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What a Pain!


Do you have pain? If you said, yes, you’re not alone because it’s estimated that 116 million adults in the US have a chronic pain condition, which is pain for more than x3mos. That’s more than the number of people affected by heart disease, diabetes, and cancer combined!!! Which is why it’s also one of the most common reasons people go to their doctor. Pain doesn’t just impact the physical body either, people feel it impacts their mental health, relationships, quality of life, productivity/functioning, and finances. Anyone that has chronic pain, could probably list off a litany of ways that pain impacts their life. It’s one of the leading reasons Americans turn to complementary health approaches such as yoga, massage, acupuncture, and meditation, etc. It’s also one of the reasons we have a growing opioid epidemic in our country. With so many people visiting their doctors with complaints of pain, a growing acceptance and use of prescription opioids for the treatment of chronic pain has become par for the course despite serious risks and the lack of evidence about their long-term effectiveness – this according to the CDC. Moreover, medical providers have written about a quarter of a billion (yes billion) opioid prescriptions in 2013 alone, which is enough for every American adult to have their own bottle of pills! So, if you currently have in your medicine cabinet: Methadone, Oxycodone (such as OxyContin®), or Hydrocodone (such as Vicodin®), be careful because these are the most common prescription drugs involved in overdose deaths. As these medications, if not taken as directed, prescribed improperly, or taken in conjunction with other medications, like Benzodiazepines (alprazolam (Xanax®), diazepam (Valium®), and lorazepam (Ativan®) can cause you to stop breathing and lead to death. In fact, more than 40% of all U.S. opioid overdose deaths in 2016 involved a prescription opioid, which equates to more than 46 deaths per day from prescription opioid overdoses alone.


ANYONE who takes prescription opioids can become addicted to them and as many as 1 in 4 people receiving long-term opioid therapy struggles with addiction. Why? Because these drugs are like a charismatic sales person who gets you to buy more and more, promising an awesome experience - one that’s free of pain and makes you feel oh so good. You see, opioids work by diminishing your sensation of pain and create a euphoric feeling, essentially relieving your pain and making you feel really good. But like most to-good-to-be-true things, it doesn’t eliminate your pain it just blocks the sensation, and you may need more medication to get the same results as time goes on - this is called tolerance. This desire for more medication is driven by changes in your brain chemistry and opens the door to a vicious cycle and potential downward spiral.


Need help with opioid addiction? Call SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. 

I wish I could say, medications, such as acetaminophen and non-steroidal anti-inflammatories commonly used for pain don’t have risks too, but they do, especially if you’re pushing the dosage envelope when you’re really hurting (I’ve been there!). So, I just want to touch on it for a moment. Back in 2005, the FDA warned that taking nonsteroidal anti-inflammatory drugs (NSAIDs) which include ibuprofen (Motrin, Advil) and naproxen (Aleve). Celecoxib (Celebrex), diclofenac (Cataflam, Voltaren) and others prescription NSAIDs increased the risk of having a heart attack or stroke (Note: Aspirin is also an NSAID but is exempt from this warning). In July 2015 the FDA took the unusual step of further strengthening this warning.


The warnings from the FDA point out:

  • Heart attack and stroke risk increase even with short-term use, and the risk may begin within a few weeks of starting to take an NSAID.

  • The risk increases with higher doses of NSAIDs taken for longer periods of time.

  • The risk is greatest for people who already have heart disease, though even people without heart disease may be at risk.

As far as acetaminophen, it’s in over 600 products, so be sure you’re not inadvertently consuming more than the recommended dose if you’re taking multiple products, and best to lay-off the alcohol when taking acetaminophen too. Takingtoo much acetaminophen or not following the label warnings can damage your liver to the point of requiring a liver transplant (if you can get one) or causing death. This happens because some of the drug is converted into a byproduct that’s toxic to the liver. If you take too much, all at once, or over a period of days, more toxin can build up than the body can handle. Also, if you have liver disease, you may want to consult your doctor and/or pharmacist before taking it.


Of course, I’m not suggesting that you just need to suck it up and bite the bullet. Pain is a signal from your body that something is wrong!This could be that your body is deconditioned, and you simply overdid it on your weekend project or activity. But, if it’s chronic, meaning you’ve had it for more than 3 months, it could be that you’ve got an underlining health condition - a compressed nerve, torn ligament, herniated disc, tumor, cancer, fibromyalgia, arthritis, neuralgia, headaches, angina, autoimmune condition the list is endless. Finding the root cause of pain is key. This might start with seeing the right provider for your condition and/or pain specialist. Functional medicine providers seek to find root causes instead of just treating the symptoms. Pain management physicians are skilled at treating every manner of pain. There are also physicians who are board certified in Integrative medicine who may offer (integrate) both an allopathic approach and complementary one. But, you don’t always need a doctor to act, you can leverage complementary therapies and apply lifestyle changes (diet, movement, smoking cessation, weight reduction, stress reduction) which may be contributing to your pain. For instance, diet can make a huge difference in reducing inflammation in the body which could be exacerbating your pain or even be causing it.


If you’re in chronic pain, consider evaluating your diet. Is it helping reduce inflammation or is it contributing to it? Are you eating processed foods and beverages? How many vegetables and fruits do you eat in a day? Do you eat fish or consume other omega-3 rich foods? Do you eat processed meats or grain-fed meats? Or are you eating organic grass-fed beef, and organic free-range poultry? Do you drink soda or fruit juice from a concentrate or other beverage with added sugar? Or, are you drinking water, golden milk, and green tea? These are just some questions to consider when evaluating how your diet might be impacting you pain.


Of course, what you eat is just one thing you can do to help with pain, there are many activities and complementary treatments to explore which include, but aren’t limited to: Yoga, meditation, tai chi, acupuncture, acupressure, transcutaneous Electrical Nerve Stimulation (TENS), The Feldenkrais Method®, massage, imagery, hypnosis, biofeedback, aroma therapy, music therapy, chiropractic, stress reduction/relaxation, music therapy, art therapy, heat/cold application, infrared saunas or heating pads, physical or occupational therapy, weight loss, exercise, nature-based therapies, and counseling.


Feeling overwhelmed? Not sure where or how to begin? Book a health coaching session now - you don’t have to face these challenges alone.


Coaching Corner:

  • How does your pain impact your life?

  • Are there any lifestyle changes you could make which might improve your pain?

  • What changes are within your power?


***For readers who might be in the St. Louis area who need help with their pain, I highly recommend the physicians at https://www.yourpainmatters.com


References & Resources

https://www.cdc.gov/drugoverdose/data/prescribing.html

https://www.ncbi.nlm.nih.gov/books/NBK92525/

https://www.health.harvard.edu/blog/fda-strengthens-warning-that-nsaids-increase-heart-attack-and-stroke-risk-201507138138

https://www.samhsa.gov/find-help/national-helpline

https://www.theacpa.org

http://www.theacpa.org/wp-content/uploads/2017/08/Nurses_Toolkit_2007.pdf

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