Abstract
Today we are witnessing a significant rise in chronic diseases and chronic pain. Modern medicine appears not to be sufficient to relieve symptoms and reduce or eliminate discomfort. The following proffers the need to look at alternate strategies. In particular, it suggests that a solution might lie if we combine modern technology with ancient wisdom and traditional approaches. This chapter serves to highlight strategies for prudent pain management. “Pain is not just from physical disorders but also from combinations of physiological, pathological, emotional, psychological, cognitive, environmental, and social factors. The keys to successful pain control are the mechanisms that initiate and maintain pain.” “Now, the public and health professionals expect to control pain by using preventive and active strategies, including drugs and physical and psychosocial interventions.” (Holdcroft & Power, 2003).
TopIntroduction
Pain is a very good servant but a bad master. – Author unknown
Everybody knows what pain is but no one really knows how to switch it off especially when it becomes persistent and annoying.
Pain is not just from physical disorders but also from combinations of physiological, pathological, emotional, psychological, cognitive, environmental, and social factors. The keys to successful pain control are the mechanisms that initiate and maintain pain. Now, the public and health professionals expect to control pain by using preventive and active strategies, including drugs and physical and psychosocial interventions. (Holdcroft & Power, 2003).
Have we lost sight of the real pathophysiology that underlies the phenomenon of pain? Are we concentrating on the end point rather than the cause of the malady? Drugs and physical therapies don’t have all the answers to pain management. Is there another way? Maybe we should take a broader look at why the pain started in the first place and then we can work out the solution to the health challenge!
TopBackground
Pain arises when a living tissue is injured and the tissue responds with “inflammation”. Inflammation involves a cascade of events involving cells, enzymes, cytokines and chemokines and other substances, which will initiate other secondary responses by other cells and blood vessels. Inflammation is the beginning of the process of repair and healing. Ancient civilisations used different modalities to manage pain. They used physical therapies, medicinal foods and herbs where appropriate.
Over the past century the pain and its management have changed dramatically. In this article I propose to discuss the reasons for the change in pain experience and will explore the practical aspects of pain management using the best from the “East & West”. While the scientists are dwelling deeply into the complex issues of pain and inflammation, patients in pain need help and advice now. Drugs alone cannot relieve all the pains and sufferings, surgical and psychological treatment may help some but for most, a holistic approach may help to reduce or relieve the pain and suffering.
The Role of Food for Health and Wellbeing
We Are What We Eat
If we supply our body with inappropriate or inferior quality materials, the tissues and structures so made will be of inferior quality. Deficiency diseases like scurvy and rickets have been known to cause deformed tissues and cause pain with different characters. By correcting the deficiencies these maladies can be cured. In our modern society it seems like more people are experiencing and suffering in pain. Is it because the newer generations are made of ‘weaker’ materials or is it that the pain threshold is reduced or the background inflammation in the body system has heightened? The fact that we have not been able to quantify and identify the missing ingredients in chronic pain, it should not deter us from searching for an answer by going “back to basics”. Our body is created to function efficiently and effectively when it is provided with all the nutrients it needs.
Modern Medical Model of Pain Management
In modern medicine pain is treated with analgesics and non-steroidal anti- inflammatory drugs. If the pain persists, then stronger narcotics and anti-inflammatory corticosteroids are used. Other drugs like anti-depression and anti-epilepsy drugs are often used in pain clinics to help modulate the pain experience. Unfortunately, all these medications have unwanted side effects. There is a growing awareness in the community that drug therapy is not the only way. People are looking for more natural alternatives, less harmful treatment modalities with more self-help involvement. They want to participate actively in the healing process. People are turning more and more to Alternative and Natural Therapies like physical therapies, (which include Physiotherapy, Osteopathy, Chiropractic) with stretching, mobilisation, manipulations, heat/cold packs and acupuncture/acupuncture related techniques, along with diet and nutritional supplements, to help manage their painful conditions.
Key Terms in this Chapter
TENS: Transcutaneous Electrical Nerve Stimulation. produces neuro-modulation through the following pathways: (1) Presynaptic inhibition in the dorsal horn of the spinal cord (2) Endogenous pain control (via endorphins, Enkaphalins, and Dynorphins) (3) Direct inhibition of an abnormally excited nerve. (4) Restoration of afferent input The results of laboratory studies suggest that electrical stimulation delivered by a TENS unit reduces pain through nociceptive inhibition at the Presynaptic level in the dorsal horn, thus limiting its central transmission. The electrical stimuli on the skin preferentially activate low- threshold myelinated nerve fibers. The afferent input from these fibers inhibits propagation of nociception carried in the small unmyelinated C fibers by blocking transmission along these fibers to the target or T cells located in the Substantia Gelatinosa (laminae 2 and 3) of the dorsal horn.
Nightshade Plants: Solanaceae (Nightshade Family) has been highly cultivated over the years - it includes potatoes, tomatoes, eggplant, sweet peppers, chili peppers (but not black pepper), tobacco and petunias. Some plants have great medicinal value, some are quite poisonous. The calyx and corolla are 5-lobed, and usually there are 5 stamens. The fruit is partitioned into 2 or 4 seed-producing divisions, and may be dry or a fleshy berry.
Xanthones: Close cousins to the polyphenols family and have strong antioxidant effects on the nervous system. They are found in several botanical tonics including St. John’s wort, gentian root nectar and mangosteen. Current research on Xanthones suggests they are beneficial in helping with many conditions including allergies, infections (microbial, fungus, viral), cholesterol levels, inflammation, skin disorders, gastro-intestinal disorders, and fatigue. Xanthones have also been found to support and enhance the body's immune system and exhibit strong antioxidant activity, which is beneficial for neutralizing free radicals in the body.
Anti-Oxidants: Chemical substances that donate an electron to the free radical and convert it to a harmless molecule.
Free Radical: An atom or molecule, which has an “unpaired electron” in the outer ring. An “unpaired electron” will also always mean that there is an odd number since “pairing” of electrons goes by 2s. Free radicals are highly reactive molecules and cause damage to nearby cells causing a cascade of chain reaction of free radical damage to other cells and tissues.
Eicosanoid: Lipid mediator of inflammation derived from the 20-carbon atom Arachidonic Acid (20 in Greek is “eicosa”) or a similar fatty acid. The eicosanoids include the prostaglandins, prostacyclin, thromboxane, and leukotrienes.
LLLT: Or Low Level Laser Therapy (also known as Low Power Laser Therapy) is the application of red and near infra-red light over injuries or lesions to improve wound / soft tissue healing and give relief for both acute and chronic pain non healing wounds, post-op pain and acupoint stimulation. First developed in 1967, it is now commonly referred to as LLLT. The red and near infrared light (600nm-1000nm) commonly used in LLLT can be produced by laser or high intensity LED. The intensity of LLLT lasers and LED's is not high like a surgical laser. There is no heating effect.
Codetron: Has been classified as Acupuncture-Like TENS. The effect of this machine is equal to or better than electroacupuncture therapy.
Inflammation: A basic way in which the body reacts to infection, irritation or other injury, the key feature being redness, warmth, swelling and pain.
Auto-Immune Disease: Normally the immune system protects us from disease and infection but if our immune system turns around and mistakenly attacks ‘ourselves’ an autoimmune disease ensues. Autoimmune diseases can affect many parts of the body like the connective tissues, nerves, muscles, endocrine system and digestive system.
Pygnogenol: The patented trade name for a water extract of the bark of the French maritime pine (Pinus pinaster ssp. atlantica). Pygnogenol contains oligomeric proanthocyanidins (OPCs) as well as several other Bioflavanoids: catechin, epicatechin, Phenolic fruit acids and taxifolin . Procyanidins are oligomeric catechins are also found in red wine, grapes, cocoa, cranberries, and apples. Pygnogenol helps the integrity of the blood vessels, skin, mental function as well as being a potent antioxidant.
Qi: (Pronounced as ‘chee’). Qi is proposed to regulate a person's spiritual, emotional, mental, and physical balance and to be influenced by the opposing forces of Yin (negative energy) and Yang (positive energy). Disease is proposed to result from the flow of Qi being disrupted and Yin and Yang becoming imbalance.