Effective and Safer Pain Management

Chronic pain affects the lives of over eight million Canadians. While opiates were once considered a humane choice for pain relief, their addictive potential has contributed to the opiate crisis, leading to a decline in their use as a solution. In my naturopathic medical practice, I often encounter patients suffering from chronic pain who are seeking alternatives that won’t harm their bodies or lead to addiction. Treating the Root Cause of Pain: The primary goal of pain management is to address the underlying cause. At our clinic, we offer laser therapy, a non-invasive treatment that accelerates the healing process for arthritis, injuries, back pain, and more. Additionally, there are many treatments and home programs that can provide relief. However, supplemental pain management is crucial during the healing process and for individuals who don’t respond sufficiently to other therapies. In this article, we will explore safer options for treating pain. Exploring Safer Alternatives:
  1. PEA (Palmitoylethanolamide): PEA is a natural medicine that shows promising results in pain management. It possesses pain-blocking effects and reduces neural inflammation, which is a common feature of many chronic pain conditions. From post-concussion syndrome and long-COVID to chronic fatigue syndrome, fibromyalgia, sciatic nerve pain, and peripheral neuropathy, PEA has demonstrated effectiveness. Importantly, this naturally occurring fat extract rarely causes side effects. A review published in the British Journal of Clinical Pharmacology concluded that PEA reduces pain and is considered very safe. In my experience, I have successfully used PEA to help patients dealing with complex chronic pain issues.
  2. Low Dose Naltrexone (LDN): As a naturopathic physician, I find LDN particularly intriguing because it helps balance the immune system and promote nervous system healing. Moreover, it is a relatively safe and cost-effective pharmaceutical medication. LDN has shown promising results in pain conditions such as fibromyalgia, low back pain, and rheumatoid arthritis. I customize the prescription according to each patient’s needs, and many individuals consider it a significant part of their wellness plan.
  3. CBD (Cannabidiol): CBD, the non-psychoactive component of cannabis, is extensively used for pain management in Canada. However, the lack of human clinical trials has hindered our understanding of its efficacy and appropriate dosages. With the recent legalization of cannabis, more studies are underway. The Canadian Arthritis Society is actively funding research in this area but has not yet endorsed CBD as a treatment. Nevertheless, one study revealed that CBD use allowed patients attending a chronic pain clinic to reduce their opioid medication intake.
  4. Natural Anti-inflammatory Agents: Use of natural anti-inflammatory agents can reduce the need for more toxic over-the-counter drugs. Curcumin, an extract of turmeric, has been proven to be more effective than ibuprofen in a five-month study on human osteoarthritis knee pain, with fewer side effects. It lowers inflammatory chemicals in the body, benefiting various disease processes. Additionally, fish oil high in EPA content possesses anti-inflammatory properties, and Boswellia, another herb, has shown anti-inflammatory effects as well. Your naturopathic physician is trained as an herbalist and can tailor herbal formulas to suit your needs and ensure they align with any existing prescriptions. They can also assist you in creating a lifestyle plan that reduces inflammation and promotes healing.
  5. Helping people live fuller lives with less pain is incredibly rewarding. Effective pain management strategies can be implemented using solutions that offer side benefits instead of side effects.

Chronic Pain: Four Legs of a Stool

Every day in my naturopathic medical practice, I see people who have chronic pain from conditions arising from their back, nerves, muscles, joints, digestive system, autoimmune disease and more.  In fact one in five Canadians over 18 suffer with chronic pain. Optimal treatment plans are more complex than those for acute pain. For chronic pain, the best treatment involves “four legs of a stool”.  Each leg provides important support in the journey of living with chronic pain while working towards real solutions.

One leg of that stool may be pain management with pharmaceutical drugs.  Living with chronic pain can affect mood, sleep, the immune system, the nervous system and more and sometimes the humane choice is to help dull the pain. But medications for pain all come at some cost when used long term.  Extended use of anti-inflammatory drugs is hard on the gastrointestinal system, kidneys and ears.  Tylenol in excess can damage the liver. Opiate pain killers are of course a last resort due to their highly addictive nature. Meds for nerve pain have a long list of side effects and have limited benefits.  There is a place for pain management, but the goal is to use as little as possible for the shortest time possible. Cannabis may provide some relief for pain sufferers, and I look forward to the day when we have the research and quality control necessary for doctors to effectively guide patients in the best use of this medicine.

The second leg of the stool is what I call passive treatments.  There is a place for surgery, however there is always the risk of complications so often more conservative treatments are preferential.  Physiotherapy, massage, chiropractic, osteopathy, injection therapy such as prolotherapy, PRP, and stem cells can all be helpful.  The form of physical therapy that has impressed me most is low level laser therapy.  This painless, safe treatment uses therapeutic wavelengths of light to stimulate rapid growth and repair of tissues, resulting in resolution of pain.  Hundreds of  human, placebo controlled clinical trials have been done on laser therapy and it has been shown to be effective in the treatment of many conditions including arthritis (to which I can personally attest), back pain, carpal tunnel syndrome, plantar fasciitis, neck pain, nerve impingement and more. This is the treatment that I have used in my clinic for 12 years on over 1,000 patients with mostly good to excellent results.

The third leg of the stool is to work towards creating a body that is balanced and vital so that it can heal itself.  When a person is full of inflammation, high blood sugar, nutrient deprived, lacks exercise, and suffers from stress and poor sleep, their cells simply don’t have what it takes to heal.  As a naturopathic physician, I coach my patients to better understand what they can do for themselves to reduce inflammation, promote healing and improve vitality.

The fourth leg of the stool in treating chronic pain is addressing the mind-body connection.  The body naturally sends alarm bells to the brain and nervous system in response to pain.  That makes sense for acute pain, as it helps us to remove ourselves from dangerous situations or protect injured areas.  To live well with chronic pain, we have to deliberately learn how to be with the pain without sending out panic signals.  Teaching my patients skills to address the emotions and thoughts around the pain helps them to experience the painful sensations without all the distress and suffering.  I also encourage them to be curious about any unhealed emotional issues that may be causing tension or energy blocks in the body.  In Chinese medicine, they say that emotional issues can block chi, and wherever chi is blocked pain or disease can occur. In Western medicine we understand that the body’s natural healing mechanisms are activated when the nervous system is in a more relaxed state. With chronic stress we can get stuck in a state of “fight or flight” instead of being able to go into the more relaxed, healing state of a calm nervous system. 

People with chronic pain do well to consider engaging in a comprehensive plan to reduce the stress of chronic pain while working actively to promote healing and resolution of the causes of their pain.  ss