancer) that caused the pain, leaving the underlying cause a mystery
- Common, little-known pain triggers include emotional trauma, painkillers, poor sleep, leaky gut, magnesium deficiency, and Lyme disease
- If you suffer from chronic pain, try lifestyle modification, dietary strategies, relearning proper posture, chiropractic, massage, herbal remedies, and other natural strategies first, before resorting to prescription drugs
December 13, 2014 | 96,099 views
By Dr. Mercola
Worldwide, more than 1.5 billion people suffer from chronic pain. In the US, it impacts about 100 million adults, which is more than the number impacted by diabetes, heart disease, and cancer combined.1
It can be a challenging condition to treat because while some chronic pain is associated with an injury or disease, in other cases there is no initial event (such as a back injury, infection, arthritis, or cancer) that caused the pain.
In some cases, pain may continue for weeks, months, or years without any clear cause. This may describe pain such as low back pain, headaches, or even neurogenic pain (sometimes called neuropathic pain), which is pain that comes from your peripheral or central nervous system.
Chronic Pain Is a Leading Cause of Disability
Chronic pain (particularly back pain) is a leading cause of disability among Americans, significantly interfering with quality of life and productivity. When the medical costs and economic costs (disability, lost wages, and lost productivity) are factored in, pain care costs the US health care system up to $635 billion a year.2
This is a strikingly high number, but you can't put a price on the damage chronic pain can do to an individual's life. For instance, according to a survey of chronic pain sufferers by the American Pain Foundation:3
- 59 percent reported an impact on their overall enjoyment of life
- 77 percent reported feeling depressed
- 70 percent said they have trouble concentrating
- 74 percent said their energy level is impacted by their pain
- 86 percent reported an inability to sleep well
Furthermore, those in chronic pain are unable to reach their full career potentials, as workers report losing an average of nearly five hours per week of productive time due to pain. For up to 20 percent, the pain forces them to take disability leave from work or change jobs altogether. Another significant percentage (13 percent) are so debilitated by pain that they must receive help with the activities of daily living.4
The side effects of pain relievers, which many believe are their only option for relief, must also be factored in. Congressional testimony from the American Society of Interventional Pain Physicians stated that Americans consume 80 percent of the pain pills in the world,5 and once you start, they set off a cascade of reactions in your body that make it extremely difficult to stop.
Opioid painkillers like morphine, codeine, oxycodone, hydrocodone, and fentanyl are one of the most commonly abused drug classes. These drugs are not only addictive, they can lead to slowed breathing and death if too much is taken, and the risks are compounded if you add alcohol to the equation.
Perhaps most frustrating of all is the fact that more than half of those surveyed by the American Pain Foundation said they felt they had little or no control over their pain.6 Often, this is because they don't even know what's causing it, let alone how to effectively treat it.
6 Common Pain Triggers That Might Surprise You
First of all, I strongly believe that you should be grateful for the pain as your body is giving you powerful feedback that typically some lifestyle activity is causing your disability. Clearly, this is not the case for most traumas, but they are a relatively minor percentage of chronic pain.
Do you know what disease causes your body to lose the sensitivity to pain? Leprosy. People with leprosy typically die prematurely from serious infections they incur as a result of the loss of feedback from exposure to harmful environmental hot or sharp objects.
If you're suffering from chronic pain that has no obvious cause, take a look through the list of triggers that follow. Oftentimes, physical pain may be the result of an underlying condition, lifestyle factor, or emotional trauma that you haven't taken into account.
1. Emotional Trauma
Few people want to be told that their pain is psychological or emotional in origin, but there's quite a bit of evidence that backs this up. One theory is that
emotional trauma (along with physical injury and environmental toxins) may stimulate molecules in your central nervous system called microglia.
These molecules release inflammatory chemicals when stressed, resulting in chronic pain and psychological disorders like anxiety and depression.7 Dr. John Sarno, for example, used mind-body techniques to treat patients with severe low back pain and has authored a number of books on this topic.8
His specialty was those who have already had surgery for low back pain and did not get any relief. This is one tough group of patients, yet he had a greater than 80 percent success rate using techniques like the
Emotional Freedom Technique (EFT).
2. Painkillers
Ironically, the very drugs that most physicians prescribe to treat pain may end up making your pain worse after just a few months of use. Dr. Sanjay Gupta, associate chief of neurosurgery at Grady Memorial Hospital and CNN's chief medical correspondent, reported:9
"…after just a few months of taking the pills, something starts to change in the body. The effectiveness wears off, and patients typically report getting only about 30% pain relief, compared with when they started. Even more concerning, a subgroup of these patients develop a condition known as hyperalgesia, an increased sensitivity to pain.
As you might guess, all of this creates a situation where the person starts to take more and more pills. And even though they are no longer providing much pain relief, they can still diminish the body's drive to breathe.
If you are awake you may not notice it, but if you fall asleep with too many of these pills in your system, you never wake up. Add alcohol, and the problem is exponentially worse. People who take pain or sleeping pills and drink a couple glasses of wine are playing Russian roulette."
3. Poor Sleep
Poor sleep can actually impact virtually every aspect of your health, and the reason for this is because your circadian rhythm (sleep-wake cycle) actually "drives" the rhythms of biological activity
at the cellular level. Further, your body needs deep sleep for tissue growth and repair, which is crucial for pain relief. According to recent research from Great Britain,
poor or insufficient sleep was actually the
strongest predictor for pain in adults over 50.
10
4. Leaky Gut
Dietary changes (see below) are crucial for managing pain, and this is, in part, due to the way they influence your gut health. Substances in grains, for instance, may increase intestinal permeability (i.e. leaky gut syndrome), allowing undigested food particles, bacteria, and other toxicants to "leak" into your bloodstream. Leaky gut can cause digestive symptoms such as bloating, gas, and abdominal cramps, as well as cause or contribute to many others symptoms, including inflammation and chronic pain.
5. Magnesium Deficiency
Among magnesium's many roles is blocking your brain's receptors of glutamate, a neurotransmitter that may cause your neurons to become hypersensitive to pain.
11 This is especially important because an estimated 80 percent of Americans are deficient in
magnesium. Two major lifestyle factors that further deplete your body of magnesium are stress and prescription drugs, putting chronic-pain patients at particular risk of deficiency.
6. Lyme Disease
Some of the first symptoms of Lyme disease may include a flu-like condition with fever, chills, headache, stiff neck, achiness, and fatigue. However, it often lingers chronically, in some people for more than a decade, causing muscle and joint pain. Because Lyme and all of its co-infections cause so many constant symptoms, it easily mimics disorders, such as multiple sclerosis (MS), arthritis, Parkinson's, chronic fatigue syndrome, fibromyalgia, and more.
If you're suffering from chronic pain and don't know why, it's worth considering Lyme disease, even if you don't think you've been bitten by a tick (it's primary transmitter). Fewer than half of Lyme patients recall ever getting a tick bite. Many Lyme patients don't remember such an event because the tick numbs your skin before biting so it is never felt. In some studies, this number is as low as 15 percent. So, if you don't recall seeing a tick on your body, that doesn't rule out the possibility of
Lyme disease.
Most Physicians Are Clueless When It Comes to Treating Chronic Pain
Surveys show seven in 10 Americans believe pain research and management should be one of the medical community's top priorities.12 But instead, it receives barely a passing mention. The APPEAL (Advancing the Provision of Pain Education And Learning) study, which surveyed undergraduate medical schools in Europe, found that even when compulsory pain courses are in place, they represent just 12 hours of the six-year program – or 0.2 percent.13 Further, most of the schools actually have no required courses on pain that all students must take.
This means that 12 hours of pain study represents a best-case scenario. At 82 percent of medical schools without compulsory pain courses, the students may be receiving even less… or no pain training at all. Though the APPEAL study took place in Europe, it echoes a similar trend identified in the US and Canada by a separate study published in The Journal of Pain.14
Most of the schools offered pain education as only a part of general education courses. Less than four percent of the schools had a required course in pain and many offered no dedicated courses at all. When physicians don't know how to effectively treat chronic pain, they resort to the only treatment they know: prescription drugs, which will do nothing to solve the underlying reasons why you're in pain. Not to mention, there are non-drug options available to treat your pain while you help it to become rebalanced using proper lifestyle strategies. Non-drug options may include:
- Chiropractic or osteopathic adjustments: According to a study published in the Annals of Internal Medicine and funded by the National Institutes of Health, patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain free in 12 weeks compared to those who took medication.15
- Massage: Massage releases endorphins, which help induce relaxation, relieve pain, and reduce levels of stress chemicals such as cortisol and noradrenaline – reversing the damaging effects of stress by slowing heart rate, respiration, and metabolism and lowering raised blood pressure.
- Acupuncture: Researchers concluded that acupuncture has a definite effect in reducing chronic pain, such as back pain and headaches – more so than standard pain treatment.16
- Physical therapy. Can be a highly effective modality for pain rehabilitation.
- Relearn proper posture: The Gokhale Method addresses the root cause of physical pain, which is often caused by improper posture. The method teaches you to reclaim your primal posture, which is the way your body was designed to stand, sit and move. You can also try Foundation Training—an innovative method developed by Dr. Eric Goodman to treat his own chronic low back pain. The exercises are designed to help you strengthen your entire core and move the way nature intended.
4 Dietary Changes to Make If You're in Pain
If you suffer from chronic pain, there's a good chance you need to
tweak your diet as follows:
- Start taking a high-quality, animal-based omega-3 fat like krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work; they positively influence prostaglandins.) The omega-3 fats EPA and DHA contained in krill oil have been found in many animal and clinical studies to have anti-inflammatory properties, which are beneficial for pain relief.
- Reduce your intake of most processed foods as not only do they contain sugar and additives, but most are loaded with omega-6 fats that upset your delicate omega-3:6 ratio, which will contribute to inflammation, a key factor in most pain.
- Eliminate or radically reduce most grains and sugars (especially fructose) from your diet. Avoiding grains and sugars will lower your insulin and leptin levels. Elevated insulin and leptin levels are one of the most profound stimulators of inflammatory prostaglandin production. That is why eliminating sugar and grains is so important to controlling your pain.
- Optimize your production of vitamin D by getting regular, appropriate sun exposure, which will work through a variety of different mechanisms to reduce your pain. This satisfies your body's appetite for regular sun exposure.
Try These Painkillers from Mother Nature
If you have chronic pain of any kind, please understand that there are many safe and effective alternatives to prescription and over-the-counter painkillers. The pain remedies that follow are natural, providing excellent pain relief without any of the health hazards that pain medications often carry.
- Ginger: This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
- Curcumin: Curcumin is the primary therapeutic compound identified in the spice turmeric. In a study of osteoarthritis patients, those who added only 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility. In fact, curcumin has been shown in over 50 clinical studies to have potent anti-inflammatory activity, as well as demonstrating the ability in four studies to reduce Tylenol-associated adverse health effects.
- Boswellia: Also known as boswellin or "Indian frankincense," this herb contains powerful anti-inflammatory properties, which have been prized for thousands of years. This is one of my personal favorites, as I have seen it work well with many rheumatoid arthritis patients.
- Bromelain: This protein-digesting enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful. Keep in mind that most of the bromelain is found within the core of the pineapple, so consider leaving a little of the pulpy core intact when you consume the fruit.
- Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used a topical preparation for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards.
- Evening Primrose, Black Currant, and Borage Oils: These contain the fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain.
- Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmit pain signals to your brain.
